Inspection on 31/07/06 for Hazeldene

This inspection was carried out on 31st July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hazeldene 12/01/06

Hazeldene 28/09/05

Hazeldene 28/02/05

Hazeldene 06/09/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Hazeldene 1 Dunbar Avenue Norbury London SW16 4SB Lead Inspector Deborah Yapicioz Key Unannounced Inspection 31st July 2006 09:00 Hazeldene DS0000028107.V301761.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hazeldene DS0000028107.V301761.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hazeldene DS0000028107.V301761.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hazeldene Address 1 Dunbar Avenue Norbury London SW16 4SB 020 8679 1462 020 8679 1462 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Jacob Lee Mr Jacob Lee Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Hazeldene DS0000028107.V301761.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th January 2006 Brief Description of the Service: Hazeldene is a five bedded small care home registered with the Commission for Social Care Inspection to cater for young adults with a learning disability. Situated in a residential street in Norbury, the home is well placed for public transport links to local amenities and shopping. There are five single bedrooms with one located on the ground floor. Communal areas consist of a spacious lounge, dining area and rear garden with paved area. Sufficient numbers of bathroom and toilet facilities are located near service users bedrooms and communal areas. The proprietor of the home, Mr Cliff Lee, is also the registered manager for the home and works most days. Hazeldene DS0000028107.V301761.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes first inspection for the year 2006/2007 and was an unannounced visit, which took place on the morning of 31st July 2006. The home was inspected under the National Minimum Standards Care Homes for Younger Adults and the registered manager / provider, Mr Jacob Lee, facilitated the inspection process. Three of the four service users were at the home during the inspection and were happy to talk to the inspector sbout their experience of living at the home Methods of inspection included a tour of the premises, observation of contact between staff and service users, talking with service users and staff. Records examined included service user plans, care manager assessments, risk assessments, medication records, complaints, health and safety and fire records. Over the last twelve months the management team have kept the Commission for Social Care Inspection informed of any significant incidents at the home. What the service does well: What has improved since the last inspection? What they could do better: Improvements are still needed with standards relating to quality assurance. Although the home uses some quality monitoring systems, a written annual plan should be drawn up for the home that is based upon the views of service Hazeldene DS0000028107.V301761.R01.S.doc Version 5.2 Page 6 users, their relatives and other relevant parties. The plan should reflect a cycle of planning; action and review of care practices. The homes statement of purpose is still being reviewed by the owner/manager who is confident that it will be available for the next inspection. The owner manager must also ensure that staff supervisions and an annual appraisal take place in line with the National Minimum Standards Fire records at the home demonstrated that fire drills are not taking place on a regular basis and a fire risk assessment was not available. Fire drills should take place at least four times a year in keeping with recommended good practise and the company policy. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hazeldene DS0000028107.V301761.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hazeldene DS0000028107.V301761.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,5, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides information and introduction opportunities for prospective service users and their families to make a choice about moving to the home, although a service users guide is not yet generally available. EVIDENCE: At the home previous inspection, a requirement to revise the homes statement of purpose to reflect the services being provided by the home. The home manager is in the process of updating the document, which will be forwarded to the Commission for Social Care Inspection Croydon office once it is completed. The home has a procedure for introducing service users to a new residential placement, which includes the homes, own assessment process and introductory visits. The home manager confirmed that cultural and religious issues were discussed at the time of referral to the home and ways of meeting these needs would be included in the service users care plans. New Service users must also have a full assessment of their needs; compiled by their care manager or other relevant person. Any new service users to the home will only be considered once compatibility with the current service users is established. Any prospective service user would have a gradual introduction to the home with a series of short visits and overnight stays. The time frame would be flexible depending on the service user. Hazeldene DS0000028107.V301761.R01.S.doc Version 5.2 Page 9 Each of the service users at the home now has a copy of the home’s own contract specifying the terms and conditions of their occupancy that included periods of notice, fees charged, and the cost of ‘extras’ not covered by the basic cost of the placement. . Hazeldene DS0000028107.V301761.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users have comprehensive individual care plans with detailed information on their needs and personal goals. Individual care plans include consultation with service users and are regularly updated by the key-worker to reflect current needs and service users wishes. The home operates a risk management strategy thus enabling the service users to participate in activities with appropriate support. EVIDENCE: Comprehensive care plans are generated from initial and ongoing assessments and liaison with relevant specialist services as needs were identified. This provides staff with detailed information that enables a continuity of care to be maintained. All individual plans of care were sampled and each contained relevant health and social care information, daily records, involvement with healthcare professionals, an action plan and regular reviews that demonstrated involvement, consultation and agreement of each service user on their plan of care. Overall, plans were being reviewed regularly however the home manager still has some concerns around the changing needs of one of the service users and is in the process of arranging a review with her care manager. Hazeldene DS0000028107.V301761.R01.S.doc Version 5.2 Page 11 The home is still in the process of introducing Person Centred Planning formats to the service users plans. The key workers at the home have attended training on Person Centred Planning so that they have a clear idea of the aim and concept of Person Centred Plans. Attendance certificates for the course were on the staff files held at the home The home operates a risk management strategy. Service users at the home have individual risk assessments depending on their needs and goals. Risk assessments covering various activities were seen on the service users files during the inspection including using the community. The home has a key worker system. The home manager explained that part of the key worker role is to advocate for the service user and involve them in the decision making process of the home. Service user views are important to the home and the staff team at the home encourage service users to make decisions about all aspects of their lives. The service users spoken to during the inspection felt that the staff team listened to them. Hazeldene DS0000028107.V301761.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users at the home are offered the opportunity to engage in age appropriate activities with an emphasis on using community based facilities. The service users have a varied programme of social activities organised by the staff team to reflect service users individual interests. The home has an open visitors policy to ensure friendships and family links are maintained. EVIDENCE: The house rules and daily routines are as flexible as possible, bearing in mind the weekday commitments of the service users. Some of the service users at the home are supported to access appropriate activities through day centres where they have individual schedules of activities. Two of the service users travel independently and enjoy perusing their own interests such as shopping. Details of the service users daily activities and commitments are kept on the service users file. The service users all have an annual holiday and on the day of the inspection the service users were looking forward to their imminent holiday. Hazeldene DS0000028107.V301761.R01.S.doc Version 5.2 Page 13 The home has its own transport. In house activities are also provided and one of the service users told the inspector that she enjoyed helping in the kitchen. The home manager confirmed that service users have the opportunity to attend religious services if they wish. Family and friends are made aware of the home’s visiting policy and there are no restrictions regarding when family or friends can visit. Service users also visit their relatives. The home menus are based on the likes and dislikes of the homes service users. They also take into account the service users health issues. Snacks and hot drinks are available at any time during the day. Service users are offered an alternative to the main meal on offer if they choose. Hazeldene DS0000028107.V301761.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal care is carried out in a way that residents prefer so that dignity and choice are maintained. Residents’ physical and emotional health needs are detailed in personal plans to offer consist care in this area. Residents’ medication is well managed to ensure good health. EVIDENCE: The service users need varying degrees of assistance with their personal care. Some service users just needs a prompt while others need more support. The level of personal support a service user needs would be detailed at their review and recorded in their personal file. Personal care is provided in private, and timings of this are flexible. The home provides consistency and continuity through designated key workers All service users are registered with a local General Practitioner and the staff team receive training on medication Significant events and accidents are recorded and monitored. Staff members monitor service user’s health and maintain up to date records. The home has a policy and procedure in place for the receipt, recording, storage, handling, administration and disposal of medication. All medication records were complete at the time of the inspection. Hazeldene DS0000028107.V301761.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is complaints policy and procedure, which facilitates good access to the complaints system for the residents, their family or their representatives. The home has the appropriate policies in place to ensure the protection of vulnerable service users. EVIDENCE: The complaints procedure was clear and contained all of the elements required to meet standard 22 including a minimum response time of less than 28 days. There have been no complaints since the last inspection. The home has a copy of the local authority Adult Protection Policy on site. The staff team have attended training on adult protection issues and a record is kept on their files. The staff team are aware of the action they must take if they need to report an incident. Hazeldene DS0000028107.V301761.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The general décor of the home is good providing a comfortable, clean and safe environment for service users to live in. Service user’s bedrooms provide privacy and reflect individual interests and preferences. EVIDENCE: Hazeldene is an ordinary family home, which has been extended to provide care to people with Learning disabilities. It is a small family-like care home currently accommodating four service users. Each of the service users in the home has a single room, which is decorated and personalised to reflect their individual taste. One of the service users spoken to during the inspection said that she liked spending time in her bedroom and had been able to arrange it in the way that she wanted to. The office /sleep in room is on the first floor of the house The home is situated in a residential area reasonably close to local shops and facilities. There was suitable domestic lighting and ventilation The home has a reasonably sized garden at the rear of the home which the service users spend time in during the summer months. The home’s premises are in keeping with the local community and were suitable for their purpose. Hazeldene DS0000028107.V301761.R01.S.doc Version 5.2 Page 17 The premises were generally bright, airy and clean on the day of the unannounced inspection. All areas of the premises viewed were clean and free from offensive odours. There are appropriate laundry facilities. Hazeldene DS0000028107.V301761.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team at the home have a range of skills and abilities, which enable them to meet the needs of the service users living at the home, however the home manager must ensure that staff meetings and supervisions occur more regularly. EVIDENCE: The staff job descriptions looked at during the inspection were comprehensive in their content and linked to achieving service users goals, as set out in their individual care plans. Due to the home’s small size, service users benefit from a family type environment and close support from a staff team who remain unchanged since the last inspection. The owner/manager works most days and is available on call in the event of an emergency. Discussions and records showed that staff respect service users’ individuality as well as demonstrate an understanding of their specific needs. In addition, the home maintains good links with other professionals and service users relatives. The home offers training opportunities to staff at all levels within the home and the home manager stated that four of the staff team have completed a National Vocational Qualification at level four. Hazeldene DS0000028107.V301761.R01.S.doc Version 5.2 Page 19 New members of staff complete an induction programme covering various subjects including health and safety, fire drills, and introductions to service users and other staff. The induction programmes are signed, dated and kept on staff files. Criminal Records Checks are completed before a new member of staff can begin work in the home. Records held at the home demonstrated that those supervision sessions have not been happening as often as they should and the staff team have not had an annual appraisal. The home manager must ensure that the staff team have received at least six supervisions this year and an annual appraisal. Staff meetings also need to be held at more regular intervals, as there had only been two since the last inspection in January. The atmosphere in the home is friendly. The staff members spoken to felt they worked well as a team and would have no difficulties approaching the manager if they needed to. The staff team were observed to treat service users with dignity and respect throughout the course of the inspection. Hazeldene DS0000028107.V301761.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The management style appears to be transparent with clear lines of accountability. In the main health and safety arrangements are adequate to ensure potential risks to service users health and safety are so far as reasonably possible identified and minimised however fire drill records were not taking place as often as they should. EVIDENCE: The home is manager by Jacob Lee who also owns the home. Mr Lee has a NVQ at level four, a registered managers award and considerable experience in Nursing and Social Care. There was a clear line of accountability within the home and the manager demonstrated a good knowledge of the service users and the staff team. The service users spoken to during the inspection said that the manager was someone they would talk to about any problems as well as other staff members. Many of the records required for the safety and well being of service users are in place including accidents, water temperatures, risk assessments, Hazeldene DS0000028107.V301761.R01.S.doc Version 5.2 Page 21 complaints, incidents, food records, service users case files, medication records and so forth. Fire records at the home demonstrated that fire drills are not taking place on a regular basis. Fire drills should take place at least four times a year in keeping with recommended good practise and the company policy. The owner/manager must also ensure that a fire risk assessment is completed. All staff members at the home must attend mandatory health and safety training including moving and handling and adult protection and copies of attendance certificates for courses attended were seen on staff files. At the homes previous two inspections the home was required to implement a quality assurance system and an annual development plan, with both involving service users. As the owner manager is still in the process of completing this, the requirement remains in force. The home has a health and safety policy and environmental risk assessments are in place. A first aid box and a fire blanket are situated in the kitchen. There are fire extinguishers throughout the house. Coloured chopping boards and knives were seen in the kitchen. Health and safety law posters issued by the health and safety executive were on display. The service users and staff made positive comments about the home and the management team. The home manager must ensure that the service users meetings take place on a more regular basis Hazeldene DS0000028107.V301761.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X X X 2 X X 2 X Hazeldene DS0000028107.V301761.R01.S.doc Version 5.2 Page 23 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1 Regulation 6(a)Sch 1 Requirement The registered provider must revise the home’s Statement of Purpose so that it accurately reflects the services provided in the home and the process for admissions. Timescale for action 31/12/06 2. YA42 23. (4)(e) The home manager must 31/07/06 ensure regular fire drill are undertaken and recorded and a fire risk assessment is completed. 31/12/06 3. YA6 14(1)(d)(2)(a)15 Service users plans must be reviewed at least every six months. An appropriate review meeting is held for service user C.L. involving the appropriate care manager to ensure that any changing needs are assessed and actioned. 18 (2) The home manager must ensure that the staff team all receive at least six supervisions per year and an annual appraisal Staff meetings need to be DS0000028107.V301761.R01.S.doc 4. YA36 31/12/06 5. YA33 21(1) 31/12/06 Page 24 Hazeldene Version 5.2 held at least six times a year with minutes of discussions and outcomes maintained. 6. YA39 24 A written annual quality assurance development plan needs to be developed for the home. The views of family members, friends / representatives and other interested parties should be sought to ensure the home is meeting its aims, objectives and statement of purpose. Risk assessments concerning safe working practices must be more detailed to clearly outline what measures are in place to reduce identified risks. The home manager must ensure the service users meetings take place on a more regular basis 31/12/06 7. YA39 24 31/12/06 8. YA42 13(4)15(1) Sch.3, 3q 31/12/06 9 YA39 12. -(5)(a)(b) 31/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hazeldene DS0000028107.V301761.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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