Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 15/12/05 for Heston House Care Home

Also see our care home review for Heston House Care Home for more information

This inspection was carried out on 15th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home continues to provide a more structured programme of activities. Very good progress has been made with the implementation of quality assurance and monitoring systems.

What has improved since the last inspection?

The home has done well in obtaining evidence of training undertaken by staff. This is an on going process, which is being pursued with the London Borough of Hounslow`s Training Department. Out of the nine requirements made at the previous inspection, seven requirements were met, one was partially met and one was not met.

What the care home could do better:

The home should be more vigilant to ensure that curtains are closed at an earlier time in the evenings, particular during the winter months when daylight hours are shorter. Further progress must be made to make safe the uneven paving slabs to the rear of the home.

CARE HOMES FOR OLDER PEOPLE Heston House Care Home 201-209 Vicarage Farm Road Heston Middlesex TW5 0AH Lead Inspector Mr Gavin Thomas Unannounced Inspection 15th December 2005 1:00pm X10015.doc Version 1.40 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 Heston House Care Home DS0000032606.V261356.R02.S.doc Version 5.0 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 Older People. 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. Heston House Care Home DS0000032606.V261356.R02.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Heston House Care Home Address 201-209 Vicarage Farm Road Heston Middlesex TW5 0AH 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) 020 8570 3040 020 8570 6099 London Borough of Hounslow Mrs Belinda Jane Calen Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (60) of places Heston House Care Home DS0000032606.V261356.R02.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. A maximum of six service users may be accommodated in the Intermediate Care Unit situated on the ground floor. There shall be a minimum of two suitably trained care staff on duty in the Intermediate Care Unit during daytime hours. New staff recruited to work in the Intermediate Care Unit are provided with appropriate training within three months of employment. Any proposed reduction in staffing levels must be discussed with the allocated inspector and agreement given prior to any such proposed reduction being made. 21st June 2005 Date of last inspection Brief Description of the Service: Heston House is owned and managed by the London Borough of Hounslow. This very large home is sub divided into eight smaller units. Each unit has a dedicated kitchenette, dining area and lounge. Three units are dedicated to Asian Elders. The home has an intermediate care unit, which provides a rehabilitation service for up to six service users. All meals are served from the main kitchen. The Registered Manager has demonstrable experience in working with older people. Diversity is recognised when recruiting staff. Heston House is set back slightly from Vicarage Farm Road which runs through Heston. The home is conveniently located for local amenities and bus routes. Heston House is situated in a large plot of land, most of which is lawned. The home provides a service for elderly frail people, who for what ever reason, can no longer live at home with support. The home aims to support service users in maintaining their independence for as long as possible. A Porto cabin has been erected in the grounds of the home for use by the Social Work Team for Older People. Heston House Care Home DS0000032606.V261356.R02.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a period of 5.5 hours. During this time, the Inspector met with two Duty Managers. One was a Senior Care Worker and one was an Assistant Resource Manager. The Registered Manager was away from the home at the time of this inspection. The Duty Managers were available throughout this inspection. The Inspector spoke with service users in Primrose, Shanti, Arsha, Khushi, Birchwood and Wellard. The home was very festive throughout with Christmas trees and decorations in all units. Light background music was also being played in communal areas throughout the home. With the exception of the services users in Primrose who were not satisfied with the quality of food and one service user stating that they required dental treatment, all other service users spoken to said they were happy and well. What the service does well: What has improved since the last inspection? The home has done well in obtaining evidence of training undertaken by staff. This is an on going process, which is being pursued with the London Borough of Hounslow’s Training Department. Out of the nine requirements made at the previous inspection, seven requirements were met, one was partially met and one was not met. Heston House Care Home DS0000032606.V261356.R02.S.doc Version 5.0 Page 6 What they could do better: 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. Heston House Care Home DS0000032606.V261356.R02.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Heston House Care Home DS0000032606.V261356.R02.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2&4 Details of terms and conditions agreed between the home and service users’ were satisfactory. A good range of support systems were in place for meeting service users’ assessed needs. EVIDENCE: The Assistant Resource Manager said that contracts of terms and conditions were in place for all permanent service users. Specific terms and conditions are agreed between the home and service users on respite care or receiving intermediate care. A completed contract was seen for the purpose of this inspection. The contents of the contract were in keeping with the criteria as set out in standard 2.2 of the National Minimum Standards for Care Homes for Older People. Heston House Care Home DS0000032606.V261356.R02.S.doc Version 5.0 Page 9 The home provides a service for four specific service user groups. They are: • Elderly service users requiring twenty-four hour care. • Asian elders. • Elderly service users requiring a respite service. • Service users requiring an intermediate care service. The home meets service users individual, cultural and religious needs in a number of ways. These include the celebration of festivals throughout the year, providing traditional meals, inviting leaders of various religious denominations to the home to meet with service users and employing staff who have an understanding of service users’ religious, cultural and communication needs. Service users in the units dedicated to Asian Elders, have access to an Asian radio channel and a selection of Asian music. The home also subscribes to Sky television for service users to view Asian television. The majority of staff employed in the units for Asian Elders speak Punjabi, Hindi, Urdu and Gujruti. Asian menus include Halal meat and a wide variety of Asian meals freshly prepared by a Chef who specialises in Asian cooking. Traditional clothing such as the sari, salwar and kameez is provided in consultation with service users and their families. The Priest from the local temple visits the home to say prayers in accordance with service users wishes. The Intermediate Care Unit opened in October 2005. The Assistant Resource Manager who also co ordinates the Intermediate Care Unit said that this unit is proving to be a successful service. Trained professionals carry out all assessments before and during the six-week stay. Service users specific care needs are identified prior to admission. This includes any specialist diets, clothing requirements and religious needs. Staff working in the Intermediate Care Unit are required to undergo an initial training programme. Staff also receive on going support and training from specialist professionals such as the Physiotherapist and Occupational Therapist. Service users receiving a respite service are encouraged to integrate with other service users. This was observed at the time of this inspection. Heston House Care Home DS0000032606.V261356.R02.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 10 Personal support is offered in ways to protect and promote service users’ privacy and dignity. EVIDENCE: All service users are accommodated in single bedrooms. The Assistant Resource Manager said that staff are required to respect service users privacy and dignity at all times. This includes knocking on service users bedroom doors before entering, keeping bathroom and toilet doors closed whilst assisting service users with personal care and ensuring that service users are dressed appropriately. It was noted on this inspection, that some service user prefer to keep their bedroom doors ajar. Payphones are provided at each end of the building. Some service users also have private telephones in their bedrooms. Staff in each unit are responsible for ensuring that service users clothing is kept not mixed up. All items of clothing are identified with a name tag. Heston House Care Home DS0000032606.V261356.R02.S.doc Version 5.0 Page 11 The Assistant Resource Manager said that all service users receive their mail unopened. If required, staff assist service users to open their mail. Heston House Care Home DS0000032606.V261356.R02.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13, 14 & 15 Links with the community are good and opportunities to develop and enrich service users’ social opportunities are on going. The meals in this home are good offering a both choice and variety. However, due to the comments made by service users in one group, the Registered Manager is required to further consult with the service users to reach an amicable solution to their views about the quality of food. EVIDENCE: The Assistant Resource Manager confirmed that service users are consulted on visitors and visiting arrangements. The home gives service users the opportunity to meet with their visitors in private. Service users bedrooms are commonly used for meeting with visitors. However, other rooms such as any of the offices may also be used for meeting with visitors. The Activities Coordinator is responsible for liaising with local groups who visit the home periodically or on special occasions to entertain the service users. This includes the local school choir and a ladies dancing group. All service users are provided with lockable facilities for the safe keeping of money and other valuable items. Monies are kept in a “property account” for service users who are unable to manage their own finances. The Assistant Heston House Care Home DS0000032606.V261356.R02.S.doc Version 5.0 Page 13 Resource Manager said that service users are supported to manage their own finances for as long as they are capable of doing so. Service users may bring their personal possessions to the home. Where possible, this is agreed with service users prior to admission. The Assistant Resource Manager confirmed that service users are made aware of their rights and procedures to access their personal records. Four service users in Primrose expressed their dissatisfaction about the quality of food served. The service users said that the cakes are too hard and only fit to be fed to the foxes. The Inspector did observe service users gathering up the cakes, which were to be later, fed to the foxes from the bedroom window by one service user. The manner in which this was done was judged to be unacceptable and service users should be discouraged from this practice. The Inspector did sample the cakes with the service users and could not fault the quality. The cakes were freshly baked and the taste and texture were judged to be satisfactory. The service users stated that crackling is not served with pork, vegetables are over cooked and burnt, blancmange is not on the menu, the skins of the jacket potatoes are too hard and meats served in any type of dishes was tough. In light of these comments, the Inspector spent a considerable amount of time talking with other service users and staff and the Chef about the quality of food. The Inspector also examined the menus and observed the different types of lunch and evening meals being served. With the exception of one member of staff who was of the opinion that vegetables were sometimes overcooked or cooked too early, everyone else spoken to was of the opinion that the home provided good quality meals. The menus examined indicated that service users are offered a wide range of wholesome and nutritious meals. Foods served on the day of this inspection included baked trout, toad in the hole, and a selection of vegetables, salads and Asian foods. The service users in Primrose stated that the toad in the hole wasn’t edible because the batter was too tough. One service user stated that they ordered a salmon salad but this was not served to them. The Inspector sampled the batter and did not find it tough or chewy as described by service users. The Inspector also observed the staff member offering to fetch the salmon but the service user declined. The Inspector sampled the lamb curry. The Inspector can confirm that the lamb was well cooked and tender. As a result of these comments, the Registered Manager is required to further consult with service users about the quality of the food. Subsequent to this inspection, the Registered Manager advised that she has implemented a food monitoring system, whereby service users are invited to Heston House Care Home DS0000032606.V261356.R02.S.doc Version 5.0 Page 14 comment on the quality of food at least three times per week. Service users comments would be recorded for monitoring purposes. One service user in Birchwood stated that they were unable to enjoy their food because they had a loose tooth. The Assistant Resource Manager confirmed that she would act on this the following day to ensure that the service user received urgent dental treatment. It was encouraging to note that one service user in the Intermediate Care Unit was being supported by a member of staff to make a hot drink independently. Heston House Care Home DS0000032606.V261356.R02.S.doc Version 5.0 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17 The home does well in giving service users the opportunity to take part in local and Parliamentary affairs. EVIDENCE: The majority of service users have relatives who advocate on their behalf. The Assistant Resource Manager stated that friends and acquaintances visit some service users from the church. The Assistant Resource Manager confirmed that service users are given the option to vote at local and Parliamentary elections. Service users are accompanied to local polling stations by staff or they have the choice of postal voting. Subsequent to this inspection, the Registered Manager explained that the home is currently consulting with two major charities regarding accessibility and availability of advocacy services for older people in the London Borough of Hounslow. Progress towards this will be monitored at the next inspection. Heston House Care Home DS0000032606.V261356.R02.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 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 The provision of adapted aids and equipment are suitable for meeting service users’ assessed needs. EVIDENCE: A call system is installed throughout the home. Pendants are provided for service users who are unable to use the wall mounted call system. A range of adapted bathing and toilet facilities are provided. These include hydraulic bath seats, adapted baths and raised toilet seats. Some service users are dependent on the use of walking aids such as zimmer frames or walking sticks. Grab rails are installed throughout the home. Wheelchairs are kept in service users bedrooms when not in use. The home has four portable hoists. Heston House Care Home DS0000032606.V261356.R02.S.doc Version 5.0 Page 17 The Intermediate Care Unit known as Roshni, is fitted with various aids and equipment for rehabilitation purposes. This includes a parallel walking bar, fulllength mirror, walking sticks and an adapted bed. Subsequent to this inspection, the Registered Manager confirmed that she had consulted with one service user about the lack of a shower in Primrose unit. The Registered Manager said that the service user was satisfied about using a shower on the ground floor. The Registered Manager explained that she would further consult with service users in Primrose about the lack of a shower in Primrose as part of the quality assurance system this year. The Registered Manager advised that action would be taken in accordance with the outcomes of service users views. Heston House Care Home DS0000032606.V261356.R02.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 In accordance with the information as given by the Registered Manager, recruitment processes in this home are satisfactory. EVIDENCE: A recruitment policy was in place. The Assistant Resource Manager confirmed that staff had been issued a copy of the code of conduct and practice as set by the General Social Care Council. The Assistant Resource Manager did not have access to staff recruitment records. Therefore, it was not possible to assess the home against the criteria as set out in Schedule 2 of the Care Homes Regulations 2001. Subsequent to this inspection, the Registered Manager confirmed that all recruitment checks are carried out in accordance with the criteria as set out in Schedule 2 of the Care Homes Regulations 2001. The Registered Manager also confirmed that the home was in receipt of copies of recruitment checks for agency staff. Heston House Care Home DS0000032606.V261356.R02.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 & 37 The home had good quality assurance and monitoring systems in place. EVIDENCE: Quality assurance and monitoring systems were in place. Service users meetings are held periodically. Service users confirmed this. The Inspector can confirm that copies of reports for visits carried out as required under Regulation 26 of the Care Homes Regulations 2001 are submitted to the Commission for Social Care Inspection. The Registered Manager has implemented detailed quality assurance and monitoring systems. A full quality audit was carried out in July 2005. The results of surveys completed by service users, staff and relatives have been analysed and published. An action plan for the results of these surveys will be monitored at the next inspection. Heston House Care Home DS0000032606.V261356.R02.S.doc Version 5.0 Page 20 A three-year business plan was in place. This included strategic objectives and performance indicators. The home was in the process of implementing part two (year two) of the business plan. The Registered Manager was advised to produce an up to date report on the implementation of the business plan for the last year. With the exception of staff recruitment records, all other records required for inspection purposes were accessible. It was noted however, that some policies and procedures were dated 1996. It was also noted that some corporate policies were included in the policies folder such as policies and procedures on Sheltered Housing and Domiciliary Care. Corporate policies and procedures, which are not relevant to this establishment, should be kept separately to avoid confusion. Policies and procedures, which are dated 1996, should be reviewed to ensure that the contents are still relevant. Heston House Care Home DS0000032606.V261356.R02.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x 3 x 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 x x x x 3 x x x x STAFFING Standard No Score 27 x 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 x x x 2 x Heston House Care Home DS0000032606.V261356.R02.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP1 Regulation 4(1(c) Sch1 (3) (4) Requirement Timescale for action 31/03/06 2. 3. OP15 OP19 16(2)(i) 23(2)(b) The staffing arrangements as set out in the Statement of Purpose for the Intermediate Care Unit must be more specific. (Timescale of 31/08/05 Not Met). The Registered Manager must 28/02/06 further consult with service users about the quality of the food. Work must be carried out to 31/03/06 make safe the uneven paving slabs in the rear garden. (Timescale of 31/10/05 Not Met). Heston House Care Home DS0000032606.V261356.R02.S.doc Version 5.0 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP15 Good Practice Recommendations Service users in Primrose should be discouraged from gathering up food to feed to the foxes for reasons as stated in this report under the section headed “Daily Life and Social Activities”. The home should be more vigilant to ensure that curtains are closed at an earlier time in the evenings, particular during the winter months when daylight hours are shorter. Corporate policies and procedures, which are not relevant to this establishment, should be kept separately. Policies and procedures, which are dated 1996, should be reviewed to ensure that the contents are still relevant. 1. 2. 3. OP24 OP37 OP37 Heston House Care Home DS0000032606.V261356.R02.S.doc Version 5.0 Page 24 Commission for Social Care Inspection West London Area Office 58 Uxbridge Road Ealing London W5 2ST 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. Extracts may not be used or reproduced without the express permission of CSCI Heston House Care Home DS0000032606.V261356.R02.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!