Inspection on 07/02/06 for Homefield Court

This inspection was carried out on 7th February 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Homefield Court 18/11/08

Homefield Court 02/08/07

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Homefield Court 1 Central Way Barretts Green Road London NW10 7AP Lead Inspector Dia Balraj Unannounced Inspection 7th February 2006 10:30 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 Homefield Court DS0000017433.V282276.R01.S.doc Version 5.1 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. Homefield Court DS0000017433.V282276.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Homefield Court Address 1 Central Way Barretts Green Road London NW10 7AP 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 8963 1618 020 8961 3857 Mr Hrant Gregorian Brindanand Camadoo Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Homefield Court DS0000017433.V282276.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration:No Date of last inspection 5th July 2005 Brief Description of the Service: Homefield Court is registered to provide accommodation and care support to 21residents of either gender, race, creed or religious affiliation. At the time of this inspection the home was operating to full capacity. The home is located in a cul de sac in Park Royal, Northwest London and surrounded by a variety of small commercial and industrial businesses. It is within ten 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 away. The home’ s manager has been in post for over a year 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 at the home. Admission is made through “spot purchase” but the home also accepts referrals from both the private and public sectors. Homefield Court DS0000017433.V282276.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out in one day with input from the residents, staff, the manager and inspection of key documentations and records at the home. The inspection findings indicated residents were happy and relaxed. Residents stated that both staff and the manager were helpful. Discussions with the residents, manager and staff suggested that effort was put into enhancing and promoting the quality of life of residents. The general consensus of residents was that they felt well cared for and their requests were acted upon by the management and staff What the service does well: What has improved since the last inspection? The manager has been in post for over a year and has implemented a number of changes. The requirements of the last inspection have generally been met. Residents’ care plans have been updated and this has provided a basis for reviewing care needs. There have been changes to the menu based on Homefield Court DS0000017433.V282276.R01.S.doc Version 5.1 Page 6 discussions at three monthly residents’ meetings. The menu caters for individual choices and the special dietary needs of residents. There have been improvements in the overall physical (internal and external) environment of the home. The manager has drawn up a maintenance programme and major repairs have been undertaken.. Bath and shower facilities have improved and safety equipment has been installed in the bathrooms to maximise the safety of residents. The procedures for recruitment of staff now ensure that appropriate checks and references are carried out before they are allowed to start work. Staff have undertaken relevant adult protection training which will help ensure the safety and wellbeing of residents is enhanced. The reviews carried out for each resident have provided a clearer picture of residents’ individual, social, leisure and holistic care needs and preferences. There is a weekly programme of activities, which includes a more diverse range of leisure, social activities and stimulation for the residents. The garden area was better maintained and therefore more accessible and safe for residents to use. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Homefield Court DS0000017433.V282276.R01.S.doc Version 5.1 Page 7 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Homefield Court DS0000017433.V282276.R01.S.doc Version 5.1 Page 8 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 Homefield Court DS0000017433.V282276.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 5 Appropriate assessment is carried out for each service user with input from a range of people associated with the users. This has ensured that only users whose needs can be met are accepted to live at the home. EVIDENCE: The service user’s guide has been reviewed following the requirement of the last inspection. In accordance with Schedule 1and 4 it needs to incorporate more information about how the religious needs of residents will be met. The guide should give full details of the staffing and management including the names and professional experiences of the key staff. The provider had met the requirement dealing with information about how the privacy of residents will be respected. The inspector was satisfied on examining 2case files of residents that comprehensive care needs assessments are carried out for each resident before they moved into the home. There was also evidence of visits to the home prior to making the decision to move. The process is assisted by input from social and medical care professionals and relatives and next of kin. Homefield Court DS0000017433.V282276.R01.S.doc Version 5.1 Page 10 The inspector was satisfied that there is an induction process that enables residents to settle in the home. Homefield Court DS0000017433.V282276.R01.S.doc Version 5.1 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Monthly reviews of residents ensured that their changing needs were being met. The health care needs of residents as identified in their care plans are individually addressed. EVIDENCE: The three care plans examined showed monthly management reviews and included: details of resident’s social skills, care needs, personal hygiene, mobility care needs, choice of activities and interests. Although the care plans are more comprehensive following the requirements of the last inspection more work is needed to help ensure that each care plan is appropriately linked to individual care needs assessment and includes residents’ mental, religious and emotional needs. Each resident is registered with a general practitioner (GP) and some have chosen to remain with the GP they have had for many years. Four GPs visit the home on a regular basis. In addition, residents are supported to access dental service every six months either at the home or visits to local surgery. Homefield Court DS0000017433.V282276.R01.S.doc Version 5.1 Page 12 The residents also receive support to access chiropody service and the district nurse visits the home twice each week. The home has good links with the local Central Middlesex Hospital and also benefit from access to emergency medical services when needed. The manager assisted the inspector with reviewing the medication administration at the home. No resident self-medicates. Homely remedies such as “Paracetemol should only be administered on prescription by the GP. There were residents’ photographs on 5 of the MAR files checked. A local pharmacist visits the home and carries out an inspection of the medication every 3 months. This practice is part of the local area Primary Care Trust community outreach service. The last inspection report by the pharmacist was satisfactory. The inspector spoke with 8 residents. They were unanimous in stating satisfaction with the care they received, the caring nature of staff and the helpful approach of the new manager. Homefield Court DS0000017433.V282276.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 The residents appeared to be able to exercise control over their lives. Residents have a varied and wholesome diet and were able to exercise choices in terms of menus. Group activities were provided as per the weekly programme. Links with advocacy support services require follow up. EVIDENCE: The home has a weekly activities schedule that included dominoes/bingo games, music movement, quiz/reminiscence sessions, board games and hairdressing/manicure treatment. The manager and deputy manager informed the inspector that residents have choices if they want to participate in some or none of the activities. A Physical activities coordinator started in January 2006 and there are 14 residents participating. There is a range of activities on offer everyday of the week. The manager informed the inspector of day and escorted shopping trips undertaken by some residents. This was confirmed by a resident. The inspection findings indicated that care plans now included the preferred activities of individual residents The care plan needs to specify the action that will be taken by staff to meet residents’ specific needs. Homefield Court DS0000017433.V282276.R01.S.doc Version 5.1 Page 14 The inspector examined the menu planning for meal times and was told by the manager this was done on a four weekly rotation, and that resident’s views are taken into account. The inspector observed two main meals being served by staff and was satisfied residents were given choices and in a few cases, staff were willing to prepare different meals in response to residents’ requests. Two residents are able to have Carribean meals according to their choice. The inspector asked some residents their views on the quality and choices of meals offered to them. The general view was that choices were offered and they were generally satisfied most of the time. Special meals were available for residents who are diabetic or have other special dietary needs. There was recorded evidence to verify that many residents are supported to maintain and cultivate contacts with their relatives and friends outside the home. The inspector noted that a few residents had visits from relatives during the inspection process. The deputy manager gave examples of successful efforts made on behalf of residents to trace estranged relatives and family members. The manager stated that he had made contact with the local borough advocacy services and is still awaiting a response. Homefield Court DS0000017433.V282276.R01.S.doc Version 5.1 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): This standard was not inspected. EVIDENCE: Homefield Court DS0000017433.V282276.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The manager has generally implemented requirements to ensure that service users live in a safe environment but more work is required.. EVIDENCE: A programme of general maintenance has been implemented following the requirement from the last inspection. Upgrading and renovation work has been undertaken as follows: the grounds, communal carpets, windows, kitchen area, guttering and some bathrooms. The patio has been extended and tarmaced. The lawn was well maintained. The residents could safely use all areas of the garden. There is an ongoing programme of carpet renewal and residents choose the colour and the carpet in their rooms. Some of the radiators throughout the building needed protective covering and thermostat valves. There was an outstanding requirement from the last inspection relating to the environmental Health inspection. This took place in November 2005. The provision of a fly screen had not been implemented. Homefield Court DS0000017433.V282276.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29, &30 The home had adequate mix of staffing with the necessary skills and experience to meet the needs of the residents. Good effort is been made to provide appropriate training to staff. EVIDENCE: The inspector noted that on each day shift, there are normally 3 care staff plus either the deputy or manager. There are normally two care staff on the night duty shift. This staffing complement appeared satisfactory to support residents and meet their individual care needs. Twelve staff have completed the NVQ level 2 training and 3 staff are currently doing level 3. In addition, staff have undertaken training in medication and a range of statutory training courses in areas such as health and safety, manual handling and first aid. The home will need to ensure that all staff are provided with training in the protection of Vulnerable adults(POVA). All of the residents interviewed stated that they were well cared for and had confidence in the skills of staff. All staff had completed necessary checks for employment to ensure residents’ well being. Homefield Court DS0000017433.V282276.R01.S.doc Version 5.1 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 and 38 Service users benefit from a well managed home where the manager and staff work together to promote the welfare of residents. The manager is addressing further areas such as Health and Safety and training of staff, which will help enhance the quality of life of residents. EVIDENCE: The manager has been managing the home since April 2005. He has over 10 years work with older people in residential settings, including 5 years as a carer. He has also worked in residential care settings as a team leader, deputy manager, health & safety coordinator and statutory trainer. He is currently undertaking the registered manager’s awards training. Several residents and staff told the inspector they are satisfied with the manager’s approach and operational plans for the home. Their views Homefield Court DS0000017433.V282276.R01.S.doc Version 5.1 Page 19 suggested the manager has been making positive changes to develop the service, with input from staff and residents. The menu has been altered to include more choices and includes culturally appropriate meals. The manager confirmed that he has a monthly supervision meeting with the proprietor but there were also regular meetings between them when necessary. The manager has established a formal programme of supervision sessions and appraisals for each staff. The information provided by the manager indicated that 2 residents manage their own finance with assistance from staff and the home manages the finances of 3 residents. Five residents have Court of Protection through Social Services. A further 10 residents reportedly have assistance from their next of kin/relatives to manage their finance. Work has progressed on maintaining Health and Safety of residents and staff. A monthly audit of health and safety was seen. Further work is required to ensure the safety of residents and staff. A full review and assessment is required of all working areas, practices and systems. Homefield Court DS0000017433.V282276.R01.S.doc Version 5.1 Page 20 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 2 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x 2 3 2 3 3 3 2 3 STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 x x 2 Homefield Court DS0000017433.V282276.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? Homefield Court DS0000017433.V282276.R01.S.doc Version 5.1 Page 22 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 4,5,6,Sch 1and 4 Requirement The registered person must ensure that the service user’s guide is updated and contains information about how the religious needs of residents will be met. The guide should give full details of the staffing and management including the names and professional experiences of the key staff The registered provider must ensure that each care plan is appropriately linked to individual care needs assessment and includes residents’ mental, religious and emotional needs. The registered person must ensure that homely remedies such as “Paracetemol”.is only given to residents when prescribed by the GP. This must be recorded on the MAR sheet The care plan needs to specify the action that will be taken by staff to meet residents’ specific needs. The registered provider must ensure that all radiators are fitted with protective covering and thermostat valves. The registered provider must ensure that the requirement from the last environmental Health inspection.in November 2005 relating to the provision of a fly screen is implemented. Timescale for action 31/05/06 2 7 12 and 16 31/05/06 3 9 Schedule3 28/02/06 4 12 12 and 16 31/05/06 5 20 16 31/05/06 6 20 16 31/05/06 7 38 13, 23 Homefield Court . The registered provider must 31/05/06 DS0000017433.V282276.R01.S.doc Version 5.1 Page 23 ensure the safety of residents and staff is enhanced. A full review and assessment is required of all working areas, 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 Homefield Court DS0000017433.V282276.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Homefield Court DS0000017433.V282276.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!