Inspection on 17/06/05 for Homemead

This inspection was carried out on 17th 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 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

Homemead 17/07/08

Homemead 09/10/07

Homemead 12/09/06

Homemead 24/01/06

Homemead 28/09/04

Homemead 14/05/04

Homemead 26/02/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Homemead 28 Park Road Teddington Middlesex TW11 0AQ Lead Inspector Simon Smith Unannounced 17 June 2005 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. Homemead G54-G04 S17373 Homemead V234810 140605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Homemead Address 28 Park Road Teddington Middlesex TW11 0AQ 020 8977 5002 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) Central & Cecil Housing Trust Ms Carmel Regan Care Home 29 Category(ies) of Dementia - over 65yrs of age (DE(E)) registration, with number of places Homemead G54-G04 S17373 Homemead V234810 140605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Care is provided for one named person, aged 63years, until she reaches the age of 65 years old. Date of last inspection 28.9.04 Brief Description of the Service: The service is operated by the Central and Cecil Housing Trust, a not-for-profit provider. The home provides accommodation for a maximum of twenty-nine older people who may have dementia. Staff support is available to residents twenty-four hours a day. The home is situated in a residential area of Teddington. The nearby high street provides a range of community facilities, such as shops, banks, pubs and restaurants. Bushy Park is a short walk away and the River Thames is close by. The Central and Cecil Housing Trust’s mission statement reads as follows: “We aim to maintain and improve the quality of life, independence and dignity of all within our care by providing comfortable, secure homes in an environment of support”. Homemead G54-G04 S17373 Homemead V234810 140605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over the course of a single afternoon and involved discussion with twelve residents, a visiting relative, the manager, deputy manager and members of the staff team. A sample of records was examined and a tour of the premises made. Two staff files were inspected. The inspector was made welcome throughout the visit and wishes to acknowledge the time and consideration that residents, visitors, the manager and staff provided during the course of the inspection. The home met 17 of 20 National Minimum Standards assessed at this visit. Three Standards were almost met. Six Requirements were made, one of which was reinstated from the last inspection of the home in September 2004. There were enough staff on duty to meet residents’ needs. Staff interacted positively with residents and encouraged them to make informed choices where possible. Staff on duty knew residents well and had a good awareness of their needs. Residents’ are supported to access specialist healthcare resources if they need them and the home works well with community health professionals. The inspector spoke with one relative who was visiting her mother. The visitor spoke highly of the manager and staff, reporting that they have good awareness of her mother’s needs and keep her family informed of important events. Residents said that they valued many aspects of life at the home, including the care provided by staff and the programme of activities. One resident commented of staff, “They look after us very well”. Residents said that staff listen to them and were confident that any complaints they made would be taken seriously. No residents raised any concerns during the visit. The home provides a good range of in-house activities and occasional outings. A vehicle is available for trips out and the home is trying to identify additional volunteer drivers. Residents confirmed that they are able to have visitors whenever they wish and that their friends and families are made welcome by staff. The inspector shared lunch with four residents, who clearly enjoyed the food provided. Residents have access to a large communal lounge and a separate dining room. Most residents chose to eat lunch in the dining room and take tea in the lounge, although are able to eat where they wish. The garden is now more accessible and a number of residents chose to spend time in this area during the inspection. Residents’ bedrooms reflected their preferences and residents are encouraged to bring personal items with them when they move in. The Homemead G54-G04 S17373 Homemead V234810 140605 Stage 4.doc Version 1.30 Page 6 home provides a salon for the visiting hairdresser. Standards of health and safety need to improve in this area to ensure the safety of residents. The manager is experienced and clearly knows the home and residents well. Staff said that the manager is approachable and supportive. Good systems of support are in place for staff. New staff receive an induction to the home and to the organisation. All staff receive individual supervision from their managers but records indicated that these sessions do not take place as often as they should. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Homemead G54-G04 S17373 Homemead V234810 140605 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 Homemead G54-G04 S17373 Homemead V234810 140605 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, 5, 6 Prospective residents are given the information they need to make a decision about moving into the home. Prospective residents and their families are able to visit the home prior to admission to establish its suitability. EVIDENCE: The home makes available good information about the services it provides. All prospective residents are afforded the opportunity to visit the home prior to moving in. Admissions are made initially on a trial basis. A formal review is held at the conclusion of this period. The home does not admit residents for intermediate care. Homemead G54-G04 S17373 Homemead V234810 140605 Stage 4.doc Version 1.30 Page 9 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) 8, 10 Residents’ healthcare needs are met. Residents are able to access to specialist healthcare resources where necessary. Residents’ privacy and dignity are respected and maintained. EVIDENCE: All residents are registered with a general practitioner locally. Records showed that other healthcare professionals, such as physiotherapists, chiropodists and opticians, visit the home where necessary. District nurses provide support to the care staff team in managing some healthcare conditions experienced by residents. District nurses are also able to make referrals to specialist community health services if necessary. Staff were observed to maintain the privacy and dignity of residents throughout the inspection. Personal care needs were met promptly and with discretion. Staff knocked before entering private accommodation and addressed residents with respect. Residents spoken to during the inspection confirmed that their opinions are sought by staff on issues that affect them. Homemead G54-G04 S17373 Homemead V234810 140605 Stage 4.doc Version 1.30 Page 10 Residents and their families are encouraged to attend resident/relative meetings (held three times each year) and three catering meetings, attended by the chef manager, provide opportunities to discuss and influence the home’s menu. Homemead G54-G04 S17373 Homemead V234810 140605 Stage 4.doc Version 1.30 Page 11 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, 13, 15 The programme of events and activities is stimulating and varied. Residents receive good support to maintain links with their friends and families. Residents enjoy the food provided by the home and are involved in developing the menu. EVIDENCE: The home provides a good range of in house activities and occasional trips to places of interest. One member of care staff is allocated to arrange the activity programme, which is supplemented by volunteers. The activity programme included two day trips to Bognor. Shorter trips are arranged to Bushy Park on a regular basis. The home’s summer fair was due to take place the day after inspection. Residents were clearly looking forward to this annual event, as it formed the focus of much conversation during the inspection. The home has an allocated vehicle, which is used to facilitate trips in the local community. However the manager advised that a lack of authorised drivers currently limits the use of the vehicle. It is recommended that the home continue its attempts to recruit additional drivers in order to increase opportunities for outings. Homemead G54-G04 S17373 Homemead V234810 140605 Stage 4.doc Version 1.30 Page 12 All residents spoken to during the inspection confirmed that they are able to receive visitors in the home whenever they wish and that their friends and families are made welcome by staff. One relative, visiting her mother on the day of inspection, confirmed that she is able to visit at any time and is kept informed of important events concerning her relative. The inspector shared lunch with three residents, who reported that the food at the home is consistently good and that they are consulted about the menu. Residents were offered alternatives to the published menu at lunchtime where necessary. The food served at the home is provided by a contract caterer employed by the Central and Cecil Housing Trust. Homemead G54-G04 S17373 Homemead V234810 140605 Stage 4.doc Version 1.30 Page 13 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 The Complaints procedure is clear and readily available. Residents feel that any complaints made would receive an appropriate response. EVIDENCE: The home has a clear Complaints procedure, including timescales for action and response. The system for the management of complaints is clear and the Complaints procedure is available in a number of locations around the home. A record of complaints received is maintained. Residents spoken to during the inspection confirmed that they felt any concerns raised by them would receive an appropriate response from the home. Homemead G54-G04 S17373 Homemead V234810 140605 Stage 4.doc Version 1.30 Page 14 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, 23, 24, 25 The home is attractively decorated, homely and secure. Indoor and outdoor communal spaces are welcoming and well used by residents. Residents’ bedrooms reflect their individual tastes and interests. EVIDENCE: The home is situated in a residential area of Teddington. The nearby high street provides a range of community facilities, such as shops, banks, pubs and restaurants. Bushy Park is a short walk away and the River Thames is close by. On street parking around the home is limited, but visitors’ parking is available outside the property. The front door of the home is controlled by a keypad entry system for the security of residents. Wheelchair access is available to the side of the building. The home has a passenger lift. A handyman is employed one day each week to Homemead G54-G04 S17373 Homemead V234810 140605 Stage 4.doc Version 1.30 Page 15 attend to non-urgent, minor repairs. The home has dedicated laundry and drying rooms, including sluice facilities. The home has a large communal lounge and separate dining room. Work had been carried out to improve the accessibility of the garden since the last inspection. This area was well used by residents on the day of inspection. Residents’ bedrooms were personalised and reflected the tastes and preferences of their occupants. A number of bedrooms contained evidence of hobbies and interests. Residents are encouraged to bring personal items, including furniture, with them on admission. Three shared bedrooms are available on the ground floor of the home. A hairdressing salon is provided in the home. The salon was unlocked at the time of inspection and thus accessible to residents. A number of items in the salon required attention to ensure the health and safety of residents. These issues are addressed in Standard 38 of this report. Two radiators in the home were not covered to ensure residents’ safety. One was sited adjacent to the back door of the home, the other in the communal lounge. See Requirement 1. Homemead G54-G04 S17373 Homemead V234810 140605 Stage 4.doc Version 1.30 Page 16 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, 29 The number and skill mix of staff was appropriate at the time of inspection. Residents are happy with the care provided at the home. Residents are protected by the home’s recruitment practices. EVIDENCE: Staff were available in sufficient numbers to meet the needs of residents during the inspection. Staff interacted positively with residents throughout the visit, actively seeking their opinions and preferences and engaging them in a meaningful way. Residents and visitors spoke highly of staff and the care they provide. At the time of the last inspection the home had a high number of staff vacancies. The manager advised that a number of staff had been appointed in recent months, including two who had started work in the last month. The manager reported that this has enabled improved continuity of care for residents. In addition to the permanent staff team the home employs four staff on a ‘bank’ basis who work regularly at the home. The manager confirmed that bank staff are recruited according to the home’s recruitment procedures. All new starters receive an induction to the organisation and the home. The probation period for new staff is six months. Homemead G54-G04 S17373 Homemead V234810 140605 Stage 4.doc Version 1.30 Page 17 Two staff files were examined during the inspection. Both contained evidence of appropriate recruitment procedure including application form and interview. The home has a long-standing arrangement with an organisation that arranges overseas volunteer placements. The manager advised that volunteers are usually involved with serving food and assisting with residents’ outings and are not involved in the delivery of personal care. This was confirmed by the Head of Human Resources at the Central and Cecil Housing Trust, who reported that volunteers’ contracts clarify that their role precludes the delivery of personal care. Homemead G54-G04 S17373 Homemead V234810 140605 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, 32, 36, 38 The manager provides appropriate leadership and interacts well with residents, visitors and staff. Systems of support for staff are in place but supervision sessions must take place more regularly. Standards of health and safety in some areas must improve to ensure the safety of residents. EVIDENCE: The home’s manager is experienced and has achieved relevant qualifications including the Registered Managers Award, NVQ level 4 and a Certificate in Management Studies. A registered nurse, the manager demonstrated a good knowledge of the home and individual residents. Staff spoken to during the inspection confirmed that the manager is approachable and supportive. The Homemead G54-G04 S17373 Homemead V234810 140605 Stage 4.doc Version 1.30 Page 19 manager advised that she meets her line manager monthly for support and supervision and that she attends monthly managers’ meetings. Staff are offered support in their roles through bi-monthly supervision sessions with their line managers. These sessions provide staff with the opportunity to address issues such as training, keyworking and any issues affecting residents. Staff files indicated that these sessions had not been taking place as frequently as required. See Requirement 2. The fuse box situated in the hairdressing salon had last been checked in May 2003 and needs retesting to ensure its safety. See Requirement 3. The fire extinguisher in the salon had last been checked in January 2003 and requires retesting to ensure it is fit for purpose. A cord was attached to the fire extinguisher, rendering it inaccessible in an emergency. See Requirement 4. A number of electrical items in the salon appeared very old and showed no evidence of portable appliance testing. See Requirement 5. The hot water temperature in the salon basin was very high and would present a risk of scalding given prolonged exposure. See Requirement 6. Homemead G54-G04 S17373 Homemead V234810 140605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x x x 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 x x 3 3 2 x STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 x x x 2 x 2 Homemead G54-G04 S17373 Homemead V234810 140605 Stage 4.doc Version 1.30 Page 21 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. 2. 3. 4. Standard 25 36 38 38 Regulation 12(1) 13(4) 12(5) 17(2) 13(4) 23(2) 13(4) 23(4) Requirement Ensure that all radiators are guarded to eliminate the risk of scalding. Ensure that supervision sessions take place with the required frequency. Arrange for testing of the fuse box situated in the hairdressing salon. Arrange for testing of the fire extinguisher situated in the hairdressing salon. Ensure that fire fighting appliances are accessible and free of obstruction. Arrange testing for electrical items situated in the hairdressing salon. Ensure that water temperatures do not present a risk of scalding. Timescale for action 30.08.05 30.08.05 30.08.05 30.08.05 5. 6. 38 38 13(4) 23(2) 13(4) 30.08.05 30.08.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Homemead Refer to Standard Good Practice Recommendations G54-G04 S17373 Homemead V234810 140605 Stage 4.doc Version 1.30 Page 22 1. 12 Continue attempts to recruit additional drivers in order to increase opportunities for outings. Homemead G54-G04 S17373 Homemead V234810 140605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 Homemead G54-G04 S17373 Homemead V234810 140605 Stage 4.doc Version 1.30 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!