This inspection was carried out on 12th September 2005.
CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 there to be outstanding requirements from the previous inspection
report. These are things the inspector asked to be changed, but found they had not done.
The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.
CARE HOME ADULTS 18-65
Hilldrop (St. Mungos) 2 Hilldrop Road, Tufnell Park London N7 0JE Lead Inspector
Beverley Brewer Unannounced 12 September 2005
th 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Hilldrop (St. Mungos) G58 s20973 Hilldrop v215826 120905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Hilldrop (St. Mungos) Address 2 Hilldrop Road, Tufnell Park, London, N7 0JE 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) 020 7700 6402 020 7607 2235 St Mungo Community Association Limited Todd Sinclair Care home 29 Category(ies) of MD Mental Disorder, PD Physical Diability, MDE registration, with number Mental Disorder over 65, A Alcohol Dependent of places Past/ Present Hilldrop (St. Mungos) G58 s20973 Hilldrop v215826 120905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Home registered for men and women with needs relating to Alcohol dependency together with mental disorder, physical disability and/or old age. Maximum of 29 beds within the above facility Date of last inspection 11th April 2005 Brief Description of the Service: 2 Hilldrop Road is a care home situated off Camden Road. The home provides care and support for 29 men over the age of 45 who have experienced homelessness combined with mental health issues and/or alcohol dependency. The home is owned and managed by the St Mungo Association.2 Hilldrop Road is a listed building which was converted from a church in 1990. Staff support service users in developing harm minimisation programmes to help them to manage their drinking. The staff team also assist service users to access mental health services in the local community. At the time of this inspection half of the 29 service users were over 65 years of age. Hilldrop (St. Mungos) G58 s20973 Hilldrop v215826 120905 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the second inspection within the new inspection schedule from 1st April 2005 to 31st March 2006. The inspection was unannounced and took place during a weekday. All of the core standards have already been assessed at the previous inspection. The purpose of this inspection was to examine the progress made in relation to the requirements made at the previous announced inspection. The majority of the time was spent speaking with the deputy manager and service users. The remainder of time was spent examining records, touring the premises and observing the interaction between staff and service users. What the service does well: What has improved since the last inspection?
The physical standard of the building has improved considerably over the past year. At the time of this inspection extensive redecoration was taking place. Hilldrop (St. Mungos) G58 s20973 Hilldrop v215826 120905 Stage 4.doc Version 1.40 Page 6 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. Hilldrop (St. Mungos) G58 s20973 Hilldrop v215826 120905 Stage 4.doc Version 1.40 Page 7 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 Standards Statutory Requirements Identified During the Inspection Hilldrop (St. Mungos) G58 s20973 Hilldrop v215826 120905 Stage 4.doc Version 1.40 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed at this inspection. EVIDENCE: Hilldrop (St. Mungos) G58 s20973 Hilldrop v215826 120905 Stage 4.doc Version 1.40 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed at this inspection. EVIDENCE: Hilldrop (St. Mungos) G58 s20973 Hilldrop v215826 120905 Stage 4.doc Version 1.40 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 14 & 17 Service users do not at present have the opportunity to have an annual seven day holiday. The present meal arrangements do not promote service users’ health and wellbeing. EVIDENCE: The Deputy Manager was able to confirm that a number of day trips had occurred over the summer although little progress had been made in organising an annual holiday. A repeat requirement has been made. The present meal arrangements whereby service users can choose whether or not to purchase a meal do not appear to promote health and wellbeing as service users may choose to spend this money on alcohol. Senior managers within St Mungo’s are in the process of discussing the way forward in relation to this. There is a plan to introduce inclusive meal arrangements although this has not happened yet. A repeat requirement has been made. Hilldrop (St. Mungos) G58 s20973 Hilldrop v215826 120905 Stage 4.doc Version 1.40 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 Staff require extensive training in the administration of medication. Service users are at risk of not receiving medication that has been prescribed. EVIDENCE: During the previous inspection in April two gaps were found in the medication administration record. At this inspection gaps were again found in the administration record. An incomplete course of antibiotics was found in the medication cupboard. Staff had failed to ensure that the service user concerned had received their medication. This is a serious matter and a requirement has been made in relation to it. Hilldrop (St. Mungos) G58 s20973 Hilldrop v215826 120905 Stage 4.doc Version 1.40 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed at this inspection. EVIDENCE: Hilldrop (St. Mungos) G58 s20973 Hilldrop v215826 120905 Stage 4.doc Version 1.40 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 & 30 Service users require much more support in keeping their rooms clean and well maintained. Some bedrooms were dirty. EVIDENCE: Three bedrooms were inspected. Two rooms were dirty. One bed was without a duvet cover or bed sheet. One table lamp was covered in dust and had a hole in it. Bathrooms still require refurbishment although work is due to commence within the previously agreed timescale. Hilldrop (St. Mungos) G58 s20973 Hilldrop v215826 120905 Stage 4.doc Version 1.40 Page 14 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 The present staffing levels allow little time for individual work with service users. EVIDENCE: Present staffing levels allow very little time for individual work with service users. Two bedrooms were dirty, one without bedlinen and one in need of a replacement lamp. Hilldrop (St. Mungos) G58 s20973 Hilldrop v215826 120905 Stage 4.doc Version 1.40 Page 15 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 41 Notifications that are required by legislation to be reported to the Commission for Social Care Inspection have not been reported. EVIDENCE: The Inspector became aware at the inspection that there had been a number of falls and admissions to hospital that had not been reported to CSCI. A requirement has been made in relation to this. Hilldrop (St. Mungos) G58 s20973 Hilldrop v215826 120905 Stage 4.doc Version 1.40 Page 16 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23
ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score x x x x x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 2 x x x x x 2 Standard No 11 12 13 14 15 16 17 x 2 x x x x 2 Standard No 31 32 33 34 35 36 Score x x 2 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Hilldrop (St. Mungos) Score x x 1 x Standard No 37 38 39 40 41 42 43 Score 1 x x x x x x G58 s20973 Hilldrop v215826 120905 Stage 4.doc Version 1.40 Page 17 yes 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. Standard YA12 Regulation 14 Requirement Service users must be given the option of a minimum seven day annual holiday outside the home which they help choose and plan. This requirement is restated. The registered person is asked to review the present arrangements with regard to meal provision so that meals are included in the weekly charge ensuring that service users health and wellbeing is promoted. This requirement is restated for the second time. The registered person must ensure that service users receive the medication they have been prescribed. An accurate record of medication administered must be maintained and all staff must receive training in medication admistration. This requirement is restated. The registered person is required to replace the table lamp in the identified room. The registered person must ensure that all parts of the home are kept clean. The registered person is asked to review the present staffing Timescale for action 31/3/06 2. YA17 16(2)(i) 31/12/05 3. YA20 13(2) 31/10/05 4. 5. 6. YA24 YA30 YA33 23 23 18 31/10/05 31/10/05 31/12/05 Hilldrop (St. Mungos) G58 s20973 Hilldrop v215826 120905 Stage 4.doc Version 1.40 Page 18 7. YA41 37 levels to provide more staff time for individual work with service users. The registered person shall give notice to the Commission without delay of any occurrence as outlined in Regulation 37. 31/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Hilldrop (St. Mungos) G58 s20973 Hilldrop v215826 120905 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Centro 4 20-23 Mandela Street London NW1 0DU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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