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Please note that the information on this website is now out of date.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 16/11/06 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 16th November 2006.

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 service users appeared appropriately dressed, well cared for and were observed moving freely and comfortably within the home. Service users who spoke to the Inspector expressed satisfaction with care and support they received and three visiting relatives reported positively in relation to the basic standards of care being delivered. Care workers were observed being attentive and competent in meeting the needs of the service users and related with them in a friendly and respectful manner. All records viewed were satisfactory and indicated that the safety and welfare of the service users were being safeguarded. Overall the home was found to be clean, hygienic and well maintained. The general atmosphere was calm and pleasant.

What has improved since the last inspection?

Of the thirteen requirements that were made at the last inspection, twelve had been complied with.

What the care home could do better:

One requirement relating to the laundry was identified at this inspection. One requirement from the last inspection regarding updated risk assessments had not been met.

CARE HOMES FOR OLDER PEOPLE Heston House Care Home 201-209 Vicarage Farm Road Heston Middlesex TW5 0AH Lead Inspector Ms Jean Bovell Key Unannounced Inspection 16th November 2006 12:20 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.V319767.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 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.V319767.R01.S.doc Version 5.2 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 Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (52) of places Heston House Care Home DS0000032606.V319767.R01.S.doc Version 5.2 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. The proposed Dementia Unit must not become operational until the outstanding environmental works are completed. The areas to be completed are: * Redecoration of the proposed dementia unit. * Area of garden to be sectioned and secured for the safety of the dementia unit service users. 27th June 2006 5. 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. There is also an eight bed dementia unit on the ground floor which has a secure garden. 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. Following discussion with the Registered Manager the Inspector was satisfied that all five conditions of registration had been complied with. Heston House Care Home DS0000032606.V319767.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out between 12:20 pm and 5:15 pm on 16th November 2006. The Registered Manager, two duty senior workers, eleven care workers, one senior and fifty service users were present. During the course of the inspection, the home’s records, documents, policies and procedures were viewed. Observations were made and tour of the building was undertaken. The Inspector spoke to six staff members, nine service users and three visiting relatives. The requirements that were made at the last inspection and all key Standards were examined. The Registered Manager was co-operative and provided appropriate assistance throughout the inspection. What the service does well: The service users appeared appropriately dressed, well cared for and were observed moving freely and comfortably within the home. Service users who spoke to the Inspector expressed satisfaction with care and support they received and three visiting relatives reported positively in relation to the basic standards of care being delivered. Care workers were observed being attentive and competent in meeting the needs of the service users and related with them in a friendly and respectful manner. All records viewed were satisfactory and indicated that the safety and welfare of the service users were being safeguarded. Overall the home was found to be clean, hygienic and well maintained. The general atmosphere was calm and pleasant. Heston House Care Home DS0000032606.V319767.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Heston House Care Home DS0000032606.V319767.R01.S.doc Version 5.2 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.V319767.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The separate needs of prospective service users are satisfactorily assessed prior to admission. Contracts/statement of terms and conditions are being appropriately signed and prospective service users receive written confirmation that specific assessed needs would be met at the home. Appropriate assistance is being provided to service users that are placed for intermediate care. Relatives and friends are able to visit the home prior to the admission of new service users. Heston House Care Home DS0000032606.V319767.R01.S.doc Version 5.2 Page 9 EVIDENCE: Appropriately signed contracts/statement of terms conditions which included confirmation that specific assessed needs would be met at the home, were evidenced on service users’ files that were viewed at the time of the Inspection. The Registered Manager confirmed that a needs led assessment was undertaken by the home in relation to prospective service users and that relatives, previous carers, social workers and medical professionals – where appropriate, were involved in the process of determining the capacity of the home to meet specific assessed needs. Five service users with a physical disability are placed in the home’s intermediate unit and all receive regular physiotherapy from a visiting Physiotherapist. Heston House Care Home DS0000032606.V319767.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9,10 and 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Requirements under Standards 7, 8 and 10 at the last inspection relating to care plans, risks assessments and records, had been complied with. One requirement under Standard 8 regarding up dated risk assessments remained outstanding. The health care needs of the service users are being met satisfactorily and their privacy and dignity are being upheld. The policy and procedures in relation to death and dying are satisfactory. EVIDENCE: Heston House Care Home DS0000032606.V319767.R01.S.doc Version 5.2 Page 11 In compliance with two requirements under Standard 7 at the last inspection: The involvement of service users in assessing separate personal, social, dietary, toileting and health care needs were clearly indicated within newly formulated care plans that were inspected at random. All care plans viewed were appropriately signed and dated. The policy and procedures on medication were in place and it was evidenced on service users records that their separate health care needs were being met satisfactorily. Risk assessments in relation to specific needs identified within care plans, such as moving and handling had been undertaken and daily recordings were being accurately maintained. This complied with requirements under Standards 8 and 10 at the last inspection. Although individual risk assessments had been carried out in relation to falls, there was no evidence of relevant updates as required under Standard 8 at the last inspection. The home’s policy on confidentiality was in place. The service users occupy separate bedrooms and members of the care staff were observed knocking on doors prior to entering and interacting with service users in a respectful manner. The Registered Manager reported that the privacy and dignity of service users were at all times respected and that personal care tasks were undertaken in privacy within bedrooms and bathrooms. Service users were able to make private telephone calls, receive confidential mail and meet with relatives and/or friends in their separate bedrooms. Service users who spoke to the Inspector confirmed that they were being treated with respect and were observed meeting with relatives in separate bedrooms. The policy and procedures relating to serious illness and death were comprehensive and recorded personal wishes and requests were evidenced within service users’ personal files. Heston House Care Home DS0000032606.V319767.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A requirement under Standard 12 at the last inspection relating to training has been met. Service users are able to be independent and maintain contact with relatives and/or friends. Nutritional meals are being provided. EVIDENCE: It was reported by the Registered Manager and confirmed by the Activities Coordinator, that in compliance with a requirement under Standard 12 at the last inspection, the Activities Co-ordinator had commenced a six-week course in Heston House Care Home DS0000032606.V319767.R01.S.doc Version 5.2 Page 13 dementia. This complied with a requirement under Standard 12 at the last inspection. An open visiting policy is being maintained at the home and contact with relatives and/or friends are being encouraged and facilitated. Several relatives visited the home at the time of the inspection. The Registered Manager confirmed that service users were able to make decisions in relation to meals, activities, clothing and when they got up in the mornings and/or retired at night. Service users were observed being with others in communal areas or resting, watching television or meeting with relatives in their separate bedrooms. All bedrooms were reflective of personal choices and interests. Varied and wholesome meals were listed on the menus and service users who spoke to the Inspector expressed satisfaction with the quantity and quality of food being provided at the home. Heston House Care Home DS0000032606.V319767.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure is satisfactory and service users are being protected from abuse. EVIDENCE: The complaints procedure is clearly detailed and accessible to service users and their relatives/friends. No complaints had been made to the home following the last inspection. The policies and procedures relating to adult abuse were in place and the records indicated that training on the protection of vulnerable adults had been delivered to the care staff. Heston House Care Home DS0000032606.V319767.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is being adequately maintained and the communal areas are suitable for shared or individual activity. Toilet and bathroom facilities are sufficient in numbers for meeting the personal needs of the service users. Individual bedrooms are personalised and the environment within is safe and comfortable. Sufficient care is not being taken to ensure that laundered garments are being to the appropriate service user. Requirements under Standard 22 at the last inspection in relation to handrails and risk assessments had been met. Heston House Care Home DS0000032606.V319767.R01.S.doc Version 5.2 Page 16 EVIDENCE: The communal areas within the separate units are adequately spacious, comfortably furnished and suitable for shared or individual activity. The surrounding gardens were tidily kept and accessible to the service users. The bathroom and toilet facilities are adequate for meeting the personal needs of the service users. It was reported by visiting relatives that laundered clothing were frequently lost or misplaced. The Inspector’s attention was drawn to various items of clothing that had been placed in a service user’s bedroom but which belonged to another person. This matter was discussed with the Registered Manager who gave assurances that appropriate action would be taken. In compliance with two requirements under Standards 22 at the last inspection: It was reported by the Registered Manager and confirmed by documented evidence, that funding had been agreed for the fitting of handrails to the ramp in the dementia garden. Risk assessments relating to the stairs and the lift were in place in the dementia unit. All the service users occupied separate bedrooms that were suitably furnished and fitted and reflected personal choices and interests. Service users reported being happy and comfortable within their separate bedrooms in which they were observed resting, reading, watching television or meeting with relatives at the time of the inspection. The home was found to be bright, airy and warm. The heating and lighting systems were in good working order and the water temperature was satisfactory. The overall environment was clean, hygienic, adequately maintained and safe. The atmosphere was calm and pleasant. Heston House Care Home DS0000032606.V319767.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s recruitment policy and procedures are satisfactory. All members of care staff receive appropriate training for meeting the needs of the service users. Requirements under Standards 27 and 30 relating to staffing levels, duty rosters and staff training, had been complied with. EVIDENCE: In compliance with three requirements under Standards 27 and 30 at the last inspection: It was evidenced on documents viewed that a review of staffing provision in relation to service users dependency levels had been appropriately undertaken. Heston House Care Home DS0000032606.V319767.R01.S.doc Version 5.2 Page 18 No issues were identified in relation to the home’s recruitment policy and procedures and personnel files contained all the required documents. Duty rosters were accurately reflective of staff on duty including the Registered Manager and hours worked. Training programmes were in place and indicated that eight care workers had achieved NVQ level 2 in care and six had enrolled for NVQ training. Appropriate training being delivered for meeting the needs of the service users included dementia, moving and handling, medication and infection control. Eight care workers had achieved level 2 NVQ in care training in care and six care workers had enrolled for NVQ training. Heston House Care Home DS0000032606.V319767.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 34, 36, 37 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Registered Manager is suitably experienced and qualified and the ethos of the home is beneficial to the needs of the service users. Quality assurance exercises are being appropriately carried out. The accounting and financial procedures of the home are satisfactory. Staff supervision is being regularly undertaken. The health and safety of the service users are being protected. A requirement under Standard 37 at the last inspection relating to records has Heston House Care Home DS0000032606.V319767.R01.S.doc Version 5.2 Page 20 been met. EVIDENCE: The Registered Manager has been in post for eight years and holds the Registered Managers Award and a Diploma in Social work. The Inspector was informed by the Registered Manager that the home aimed to provide a caring, supportive and inclusive environment in which service users were respected and encouraged to maintain their independence. The records indicated that the views of service users, relatives and stakeholders had been obtained and appropriately summarised. Service users’ monetary allowances are safeguarded at the home and financial records were found to be satisfactory. A valid Employers Liability Insurance Certificate was in place. Accurate and up to date records were being maintained and it was indicated that staff supervision was delivered approximately every six weeks. Health and safety checks on portable appliances, water temperature, gas appliances and fire safety were being regularly undertaken and recorded. Tests for Legionella had been carried out. Heston House Care Home DS0000032606.V319767.R01.S.doc Version 5.2 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 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X 2 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 Heston House Care Home DS0000032606.V319767.R01.S.doc Version 5.2 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 OP8 Regulation 13(4) Requirement Risk assessments for falls must be in place for all service users and must be updated following any falls. This is restated from the last inspection. (Previous timescale 22/08/06) The Registered Person must ensure that laundered items of clothing are appropriately placed. Timescale for action 01/12/06 2 OP24 16(2)(e) 20/12/06 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 Heston House Care Home DS0000032606.V319767.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection West London Area Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V319767.R01.S.doc Version 5.2 Page 24 - 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!