Inspection on 06/02/09 for Huguenot Place

This inspection was carried out on 6th February 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Huguenot Place 06/02/07

Huguenot Place 23/02/06

Huguenot Place 03/08/05

Huguenot Place 17/02/05

Huguenot Place 24/06/04

Huguenot Place 04/12/03

Similar services:

Foxley Lane (121a)

Avenues (The) (Neave Crescent)

Banstead Road South (21)

Rela Goldhill Lodge

RNID

Therapia Road, 26

Annaly House

Wick Road ( 302, Flat 1 & 2)

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Huguenot Place 6 Huguenot Place London SW18 2EN     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: Louise Phillips     Date: 0 6 0 2 2 0 0 9 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. that people have said are important to them: They reflect the things 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 Adults (18-65 years) 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 Adults (18-65 years) Page 2 of 28 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 Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Huguenot Place 6 Huguenot Place London SW18 2EN 020-88770518 02088712684 ssmith@servitehouses.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Riverhaven care home 5 Number of places (if applicable): Under 65 Over 65 0 0 mental disorder, excluding learning disability or dementia sensory impairment Additional conditions: 5 5 One named male service user aged over 65 years Date of last inspection Brief description of the care home Huguenot Place is a care home for up to five adults who have a mental health problem and also a hearing impairment. The home is situated on a main road within walking distance of Wandsworth shopping centre and the public transport links served by the area. Accommodation at the home is provided over three floors, with individual bedrooms, laundry area, lounge and kitchen/ dining area. There is also a wellmaintained patio garden to the rear of the property. Care Homes for Adults (18-65 years) Page 4 of 28 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection took place over one day and included a visit to the service by a Regulation Inspector. When we visited we spoke to people who live and work at the home and the manager. We also looked at records, observed what was going on and looked at the environment. At the time of the inspection there was a vacancy at the service, so we sent surveys to the four people who currently live there, and they all responded to us. Since the last inspection the Registered Manager has been on long term leave and a agency manager was managing the service when we visited. She had been in the position for approximately six weeks, and is referred to as the manager in this report. Care Homes for Adults (18-65 years) Page 5 of 28 Care Homes for Adults (18-65 years) Page 6 of 28 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 Adults (18-65 years) Page 7 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 28 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. There is relevant information obtained about people prior to their moving to the service, and relevant assessments carried out. This helps to ensure that the service is the right place for people to move to. Evidence: At the time of inspection four people were living at the service. Some have been living there for many years, whilst other people had moved in more recently. We looked at the admission information for one person and saw that it contained details about their personal history such as significant life events, their family, interests and hobbies. Information was also recorded about how they like to spend their time during the week. Prior to moving to the service an initial assessment had been carried out describing their independence in areas, any personal hygiene needs and their mental health symptoms and behaviours associated with this plus information received from their Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: care manager. People are invited to spend days and overnight visit at the home to help decide whether they want to move to Huguenot Place An assessment for admission form had been completed by their keyworker at the service, which covered all activities of daily living, such as communication needs, medication and areas of rehabilitation. Care Homes for Adults (18-65 years) Page 10 of 28 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements are needed to the care planning for people who use the service. The implementation of a more person-centred approach will enhance the care planning and focus more on the aims of people who live at the home. The risk assessments are detailed and relevant to ensure risks to people who use the service are minimised. Evidence: Each person who uses the service receives support on an individual basis and observations during the inspection are that they have positive relationships with staff. Feedback from people who use the service are that they feel the staff treat them well and generally listen to what they say. We looked at the care files for two people who use the service. Each person has a care plan that is reviewed monthly, which is signed by them and their keyworker, who oversees their care and support at the home. The information in these is at times quite Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: brief, and more information is needed around the agreed action for needs identified under the headings aims and objectives. An example of this is the care plan for one person is around their budgeting, with the aim for them to be independent in this. The agreed action for this states staff to assist in money management and payment of rent, which does not give any indication how the persons independence in this is to be achieved, or steps taken towards this. Similarly, an agreed action in a care plan for cooking says for the person to prepare (their) own meals weekly and to do shopping, which is an aim, not a detailed action. Even though these are reviewed monthly, it is unclear how they are reviewed, and whether all the care plans are looked at as part of this process. This is because for one person, their care plan for activities says about the involvement of the activities worker in one-to-one work, yet there is currently no activity worker at the service. We were informed that they left this position approximately three months previously. Whilst there are care plans for each person, and these are reviewed regularly, the areas highlighted above indicate that further work is needed to ensure these are appropriately detailed, and up-to-date. A person-centred approach needs to be introduced at the service, and this needs to be developed into the care plans, to ensure that they meet peoples rehabilitative aims and independence needs. The manager said that this is something that she is planning to implement at the service. The care files are stored in large folders on a shelf in the office at the service. It is recommended that these are stored in a lockable cabinet to maintain confidentiality at all times. Thee are individual risk assessments for each person, and these were seen to have been updated regarding any recent incidents that they had been involved in, or safety needs identified. Risk assessments are also in place regarding significant safety factors in each persons history, which staff need to be aware of and support the person with. The risk assessments are in a good format and well detailed to ensure that risks to people who use the service are minimised. Care Homes for Adults (18-65 years) Page 12 of 28 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 use the service are able to pursue individual activites. Consideration should be given to the service offering more group-based activities, if people who use the service wish. Evidence: Whilst at the service we observed the people who live there carrying out their daily lives, requesting support from staff as necessary. When we arrived some people had already gone out for the day, whilst one was still in bed and others coming and going as they pleased. One person spoken to said that they enjoy living at Huguenot Place and that they are able to visit friends and go out to the pub when they want to. Feedback from our surveys indicate that people are able to make decisions about what they do each day, and can generally do what they want in the evenings and at weekends. Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: As stated earlier, the activity care plan in peoples care files highlights the involvement of an activity worker, who we have been informed no longer works at the service. The manager said that this has had an impact on one-to-one work that people used to have, but that the staff at the service do try to continue this. Records indicate that activities over the past year have taken place at the service, such as a barbecue, day trips and an art workshop. However, since the activity officer left, there are no records of such events having taken place, and no current future plans for similar activities. This is reflected in the activity record, held in each persons care file, which was seen to include entries such as putting dishes in dishwasher, hospital appointments and emotional support. Such entries are not appropriate and should not be recorded as an activity, as they do not indicate the activity provision of the service. Instead, what should be recorded are the actual activities that people do, which the manager described as where one person goes to college, others see friends, artwork or going to the deaf club. During the inspection we also saw one person playing cards with a staff member. Most of the people who live at the service are independent in their daily lives, though occasional support is needed by one person, for safety reasons, when they are out, and the manager said that the service can accommodate this. Whilst being independent, people also contribute to the community living aspect of the service, and share the tasks of preparing dinner, laying up the dinner table and clearing up after meals. Feedback from people who use the service is that they like the food, and one person said that they particularly like that they can have sausages for breakfast. They said that they are able to prepare their breakfast and lunch, and evening meal if they do not want to eat the same as everyone else. Fresh fruit is available in the lounge area for people to help themselves to. A variety of food was observed in the fridge, freezer food cupboards and basement, and most were seen to be appropriately labelled with a use by date where they had been opened. Foods such as cereals, rice and pasta that have been decanted into alternative food containers must also be labelled with a use by date. Care Homes for Adults (18-65 years) Page 14 of 28 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 who use the service are able to have their physical, emotional and medical needs met through the service and its positive links with relevant professionals Evidence: Records are maintained of appointments that people who use the service have with their doctor, chiropodist, advocate and mental health professionals, as appropriate. The manager said that the service has developed good links with local deaf services, which benefits the people who use the service. We looked at the medication system in use at the service and found that this is being appropriately managed, with records maintained of medication received into the home and that which is administered. A photo of each person who receives medication is attached to the MAR (medication administration record) chart. During the inspection a discrepancy was identified on one medication chart, and this was rectified by the manager at the time. Similarly, it was found that staff were recording where PRN (as required) medication had not been given, which is unnecessary, as this need only be recorded when administered. Care Homes for Adults (18-65 years) Page 15 of 28 Care Homes for Adults (18-65 years) Page 16 of 28 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. The service has appropriate procedures for addressing complaints and minimising risks to people who use the service. Evidence: The service has a complaints procedure that is also available in pictorial format for easier access to users of the service. A complaint book is held to record any issues that are raised, and people who use the service say they know who to talk to if they are not happy about something. For each person who uses the service, there is a missing persons data sheet that contains a recent photo and description of them, along with details about their communication needs and any particular anxieties they may have, particularly if they are out on their own. There are risk assessment in place for hazards identified in the environment, along with some for everyday tasks, such as carrying shopping, personal safety and kitchen safety. The first aid kit held at the service is checked monthly, and regular health and safety audits are carried out, such as checking of fire exits, floor coverings, light fittings and outside areas. Records indicate that the fire alarm system and equipment is tested routinely inCare Homes for Adults (18-65 years) Page 17 of 28 Evidence: house, and by external contractors where necessary. There are policies and procedures informing staff of what they should do in the event of any allegations of abuse occuring at the service, and staff training records indicate that most staff have received recent training in safeguarding adults. Care Homes for Adults (18-65 years) Page 18 of 28 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 environment is welcoming, clean and homely in most areas, however some improvements are needed to ensure the safety and comfort of people who use the service. Evidence: All areas of the service are spacious, airy, clean and tidy. The layout of the service is homely and the communal areas accessible and comfortable. However, since the last inspection some areas are starting to look a bit tired and in need of updating. This includes the kitchen and the lounge area, which has stained carpet and the walls in need of repainting. The furniture in the lounge should be replaced, as they are mis-matching and do not promote a homely environment. The cupboard on the ground floor that contains the water heater needs to be kept locked at all times, as it contains exposed hot water pipes. Similarly, the exposed hot water pipes in the kitchen area need to be boxed in as they are a safety risk and unsightly. The flooring in the ground floor WC needs replacing, as well as the radiator, which has rust spots on it. Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: The worktop in the laundry area needs to be replaced as this is badly stained, and areas in the bathroom on the first floor need attention, such as the replacement of the broken door handle, replacement of stained flooring and the skirting board at rear of the sink. Care Homes for Adults (18-65 years) Page 20 of 28 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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. Risks to people who use the service are minimised through appropriate recruitment checks, though improvements are needed to ensure all staff are appropriately trained for their role. Evidence: The staff at the service have been working for varying periods of time, and staff feedback that they received an induction to their role, and that they feel there is good teamworking at the service. Two staff recruitment files were looked at during the inspection. these contain a checklist of information obtained in relation to the persons recruitment, such as references, identification and a Criminal Records Bureau (CRB) check, plus a photograph of the staff member. There is evidence that staff receive an induction to their role and undergo a period of probation prior to being confirmed in post. Interview questions and responses are also held. A staff training profile is held for each staff member, which details that they have had recent training in medication administration, relevant British Sign Language courses, mental health awareness, equality and diversity, Mental Capacity Act and health and Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: safety. Staff have received training in fire safety, food hygiene first aid and safeguarding, but for some these courses took place between two and four years ago and must be updated. Care Homes for Adults (18-65 years) Page 22 of 28 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 manager is competent and understands the responsibilities of their role Evidence: Since the last inspection there have been some management changes at the service, with the Registered Manger having been on long term leave for approximately five months, with an interim manager currently covering the management of the service, and another similar Servite Houses care home. The organisation should consider proposing a different person to be the Registered Manager if the current Registered Manager has not returned from leave after a period of six months absence. The current manager had been in post for approximately seven weeks at the time of the inspection. She said that she has previous experience in running a supported housing service, and has a number of years experience working with people with mental health needs. She said she is due to start a BSL course in April 2009. The manager demonstrated a good understanding of areas where the service needs to improve, and discussed plans to develop the service to create betters outcomes for the Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: people who live there, particularly towards the service adopting a person-centred approach. Quality monitoring at the service takes place through monthly group meetings with people who live at the service, a monthly residents questionnaire where feedback is gained about the accommodation, food and staff. There are also staff meetings to discuss relevant issues. The most recent visit, in accordance with Regulation 26 of the Care Homes Regulations 2001 is recorded as having taken place in September 2008, and it is required these are done monthly, with a record held at the service. The service holds certificates to demonstrate that relevant health and safety checks are carried out on the, water chlorination, electrical installation and gas safety. However, the Portable Appliance Test stickers on electrical equipment around the home was dated to have taken place in November 2007, and this must be carried out at least annually. Care Homes for Adults (18-65 years) Page 24 of 28 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 Adults (18-65 years) Page 25 of 28 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 6 15 The care plans must be fully reviewed and updates when necessary. This so that care planned and provided is relevant and what people want from the service. 30/04/2009 2 10 17 All records relating to people 31/03/2009 who use the service must be kept up-to-date and kept securely at the home. This is so that people who use the service are assured that information about them is kept confidential. 3 17 16 Food that is decanted into alternative containers must be labelled with a use by date. This is so that people who use the service are provided with suitable and nutritious food 13/03/2009 Care Homes for Adults (18-65 years) Page 26 of 28 4 35 18 Staff must receive training in the work they are expected to perform, this must include food hygiene, first aid and safeguarding The is to ensure that risks to people who use the service are minimised. 30/06/2009 5 39 26 The Registered Persons must ensure that visits in accordance with this regulation are carried out, and a report maintained at the service. So that people who use the service are assured that the quality if the service is monitored and actions taken where necessary. 31/03/2009 6 42 23 An up-to-date PAT certificate 31/03/2009 must be held at the service to demonstrate that these checks have been carried out. To ensure the safety of the facilities for people who use the service. 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. No. Refer to Standard Good Practice Recommendations 1 12 If people who use the service wish, then more group-based activities should be arranged and provided by the home. Care Homes for Adults (18-65 years) Page 27 of 28 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). 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