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Inspection on 21/06/05 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 21st June 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 Registered Manager was on annual leave on the first day of this inspection. Members of the senior team demonstrated competence and a good understanding of the running of the home in the absence of the Registered Manager. The home maintains good practice systems already in place. The home is also keen to raise standards and develop the service where required.

What has improved since the last inspection?

Since the appointment of an Activities Co Coordinator, the home is now able to offer service users a more structured and varied programme of activities and entertainment. Good progress is being made towards implementing quality assurance and monitoring systems. The quality of care plans continues to improve. The content of care plans examined was more focused on service users specific needs.

What the care home could do better:

The London Borough of Hounslow must now prioritise repair work to the uneven paving slabs to the rear of the home. Although the Inspector observed staff accompanying service users to the garden at the time of this inspection, some of the paving slabs were judged to be a potential trip hazard.

CARE HOMES FOR OLDER PEOPLE Heston House Care Home 201-209 Vicarage Farm Road Heston Middlesex TW5 0AH Lead Inspector Gavin Thomas Unannounced 21 and 22 June 2005 at 10.55am 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 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 G61-G10 s32606 Heston House v214205 210605 Stage 4.doc Version 1.30 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 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 G61-G10 s32606 Heston House v214205 210605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 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. Date of last inspection 17 and 18 January 2005 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 nine 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 G61-G10 s32606 Heston House v214205 210605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over ten hours. The atmosphere in the home was pleasant and welcoming. One service user spoken to said they were dissatisfied with the quality of some of the foods served. The same service user said there was no shower in Primrose Unit and the television in Primrose unit was broken. All other service users spoken to said they were satisfied with the quality of service. This included staff support, quality of food, activities and visiting arrangements. Service users spoken to were either at the home on long term placements or short term for intermediate care or respite care. The Activities Co Coordinator was positive about services users response to the revised programme of activities and entertainment. What the service does well: What has improved since the last inspection? What they could do better: The London Borough of Hounslow must now prioritise repair work to the uneven paving slabs to the rear of the home. Although the Inspector observed staff accompanying service users to the garden at the time of this inspection, some of the paving slabs were judged to be a potential trip hazard. Heston House Care Home G61-G10 s32606 Heston House v214205 210605 Stage 4.doc Version 1.30 Page 6 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 G61-G10 s32606 Heston House v214205 210605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Heston House Care Home G61-G10 s32606 Heston House v214205 210605 Stage 4.doc Version 1.30 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 standard(s) 1, 3 & 6 The home’s Statement of Purpose and Service User Guide provides service users and prospective service users with details of the services the home provides enabling an informed decision about admission to the home. Good systems were maintained for the assessment and admission of prospective service users. EVIDENCE: A Statement of Purpose and Service User Guide were in place. All service users had been issued with a copy of the Service User Guide. Both documents were well written. However, the staffing arrangements as set out in the Statement of Purpose for the Intermediate Care Unit must be more specific. There have been no changes to the procedures regarding the assessment process with prospective service users for this establishment. Social work teams carry out needs led assessments. Subsequent assessments are carried out by the home once a prospective service user has been referred to the home by the social work team. The Registered Manager explained that the assessment process does not always apply to service users who are admitted to the home at short notice for respite care. In these circumstances, the home Heston House Care Home G61-G10 s32606 Heston House v214205 210605 Stage 4.doc Version 1.30 Page 9 would meet with the service user within 48 hours after admission to discuss their care needs and to devise a care plan with the service user. Service users are informed in writing of the outcome of their assessment. Three service users were admitted to the Intermediate Care Unit at the time of this inspection. The three service users said they were benefiting from the types of support they were receiving and were impressed with the overall quality of the service. The Registered Manager has overall responsibility for the Intermediate Care Unit. The day – to – day running of this unit is co coordinated by one of the three Assistant Managers. Operational meetings take place on a weekly and monthly basis. Health and Social Services professionals are included in these meetings. It was noted at the time of this inspection that staffing levels had been reduced in the Intermediate Care Unit. In accordance with one of the conditions of registration, the home may only reduce the staffing levels with prior agreement from the CSCI. Subsequent to this inspection, the Registered Manager did submit these proposals in writing to the CSCI. The CSCI has since agreed for the home to reduce the staffing by one during the daytime when there are three or less service users in the Intermediate Care Unit with low dependency levels. Heston House Care Home G61-G10 s32606 Heston House v214205 210605 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9 & 11 A consistent care planning system was in place, which adequately provides staff with information to satisfactorily meet service users needs. The systems for the administration of medication are good with clear arrangements in place to ensure service users medication needs are met. EVIDENCE: Care plans were in place for all service users. The care plan methodology has been reviewed to maintain consistency. Senior staff are responsible for monitoring the implementation of care plans. The quality of care plans examined was good and well maintained. Monthly care plan reviews are carried out. The Assistant Manager said that the content of care plans are discussed with service users at statutory reviews. Service users do not currently sign their care plans. This must be explored and where possible, service users should be given the opportunity to agree and sign their care plans. The Assistant Manager said that none of the service users had pressure sores. Service users health needs were recorded in their care plans. The District Nurses continue to visit the home twice weekly. The Health Care Advisor and District Nurses provide professional advice on the management of incontinence. Referrals are made to the Community Psychiatric Nurse when required. Primary health care treatments are arranged for service users. These Heston House Care Home G61-G10 s32606 Heston House v214205 210605 Stage 4.doc Version 1.30 Page 11 include dentistry, chiropody and opticians. Six service users had dementia. Two of the six service users had been assessed and waiting to be moved on to more suitable placements. The home does not have a category of registration to accommodate service users with dementia. Prior to this inspection, the Registered Manager had submitted a draft proposal to the CSCI for the home to accommodate up to six of service users with dementia. Given that there are service users already in the home with a diagnosis of dementia, the home is required to make application to the CSCI to continue providing for these service users for as along as their assessed needs can be met. Fluid and nutritional charts are implemented in accordance with service users individual health needs. Service users weights are taken on admission. The home must implement a system whereby service users weights are taken and monitored more frequently. A medication policy was in place. The home is now using the Monitoring Dosage System for medications. This system was introduced in the home in March 2005. Staff had received training on the implementation of the new system. Medications were stored in locked cabinets in individual units. The most recent Pharmaceutical audit was carried out in June 2005. A report for this visit was available in the home. The Registered Manager explained that she was still experiencing difficulties with one GP who was reluctant to give written consent for service users to be given homely remedies and carry out medication reviews without remuneration. The Registered Manager was advised to contact the Primary Care Trust regarding this matter. A policy on dying and death was in place. The Registered Manager said that service users are given the option of discussing their last wishes on admission. Some of the forms for recording service users last wishes were blank. The home should record if service users have chosen not to express details of their last wishes or as far as possible, obtain these details from service users representatives. Heston House Care Home G61-G10 s32606 Heston House v214205 210605 Stage 4.doc Version 1.30 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 standard(s) 12 & 15 Links with the community have improved. The meals in this home are good offering both choice and variety and catering for special dietary needs. EVIDENCE: The appointment of an Activities Co Coordinator has shown a marked improvement in the opportunities for service users to engage in a wider range of activities. Some service users were on an outing to Richmond Park at the time of this inspection. A programme of activities was displayed in the home. Service users spoken to said they enjoyed the types of activities offered to them. The Activities Co Coordinator maintains good records to evidence all activities carried out with service users. Entertainment and events are included in the home’s newsletter. One service user was not happy about a faulty television in the home. The Registered Manager said that this television had been replaced. The television must be repaired or replaced to enable service users to view all channels. Service users meetings are held monthly. An interpreter, who is also one of the staff team, attends the meetings in the Asian Elders units. Although service users meetings are held separately for Asian and English speaking service users, service users may attend either of the meetings. Heston House Care Home G61-G10 s32606 Heston House v214205 210605 Stage 4.doc Version 1.30 Page 13 The home continues to provide a range of balanced meals. One service user said that some of the foods such as the sausages were too bland. They did not like the toppings on the pies and some foods were too greasy and sweet. Service users spoken to in four units said they enjoyed the food. The service users said that the food is generally good and “lovely”. For the purpose of this inspection, the Inspector sampled a range of meals served. These included shepherds pie, mashed swede, peas and dhal. The food was judged to be of good quality. It was freshly prepared and appetising. The Registered Manager said that menus were discussed at a recent service users meeting. It was agreed with service users that the menu would be reviewed. Services users were also informed that the home would review some of the types of food such as sausages. The Registered Manager agreed that alternate foods could be bought for service users who found some of the foods too sweet such as desserts. The service user was satisfied with this outcome. Heston House Care Home G61-G10 s32606 Heston House v214205 210605 Stage 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 The home has a satisfactory complaints system with some evidence that service users feel that their views are listened to and acted upon. Procedures for the safety and protection of service users are reviewed periodically. EVIDENCE: A complaints policy was in place. There were no changes to this policy. The complaints procedure was displayed in the home. The format of the complaints record had been revised since the last inspection. A process was in place for visitors, service users or staff to submit any concerns or matters to the Registered Manager. Adult Protection policies and procedures were in place. Staff had attended updated training on adult protection. The Registered Manager said that systems for safeguarding service users are subject to periodic review. One incident of theft was reported to the CSCI since the last inspection. One member of the public attempted to gain unauthorised access to the home. Appropriate action was taken at the time. The home has since increased the supervision of one of the exit doors when service users are leaving or returning to the home. Heston House Care Home G61-G10 s32606 Heston House v214205 210605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21 & 26 The overall quality of furnishings and fittings were of good quality. The uneven paving slabs to the rear of the home must be repaired to provide a safer environment for those living or working there and visiting. EVIDENCE: The home was clean and well presented at the time of this inspection. A programme of routine maintenance and renewal of the fabric and decoration of the premises was in place. The ratio of toilets and bathing facilities were in keeping with the ratio as set out in Standard 21 of the National Minimum Standards for Care Homes for Older People. One service user said that Primrose unit does not have a shower and they would prefer a shower as opposed to having a bath. This option must be explored. The requirement made at previous inspections to make safe the uneven paving slabs and repair a broken windowsill remains outstanding. The CSCI agreed to an extended timescale for this work to be carried out. However, the London Borough of Hounslow must now make a firm commitment to making this area of the home a safer environment. Heston House Care Home G61-G10 s32606 Heston House v214205 210605 Stage 4.doc Version 1.30 Page 16 Rose bushes growing over the paving area were judged to be potential hazard. These bushes were trimmed back from the walkway at the time of the inspection. There is a lounge and dining area in each unit. Lighting in all units inspected was domestic in character. Service users were sitting in the garden and on the roof garden at the time of this inspection. Service users may entertain visitors in their bedrooms. This was observed at the time of the inspection. Other private areas are available on request. A room is provided on the first floor for service users to use as a quiet room. This room may also be used for prayer. A separate room is provided for hairdressing. The Intermediate Care Unit was fitted with equipment for rehabilitation purposes. An assessment carried out by an approved contractor confirmed that the services and facilities comply with the Water Supply (Water Fittings) Regulations 1999. Records examined indicated that the water services and facilities would need to be tested again in the year 2009. The premises were free from offensive odours throughout. Laundry facilities are situated on the ground floor and away from the food preparation area. Hand washing facilities are prominently sited throughout the home. Arrangements were in place with an approved contractor for the safe disposal of clinical waste. A policy on the control of infection was in place. The Registered Manager said there were no changes to this policy. Heston House Care Home G61-G10 s32606 Heston House v214205 210605 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 30 The home continues to make good progress with opportunities for staff training and development. However, the retention of evidence for training undertaken by the staff team needs to be improved upon. EVIDENCE: The Registered Manager reported that there have been no changes to the staffing levels and staffing ratios since the last inspection. There is a minimum of one member of staff on duty in each unit at all times. Senior staff who are supernumerary to the staff team assist in any of the groups when required. A staff training and development programme was in place. The home is doing well in providing appropriate training for the staff team including NVQ training. Induction and foundation training programmes were in place. It was noted however, that there is still lack of evidence for some of the statutory training undertaken by members of the staff team. The Inspector was informed that efforts have been made to obtain this evidence from the London Borough of Hounslow training department. The home was in the process of devising individual training and development profiles. A draft version of this profile was available for inspection purposes. Heston House Care Home G61-G10 s32606 Heston House v214205 210605 Stage 4.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 35 & 38 The Registered Manager is supported well by the senior staff team in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. Good progress is being made in reviewing the home’s performance through a detailed programme of self – review and consultations, which will include seeking the views of service users, staff, relatives and significant others. EVIDENCE: The Registered Manager has achieved the Registered Manager’s Award. In addition to this, the Registered Manager also has other relevant professional qualifications including a Diploma in Social Work. The Registered Manager has now registered her professional status with the General Social Care Council. Records examined confirmed this. A valid Employers Liability insurance certificate was in place. The home is making continuous progress with quality assurance and monitoring systems. Heston House Care Home G61-G10 s32606 Heston House v214205 210605 Stage 4.doc Version 1.30 Page 19 Surveys have been produced in draft form for service users, staff, relatives and significant others. The Registered Manager said that these would be distributed in due course. An annual development plan was in place. The Registered Manager said this plan would be reviewed later this year. The Registered Manager continues to monitor the quality of the service. This includes the quality of food, the numbers of falls and incidents in the home and seeking the views of service users about the quality of service via service users meetings. The Registered Manager said she also speaks to service users informally on a one to one basis. Sixteen relatives attended the carers meeting in April 2005. The Registered Manager proposes that the carers meetings are carried out bi annually. A survey for monitoring the provisions of respite care was being devised. The home was working towards the Charter Mark award. The three Assistant Managers and the Activities Co Coordinator have delegated responsibilities. A full time Business Support Manager and administrators also support the home. The Inspector can confirm that copies of reports for visits carried out as required under Regulation 37 of the Care Homes Regulations 2001 are supplied to the CSCI. The home maintains good records with regards to service users finances. It was noted however, that where the London Borough of Hounslow acts as corporate appointee for some service users, all of the details for managing these service users finances were not available in the home. The London Borough of Hounslow must supply the CSCI with details on how service users finances are managed including the types of accounts used for depositing service users finances. This requirement remains outstanding from the previous inspection. Health and safety monitoring systems were in place. A corporate health and safety audit was carried out in May 2005. An up to date maintenance check for gas appliances was outstanding. The Registered Manager said that this would be done once the London Borough of Hounslow has appointed an approved contractor to carry out the work. A legionella test was carried out in November 2004. The results of this test were satisfactory. A water hygiene risk assessment was carried out in May 2005. The Registered Manager said that recommendations made as a result of this assessment were referred to the London Borough of Hounslow – Corporate Property Unit for implementation. Heston House Care Home G61-G10 s32606 Heston House v214205 210605 Stage 4.doc Version 1.30 Page 20 The Registered Manager said that an approved contractor was in the process of servicing the hot water systems in the home. However, documentary evidence must still be provided to confirm that all bathing and showering facilities are thermostatically controlled. Hot water temperatures for bathing and showering appliances are tested regularly and recorded. Records examined indicated that hot water delivered to bathing and showering facilities is delivered within a safe range. Fire safety procedures in place included routine fire drills and weekly testing of the fire detection system. Records examined confirmed this. The carpet in the corridor was being vacuumed during this inspection. The flex from the vacuum cleaner, which trailed through the corridor, was judged to be a potential trip hazard. Although safety-warning signs are provided in the home, none were being used for this particular task. Safety warning signs must be used to prevent accidents. Some of the windows on the first floor were opened too wide. The windows were put back to restricted openings at the time of the inspection. The Assistant Manager explained that the staff team are constantly reminded about this practice. Heston House Care Home G61-G10 s32606 Heston House v214205 210605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 3 2 x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x 2 x x 2 Heston House Care Home G61-G10 s32606 Heston House v214205 210605 Stage 4.doc Version 1.30 Page 22 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 1 Regulation 4(1)(c ) Schedule 1(3)(4) 23(2)(b) Requirement The staffing arrangements as set out in the Statement of Purpose for the Intermediate Care Unit must be more specific. Work must be carried out to make safe the uneven paving slabs and the broken window sill in the rear garden. (Timescale of 31/5/05 Not Met). The televsion in Primrose unit must be repaired or replaced. Services users must be consulted on the lack of a shower facility in Primrose unit. Action must be taken to provide these facilities in accordance with service users needs and wishes. Evidence of all training undertaken by staff must be retained in the home. The London Borough of Hounslow must supply the CSCI with information regarding the management of service users finances including the different types of accounts used for service users finances. (Timescale of 31/3/05 Not Met). All gas appliances must be serviced by an approved Timescale for action 31/8/05 2. 19 31/10/05 3. 4. 12 21 23(2)(c ) 23(20(j) 31/7/05 31/7/05 5. 6. 30 35 18(1)(a) (c )(i) 16(2)(l) 31/8/05 31/8/05 7. 38 23 (2)(c ) 31/8/05 Page 23 Heston House Care Home G61-G10 s32606 Heston House v214205 210605 Stage 4.doc Version 1.30 8. 38 13(4)(c ) 9. 38 13(4)(c ) contractor. (Timescale of 18/2/05 Not met). Documentary evidence must be obtained to confirm that all bathing and showering facilities are thermostatically controlled. (Timescale of 28/2/05 Not Met). Safety warning signs must be used to avoid any unnecessary accidents. 31/8/05 22/7/05 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 11 Good Practice Recommendations The home should record if service users have chosen not to express details of their last wishes or as far as possible, obtain these details from service users representatives. Heston House Care Home G61-G10 s32606 Heston House v214205 210605 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Ground Floor 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. 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