Inspection on 18/11/08 for Homefield Court

This inspection was carried out on 18th November 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Homefield Court 02/08/07

Homefield Court 07/02/06

Homefield Court 25/02/05

Homefield Court 11/05/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Homefield Court 1 Central Way Barretts Green Road London NW10 7AP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Tony Lawrence     Date: 1 8 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Homefield Court 1 Central Way Barretts Green Road London NW10 7AP 02089631618 02089613857 homefieldcourt@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Hrant Gregorian care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 23 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Homefield Court is a registered care home for 23 older people. The home is located in Park Royal, Northwest London and surrounded by a variety of small commercial and industrial businesses. It is within 10 minutes walk to the Central Middlesex Hospital and local ambulance station. There is a large hypermarket store about 15 minutes walk from the home, a local post office and additional shopping is a short drive to Harlesden town centre. In addition, the home is close to two local bus routes and the Harlesden underground station is about 15 minutes walk. The homes manager has been in post since April 2005 and is supported by a complement of experienced care staff, some of whom have been working at the home for several years. A key worker system is operated. Admission is made through spot purchase but the home also accepts Care Homes for Older People Page 4 of 27 Over 65 23 0 Brief description of the care home referrals from both the private and public sectors. The home currently has full occupancy. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We made this unannounced visit on Tuesday 18th November 2008 from 09:00 - 15:45. We reviewed outcomes for people living in the home against the key National Minimum Standards for Care Homes for Older People. We did this by spending time talking with people living in the home, staff on duty, the Manager and Deputy Manager. We also checked some of the care records kept in the home. We looked around the home and saw all communal areas and some of the residents bedrooms. The provider sent us an Annual Quality Assurance Assessment in October 2008. The AQAA gave us information about how the home provided good outcomes for residents. We have used information from the AQAA to write this report. Care Homes for Older People Page 6 of 27 Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may choose to live in the home can be sure that their care needs will be assessed, but the provider should make sure that local authorities provide information about the care needs of people they place in the home. Evidence: I did visit before I moved in. People were very welcoming. Comment from a resident. Pre-assessment before admission for appropriate referral. New residents are able to visit, spend half a day and have lunch. This does include their relatives. Extract from the providers Annual Quality Assurance Assessment (AQAA). During this visit we checked the information the home had received about 3 residents before they moved in. We saw that health and social care professionals had provided some good information about two people. The third persons file included little Care Homes for Older People Page 10 of 27 Evidence: information from the social services department responsible for funding the placement. Manager and staff from the home had completed the providers own care needs assessment for each of the three people. This was done before or shortly after they moved into the home. Staff made good use of the information that had been provided by other agencies to complete their own assessments. While residents can be sure that staff from the home will assess their needs before they move in, the provider should also make sure that local authorities provide relevant and up to date information about people they place in the home. We saw that the homes referral and admission policy and procedures included visits to the home for potential new residents and their relatives. One person told us that they had visited the home before moving in and they said that they had found the visit very helpful. We also saw that one person visited with a relative during this inspection. The manager told us that the home did not provide intermediate care and Standard 6 did not apply. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home can be confident their social and health care needs will be well assessed, recorded and met in the home. Staff will work with residents to make sure that they get the health care support they need. People can be confident that they will get the medication they need and this will be managed safely. Evidence: I always see visitors in my room, its quieter and more private. Comment from a resident. Whenever Mother needs medical support it is always promptly provided for her. Comment from a relative. The care plan reflects the care needs for each resident. We review monthly, according to the residents needs. We have good relationships with health care professionals. Extract from the providers Annual Quality Assurance Assessment (AQAA). Care Homes for Older People Page 12 of 27 Evidence: During this visit we checked the care plan files for three people living in the home. All three files included a current care plan that had been based on the homes assessments and information provided by other agencies. We saw that the care plans covered the personal, social and health care needs of residents but there was a need to make sure that social care needs were covered for one person aged under 65 who had recently moved into the home. This persons social care needs would be very different from those of other, older people living in the home and care should be taken to make sure these are assessed and recorded. Staff can then make arrangements to make sure that the identified needs are met appropriately. The care needs assessments we saw covered a number of appropriate areas, including peoples personal care, nutrition, activities, communication, safety, night care and end of life care. We saw that the assessments were used to develop care plan goals and guidance for care staff. The care plan areas, identified objectives and guidance for staff were reviewed and updated each month by the homes deputy manager. We also saw that peoples health care needs were well assessed and recorded and there was evidence of effective joint working with health care professionals. This included work with peoples GPs, mental health services, hospital clinics, dentists, opticians and chiropodists. In particular, we saw that staff from the home had worked well with other agencies to make sure that one person was cared for safely. This had involved working with social services and mental health services to agree a plan of care and providing equipment to minimise identified risks to the person. During this visit we checked the homes systems for managing residents prescribed medication. The manager told us that he worked with a local pharmacist and residents GPs to make sure that people received the medication they needed. The pharmacist delivered all prescribed medication each week and this was securely kept in a lockable medication trolley. We also checked the Medication Administration Record (MAR) sheets for 12 people living in the home. The MAR sheets were well completed and up to date and showed that people were receiving the medication they needed, at the correct times. People living in the home who spoke to us during this visit were very positive about the care and support they received from staff. They told us that staff always treated them with respect, offered them choices and accepted their decisions. Two people told us that if they wanted privacy, they could go to their rooms at any time. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home know they will be supported to take part in appropriate activities. Staff need to record more information about residents cultural and faith needs. Residents enjoy a varied and nutritious diet. Evidence: I always enjoy the food, its very good. Comment from a resident. There are plenty of activities at the home for the people who wish to and are able to take part. Comment from a relative. The food appears to be healthy and balanced. Comment from a relative. Daily activity records show residents taking part and the type of activity. Some residents have commented they would like to go away for a few nights holiday. We are looking into this. Extract from the providers Annual Quality Assurance Assessment (AQAA). We saw that the three residents files we checked during this visit included some Care Homes for Older People Page 14 of 27 Evidence: information about their hobbies and interests and how people would be supported to continue these in the home. The Manager told us that the home employed an Activities Worker who worked Monday - Friday. The Activities Worker told us that she talked to individuals and groups of residents to get their ideas about the sort of activities they enjoyed. During the afternoon we joined in with a session for 7 residents organised by the Activities Worker. This involved a gentle exercise session, followed by ball games and bingo. We saw that the residents all enjoyed the exercise and ball games, joining in enthusiastically. While the care plans we checked included information about social and recreational needs and how these would be met, more work is needed to include information about peoples cultural and religious needs. For example, one residents religion was not recorded on their care plan, although it was recorded on information provided by the local authority responsible for placing the person in the home. A second care plan recorded the persons religion, but there was no information about how these needs would be met. The third care plan did not include sufficient detail about how the persons cultural care needs would be met. The Manager and staff must make sure that these important areas are covered fully in each persons care plan. We saw that the three care plan files we checked during this visit included information and contact details for residents relatives, friends and other significant people. The details were well recorded and included information for staff about when to contact each person. We also saw that all three care plan files included risk assessments completed by staff from the home. The assessments covered personal safety, mobility, falling and wandering. The assessments were reviewed monthly by the deputy manager and included clear guidance for staff on how to minimise risks to individuals. We saw that the menus showed a good variety of nutritious meals were provided in the home. Residents told us that they enjoyed the food, there was plenty of choice and alternatives were always available. The menus also showed us that regular snacks and drinks were available throughout the day. Care Homes for Older People Page 15 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their relatives can be confident the provider will respond appropriately to any concerns they might have. Residents are cared for safely and managers and staff work well with other agencies to make sure that residents are protected. Evidence: This is a good home, Ive always felt safe and well looked after here. Comment from a resident. We welcome any complaints. We have had no complaints this year and were always receiving thank you cards and letters from relatives. Extract from the providers Annual Quality Assurance Assessment (AQAA). During this visit we saw that the providers complaints procedure was displayed in the homes hallway, easily accessible for residents, staff and visitors. The Manager told us that there had been one formal complaint since our last visit. This followed an incident when a resident left the home and did not return for some hours. This incident was reported by the Manager to the local authority as a safeguarding adults alert. Managers and staff from the home responded well to this incident and took appropriate actions to make sure that the person was safe. This included providing some equipment for the resident, arranging for a professional assessment and agreeing future actions with the local authority. While all the organisations involved in Care Homes for Older People Page 16 of 27 Evidence: the persons care have now agreed strategies to keep the person safe, we would recommend that staff from the home notify the local authority when any resident stays away from the home overnight. This would make sure that all those involved in the persons care were aware of potential risks and support could be provided to the home, if required. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides good standards of shared and private accommodation. Residents are happy with their bedrooms and many have personalised their rooms with their own furniture and other possessions. Evidence: I like my room, Ive got everything I need there. Comment from a resident. The home is clean, cosy and welcoming. Comment from a relative. We always get complimented. Audits from the relatives and residents are positive. New dining chairs and some new bedroom furniture have been purchase. The home is always kept clean. Extract from the providers Annual Quality Assurance Assessment (AQAA). Homefield Court is a purpose built home surrounded by industrial and hospital premises in Park Royal. The home is within a short walk to a large supermarket, bus routes and an underground station. There are bedrooms on the ground and first floor and there is a stair lift for people who cannot walk up the stairs. All communal areas are on the ground floor. There are enough toilets and bathrooms for residents to use on both floors. Care Homes for Older People Page 18 of 27 Evidence: During this visit we saw all communal areas and some of the residents bedrooms. All parts of the home we saw were clean, pleasant and hygienic. Communal areas and bedrooms were well decorated and comfortably furnished. The bedrooms we saw were comfortable and residents had brought their own furniture, possessions, pictures etc to personalise their rooms. The home had a large garden that people told us they could use in good weather. When we last visited the home we made a requirement that door closers must be fitted to fire doors in the home. During this visit we saw that some doors had been fitted with closers activated by the homes fire alarm system, but other fire doors were propped or wedged open. The Manager and provider must make sure that, where fire doors need to be kept open, they are fitted with door closers activated by the fire alarm system. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are well trained and supported to make sure that people are cared for safely in the home. There is a need to review staffing levels to make sure that there are enough managers and staff available at all times. Evidence: The people at Homefield Court are without fail, kind, thoughtful, attentive, helpful and competent in their care. Comment from a relative. 60 of staff have NVQ Level 2 or above. Staff turnover is 3 . We have used no agency staff in the last 12 months. Extract from the providers Annual Quality Assurance Assessment (AQAA). During this visit we spent time talking to staff, the homes Manager and deputy manager. We also saw care staff and the Activities Worker supporting residents throughout the day. We saw that staff worked well together to make sure that people had the help and support they needed. We checked the homes rota and this was evidence that there is one senior care worker and 2 care staff on each shift, with the manager or deputy manager. At weekends, the deputy manager or a senior carer was on duty with 2 care staff. As the home had 23 residents and no vacancies when we visited, we would recommend that the provider reviews the staffing levels to make Care Homes for Older People Page 20 of 27 Evidence: sure that managers have time to carry out management tasks and that there are enough care staff on duty at all times to meet residents care needs. During this visit we checked the personnel files for two people working in the home. We saw that both files included all of the employment checks needed to make sure that staff are suitable to work with vulnerable adults. The Manager told us that all but two of the care staff working in the home had completed their NVQ Level 2 qualification training and five staff had gone on to Level 3. Staff told us that they were able to do all of the training they needed to carry out their jobs effectively. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed, staff have access to all of the policies and procedures they need to provide good standards of care and standards of record keeping in the home are good. Evidence: If I was worried about anything, Id talk to the Manager. Comment from a resident. The Manager is an unusually kind, gentle and sensitive man and I am delighted with the level of care. Comment from a relative. During this visit we spent time talking with people living in the home, the Manager and Deputy Manager. We also checked some of the care records kept by managers and staff. The Manager told us that he had more than 15 years of working in social care services for older people and people with mental illness. He had completed his National Vocational Qualification (NVQ) Registered Managers Award and we have registered Care Homes for Older People Page 22 of 27 Evidence: him as a fit person to manage a home for vulnerable people. The Manager told us that the provider sent quality assurance surveys to all residents and their relatives each year. The results of the surveys were collated and used to identify improvements to the standards of care provided in the home. This showed that people were consulted about the quality of care and support they received in the home. Residents who spoke with us during this visit were very positive about the care provided. The Manager also told us that the provider carried out a monitoring visit to the home each month. We saw evidence that the visits took place and a written report was sent to the home after each visit, highlighting issues that needed to be addressed by the manager and care staff. We saw that the monthly monitoring visits included the provider spending time with residents and their relatives, to get their views on the services provided. Information from the providers Annual Quality Assurance Assessment (AQAA) was evidence that the provider had developed all of the policies and procedures needed to meet these Standards. There was also evidence in the AQAA that the policies and procedures were reviewed regularly. During this visit we checked a selection of records kept in the home, including residents care plans and risk assessments, daily care notes and health and safety records. We saw that records were well kept and up to date. This was evidence that peoples care needs were assessed, recorded and met in the home. We saw no health and safety issues during this visit, apart form the need to make sure that fire doors that need to be kept open were fitted with door closers activated by the homes fire alarm system (see Standard 19). Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 12 15 The manager and staff working in the home must make sure that they assess, record and meet residents cultural and religious care needs. This will make sure that residents experiences of living in the home meet their expectation and preferences. 27/02/2009 2 19 23 The Manager and provider 30/01/2009 must make sure that, where fire doors need to be kept open, they are fitted with door closers activated by the fire alarm system. This will make sure that residents, staff and other people are protected in the event of a fire. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. Care Homes for Older People Page 25 of 27 No. Refer to Standard Good Practice Recommendations 1 3 The provider should make sure that local authorities provide relevant and up to date information about people they place in the home. The social care needs of people aged under 65 should be assessed and recorded as part of their care plan. Staff from the home should notify the local authority when any resident stays away from the home overnight. The provider should review the staffing levels to make sure that managers have time to carry out management tasks and that there are enough care staff on duty at all times to meet residents care needs. 2 3 4 7 18 27 Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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. 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