Inspection on 26/09/07 for Hotel in the Park

This inspection was carried out on 26th September 2007.

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 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

Hotel in the Park 22/05/06

Hotel in the Park 26/01/06

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

CARE HOME ADULTS 18-65 Hotel in the Park 130 Sewardstone Road Bethnal Green London E2 9HN Lead Inspector Anne Chamberlain Unannounced Inspection 26th September 2007 10:20 Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 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 Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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. Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hotel in the Park Address 130 Sewardstone Road Bethnal Green London E2 9HN 0208 983 1394 020 7267 9099 hotel@camdensociety.co.uk 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) The Camden Society Miss Sandra Gustave Care Home 7 Category(ies) of Learning disability (7), Physical disability (7) registration, with number of places Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd May 2006 Brief Description of the Service: Hotel in the Park is a respite service for adults who have learning disabilities. It offers 7 beds and is managed by the The Camden Society. The hotel offers short and longer breaks up to a maximum of around six weeks per year, for each person. The premises are fully adapted for disability and all the bedrooms single and double, are en-suite. There is a comfortable lounge, stylish dining room and a large garden with outdoor garden furniture. The hotel is situated in a quiet street in Bethnal Green, adjacent to a large and beautiful park, and close to Cambridge Heath Road and good transport links. The building is owned by the London Borough of Tower Hamlets and there are offices on the second floor which are currently empty. The London Borough of Tower Hamlets has a block booking with The Camden Society for the rooms in the hotel, and is charged a unit cost of £205 per night by them. Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The service submitted an Annual Quality Assurance Assessment (AQAA) prior to the site visit by the inspector. This contained useful information and evidence. The aim of the unannounced inspection was to test the key standards and compliance with previous requirements. The inspector spent six hours at the service. She viewed the files of three guests and looked at their medication arrangements. She viewed key documentation, policies and procedures, and made a tour of the building. The inspector spoke briefly with residents and exchanged greetings with staff. She also contacted a person who knows the service well who gave her feedback. The inspector would like to take this opportunity to thank the guests, manager and staff for their assistance and co-operation with the inspection. The inspector came to the hotel to look at the service and to talk with guests, staff and the manager. What the service does well: The hotel offers a very specialised respite service. It is equipped to support people with quite severe physical disabilities and workers have the skills to support people who have challenging behaviours. The hotel is well managed. The management systems are developed and effective. Paperwork is clear and unambiguous. The guests files are very tidy and well maintained. The environment is welcoming, fresh and clean. The bedrooms are quiet and restful and the communal rooms are attractive. The garden is tidy and inviting. Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 6 Guests at the hotel have opportunities to do many activities. A stakeholder said Folk get a lot of activities when they are there. The hotel can accommodate people with all kinds of needs….. and they get a chance to do lots of different activities. The inspector thought people were getting a good service at the hotel. What has improved since the last inspection? The hotel has responded well to previous requirements and none have been restated. The hotel has a cleaner and gardener in post now. This frees staff up to spend quality time with guests. A trampoline has been set up in the garden. Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 7 Female only weekends have been developed and are proving very successful. The hotel has its own chef now…….. and its own cleaner who keeps it looking really nice. What they could do better: The inspection resulted in two legal requirements and two good practice recommendations. The management of medication is not easy in a respite situation and generally the hotel copes well. However a requirement and a recommendation have been made to improve practice. The recording of some safety checks has been omitted and a new chair is needed to replace a very shabby one. Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 8 The inspector said that people must take their medication home with them….. and that a new chair was needed in the reception office. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Guests experience good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Assessment of persons referred is thorough. EVIDENCE: The manager explained to the inspector the process which she goes through with new referrals. The inspector saw on guests files the paperwork which is completed. She felt that assessment is thorough and adequate. She was however, concerned to hear that there had been an occasion this year when the manager was coerced into receiving into the home an individual about whom she had no information. This is poor practice which compromises safety, and the inspector trusts will be an isolated incident. Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. Guests experience good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Service users needs are well reflected in their individual working practices. Risks are properly assessed and guests are supported and encouraged to make choices. EVIDENCE: Guests all have in their files a document called working practices. This guides carers in their needs, likes and dislikes. The manager stated in the AQAA that the working practices are updated no less than once in twelve months or after any significant change. This was borne out in the guests files. The manager stated that activities at the hotel are planned in a person centred way. Guests are asked to indicate what they would like to do whilst they are Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 12 there. Sometimes there may not be an opportunity at a particular visit so carers make a note for the next time the person stays. In this way guests are encouraged to make decisions. They also decide what they would like to eat and whether or not they choose to join in with an activity. This was verified by the inspector with the guest monitor sheets which record what guests have done during their stay. The service undertakes risk assessments for individuals, for example for epilepsy, and general risk assessments of hazards which are common to all, like fire. The inspector noted the indivdual assessments on guests files. The manager stated that she controls risk by taking into account the behaviours of guests when booking them. In this way carers can manage the needs presented. The manager said she is sometimes put under pressure to accommodate individuals against her better judgement. She resists this as safety is her prime concern. Some guests need one to one provision and this is provided. Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17. Guests experience good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Guests participate in appropriate recreation and leisure activities in the community and the hotel. They enjoy a healthy diet in pleasant surroundings. EVIDENCE: The hotel does not provide a service during the day. Guests have alternative day time provision. However at times arrangements fail and guests are collected late for day services, or are without services in holiday periods. The hotel then provides creatively within their budgetary constraints. The hotel and funders need to be clear on what basis guests are staying. The inspector suggested a contracts meeting between the hotel and the funders might be fruitful in clarifying these issues. Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 14 Guests undertake a number of leisure activities in the community, including bowling, cinema, free London events, theatres and trips to the seaside. They also attend Bubble club and Octopus club and go shopping. The inspector saw evidence of these activities in the guest monitoring sheets, in photographs and on the activity noticeboard. Guests also watch films at home, play snooker and other games, interact and engage together in the home. Whilst she was inspecting she observed a guest playing snooker with a carer and another guest enjoying the garden. They both seemed very relaxed in the hotel. Families can call guests on the telephone and may visit, although late night visits and large family groups are not encouraged. Meals are taken in the stylish dining room. Keyworkers are consulted about what foods their guests particularly like and any religious or cultural needs. The hotel employs a chef and the inspector met him. This releases staff from cooking to give guests their full attention. Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Guests experience good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Personal support is provided in a sensitive, personalised manner. Physical and emotional needs are met. Medication is safely administered but practice can be improved. EVIDENCE: As previously stated the working plans ensure that guests receive their personal care in a way which suits them. The carers also have operational guidelines which are a set of policies about how to do things. The manager stated that the ethos of the hotel is to support independence and this is integrated into all care tasks. Work is also underpinned by health and safety guidelines and manual handling training, which all staff undergo. As previously mentioned the hotel is fully adapted for disability. The manager stated on the AQAA that guests have regular medication reviews, either in the community or at the hotel. A psychiatric nurse calls regularly. Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 16 Some guests have no health issues, others have complex health needs. The inspector noted copies of health action plans on guests files. She felt that carers support the physical or emotional needs of guests. The inspector viewed the arrangements for the administration of medication. The hotel has a medication policy. They also keep a folder of medicine administration record (MAR) sheets for current residents, which the inspector viewed. The inspector was satisfied with the system for the administration of medication. However there were preparations in the medication cabinet which should have been sent home with guests when they left. The home must not store medications for guests (see requirements). The inspector noted that on carer has not added his specimen signature to those already at the front of the medication folder, and this should be done (see recommendations). Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Guests experience good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The complaints procedure is accessible. Complaints are dealt with professionally. Guests are protected and safeguarded from abuse. EVIDENCE: The inspector viewed the arrangements for complaints. The policy has clear stages and timescales. The inspector understands that the service manager has recently changed and pointed out to the manager that her photographs would need to be changed in the information. The complaints form was clear. A log is kept of complaints and the inspector was pleased to see that the complaints procedure is being used. She read through the most recent complaints and felt that the forms were well designed. They included space to record follow up actions. The manager is dealing with complaints in a professional way. The inspector viewed the adult protection policy. This is kept in the operational guidelines and also in a file on its own as a preface to the local authority policy. The policy makes it clear that the local authority policy must be followed in conjunction with the organisational policy. Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Gusts experience good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The hotel is bright, comfortable, and maintained at a good standard of hygiene and cleanliness. EVIDENCE: Over the three site visits the inspector has made to the service, the standard of the environment has remained high. The décor is fresh, the bedrooms comfortable and the communal areas modern and stylish, particularly the dining room. The furnishings at the home are generally good but a new chair is needed in the reception office (see recommendations). Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 19 The hotel is clean and hygienic with no unpleasant odours. Cleaners are employed and the inspector felt that this ensures that standards do not fall, and that carers can dedicate themselves fully to the guests. There is some laundering of foul linens and this is done separately on a high temperature wash. The laundry room also has a sluice and an impermeable floor. The manager stated that carers have had infection control training recently, and understand the need for gloves aprons and hand washing. Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35. Guests experience good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Levels of skills and experience in the staff team are satisfactory and the recruitment process is sound. The staff are well trained. EVIDENCE: Unfortunately it was not possible to access staff personnel files on the day of the inspection. The manager accessed a variety of other sources to assist the inspector with information. The manager stated that recruitment includes an application form, job descriptions, person specification, equal opportunities interview, two professional references and a Criminal Records Bureau (CRB) check. The manager stated on the AQAA that the hotel has employed a diverse team of carers. The inspector noted on the operational guidelines sections on antidiscriminatory practice, religious beliefs and cultural needs. The inspector believes that the hotel is taking these matters seriously, and staff awareness is high. Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 21 The manager stated that the percentage of carers with NVQ 2 or above is around 50 . Two carers have NVQ 3. New carers are expected to be willing to undertake NVQ studies. The manager further stated that she is now on the interview panel for new carers and questions previous experience and existing skills. New carers receive induction training and are on probation for six months. The manager stated that the following are considered to be core training, refreshed each year: First Aid, Epilepsy, Fire, Food Hygiene, Medication, Health and Safety, Risk Assessment, Mental Health and Protection of Vulnerable Adults. She said that the organisation is extremely organised in its approach to training and individuals do not fall behind with training. Free training provided by the local authority is also accessed. The manager said that she aims to supervise carers every six weeks and carers also have annual appraisal. The inspector viewed the form which is used for supervision. It has a good format. She also viewed a completed supervision form for a carer, and for the manager. Based on the above evidence the inspector felt that carers at the hotel are well trained and supervised. Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42. Residents experience good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The hotel is very well run. Health and safety are promoted, but quality assurance could be developed further. EVIDENCE: The manager said that she is now registered with the Commission for Social Care Inspection (CSCI) and indeed her name appears on the registration certificate. She further stated that she is currently undertaking the Registered Managers Award. Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 23 The inspector viewed some surveys returned by guests. These were user friendly and indicated a high level of satisfaction. She also saw a very nice handmade card from a service user, saying how much he liked the hotel and everyone there. The inspector suggested that rather than complete the surveys at the hotel, the guests might be assisted at their day centres or by someone within their social network to complete the forms. This might improve the objectivity of the exercise. Aside from this, quality assurance is expressed by families with gifts of chocolates for the staff and kind comments on the telephone and in person. The inspector suggested that the hotel should record these expressions of appreciation but also devise another way of measuring quality assurance (see recommendations). The inspector viewed the records of fire protection. There is a fire risk assessment and a fire safety policy, also a generic fire risk assessment. The outside contractor visited to check the system on 18/8/07. Fire alarms and doors were checked by staff on 9/7/07. The manager said that the emergency lighting is checked but the person doing it had not completed the boxes to show it had been done. This must be done for a full record (see requirements). Fire drills are carried out regularly. The inspector viewed the arrangements for the Control of Substances Hazardous to Health (COSHH). The substances are stored appropriately in a locked cupboard in the laundry room. The manager has a file with product information for each preparation. The inspector viewed the accident and incident file. She noted that accidents are recorded clearly in a purpose made book. Incident sheets are completed and the inspector noted that staff fairly frequently suffer injury from the challenging behaviour of guests. This underlines the importance of the managers discretion over the mix of guests staying in the hotel at any one time. Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 x 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 3 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x 3 x x 3 x Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO NO 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. Standard YA20 YA42 Regulation 13 23 (4) Requirement Timescale for action 01/11/07 The hotel must not store surplus stocks of medication for guests. Emergency lighting must be 01/11/07 checked regularly and the checks recorded. 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. 2. Refer to Standard YA20 YA24 Good Practice Recommendations The list of specimen signatures at the front of the medication folder should include all of the carers. A new chair is needed in the reception office. Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hotel in the Park DS0000063544.V345459.R01.S.doc Version 5.2 Page 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. 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. 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