Care Home: Hart House

Annual service review Name of Service: Hart House The quality rating for this care home is: The rating was made on: two star good service 1 3 1 1 2 0 0 8 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 review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Carolyn Delaney Date of this annual service review: 2 1 1 0 2 0 0 9 Annual Service Review Page 1 of 8 Information about the service Address of service: 91 Hamstel Road Southend on Sea Essex SS2 4NF 01702619611 F/P01702619611 harthouse1@btconnect.com Telephone number: Fax number: Email address: Provider web address:   Name of registered provider(s): Conditions of registration: Category(ies) : dementia mental disorder, excluding learning disability or dementia Mr Richard Jeremy Hart,Mr Stephen David Hart Number of places (if applicable): Under 65 Over 65 0 8 2 2 Have there been any changes in the ownership, management or the Yes service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service Hart House provides accommodation for up to eight adults who have a diagnosed mental health disorder or illness including drug induced psychosis, schizophrenia and compulsive obsessive disorder. The home provides short-term rehabilitative care from six to eighteen months. However residents living at the home have been supported for longer periods according to their progress with treatment etc. Hart House is a residential style property situated close to Southend on Sea town centre. People living at the home have their own personal accommodation and access to attractive, homely communal areas, including lounge / diner, kitchen and a well-maintained garden. None. 1 3 1 1 2 0 0 8 Annual Service Review Page 2 of 8 The fees charged by the home range from £800.31 - £1,013.74 per week. Annual Service Review Page 3 of 8 Service update since the last key inspection or annual service review: What did we do for this annual service review? We carry out an Annual Service Review for services which have 2 star good, or 3 star excellent ratings and who provide good outcomes for people they serve. In carrying out this review we looked at all of the information that we have received about the home, or asked for since the last key inspection. We last inspected the home on 13th November 2008. We reviewed the information in the homes Annual Quality Assurance Assessment (AQAA), which was returned to us on 14th October 2009. The AQAA is a self-assessment in which the manager is legally required to tell us how well outcomes are being met for people who live in the home. It also provided some numerical information about the service including numbers of staff who work there, the number of complaints received etc. We sent surveys to residents, staff and health care professionals to complete. At the time of completing the review we had received returned surveys from five people living in the home, one member of staff and three social and health care professionals. Comments received were included in this report. We also reviewed any information we have received about how the service has managed any complaints or safeguarding (protecting people) issues. We looked at the information that the manager told us about things that have happened in the home such as illness or injury or any other event which would affect people who live there. These are called notifications and the manager must legally inform us of them. What has this told us about the service? The manager told us in the Annual Quality Assurance Assessment about the ways in which they engaged with the people to obtain their views about the service they received. They told us that they continued to hold group meetings when the residents required or requested them. They said that residents suggested most of the topics discussed in these meetings and they were involved as much as possible in all aspects in the running of the home and making decisions on some of the in house policies and routines. They told us that they encouraged relatives and friends into the home and listened to any of their views so that they could improve the service. The manager told us of the improvements made as a result of listening to people. They told us that there had been a change in the room allocation at the residents request as the only female felt she would like to move downstairs because she felt embarrassed when the men walked around in their underwear at night. Another male resident requested a downstairs room and was given one as soon as one became available. The manager told us that the residents had asked if they could choose what they eat on a daily basis and said they wanted the weekly menu taken down. They told us that this was done and the people who relied on staff to cook meals for them could choose at the beginning of the day what they would like that day or if they would like to eat out. The manager told us that they had discussed the annual holiday and that residents said they would like to do more funded days out and not go away for a whole week this year. They said that plans were being made at their request to book a day trip/weekend to France/Belgium in the future and residents were being supported to obtain passports. Annual Service Review Page 4 of 8 The manager told us that as part of the process for assessing the needs of people before they moved into the home that each person would complete a referral form and that an assessment of their needs would be completed. They said that people were invited to stay at the home on a trail basis commencing with day visits followed by overnight stays. They told us that during these visits a care plan was developed with the individual and that they would be shown around the local community, supported in registering with a general practitioner and access local advocacy services. The manager told us that there had been one person admitted to the home within the previous twelve months and that there had been no breakdowns in placements (where a person would move out of the home as their needs were not being met). Two social and health care professionals who completed surveys told us that the homes assessment arrangements always ensured that accurate information was gathered and that the right service was planned for people. Three of the five residents who completed surveys told us that they had been asked if they wanted to move into the home. Three of the five told us that they had received enough information about the home before they moved in so that they could decide if the place was right for them. The manager told us that they encouraged residents to reach their optimum independence and make decisions that affect their lives. They said that they helped and supported people to budget with the homes personal allowances given for shopping yet dont interfere with their personal choices or personal finances. They said that they encouraged residents to participate in the policies and procedures relating to the home and discuss all of these together on a regular basis. The manager said that they supported people to take responsible risks and praise them when they achieve their personal goals. They said that they offer support and guidance for safety, which sometimes involved the local police security officer who visited the home and advises them of safety issues. Four of the five residents who completed surveys told us that they always make decisions about what they do each day and that they can do what they want during the day, in the evening and at weekends. Two of the three health and social care professionals told us that the service supported people to live the life they chose. One said that it usually does. Residents are encouraged to choose their own G.P. and the staff they prefer working within the unit. We reviewed notifications we had received about the home within the previous twelve months. We had received no notifications of injury, illness or incidents affecting the wellbeing of people living in the home. Each of the three social and health care professionals told us that peoples social and health care needs were usually properly monitored, reviewed and met by the home. Four of the five residents told us that staff usually listened and acted on what they said. The manager told us of the ways in which they support residents to live their lives in the manner of their choosing. They told us that they seek out any opportunities for residents to re learn old lost skills and look into and encourage new subjects that interest them. They encouraged people to look ahead to their eventual discharge from the home and to try to set them up with enough activities, interests, and possible voluntary or paid work to fulfil their time. Residents were supported in exploring the local area to see what is on offer to them and help them select interesting and worthwhile educational and work based subject. Residents family and friends were invited into the home and encouraged to participate in the activities and routines. Residents are offered support and guidance around developing their personal Annual Service Review Page 5 of 8 relationships if they so wish and advise them accordingly i.e birth control. Residents are supported in registering their vote in local and general political elections should they wish to do so. The manager told us of the arrangements for safeguarding people who live in the home from harm and for receiving and dealing with complaints. They told us that there had been two complaints received within the previous twelve months. Both had been responded to within the time frames in the homes policy and procedure and neither had been upheld. One safeguarding alert had been raised and this was referred to the local safeguarding team in line with local guidelines. Staff have training around safeguarding issues and residents have opportunities to raise concerns and to speak to someone informally if they are unhappy. We had received no complaints about the service within the previous twelve months. Four of the five residents who completed surveys told us that they knew who to speak to informally if they were unhappy and how to make a formal complaint. Two of the social and health care professionals told us that the service usually responded responded appropriately to concerns or complaints. One member of staff told us that they knew what to do if a resident or other person made a complaint or raised concerns. The manager told us of the arrangements for providing suitable accommodation for people who live in the home. They said that all residents could make decisions about their personal space and how it was decorated. Residents had access to well maintained and comfortable shared spaces including lounge / dining room and a garden area. Residents had keys to front door and their bedrooms to maximise privacy and dignity. Residents have access to a computer and have their own secure passwords. Four of the five residents who completed surveys told us that the home was always fresh and clean. The manager told us about the arrangements for ensuring that residents were supported by skilled staff who knew their needs. There is a core staff team who have worked at the home for some time. Residents were involved in the selection process for recruiting new staff. The manager told us that all of the appropriate checks were carried out before a person commenced work at the home and all new staff completed a twelve week induction programme to help them familiarise themselves with the needs of residents and the homes policies and procedures. They told us that two staff are employed each shift and more staff are used should residents need to be escorted out of the home. All staff undergo a training programme to help them meet the needs of residents. Where agency staff were employed the manager ensured that staff who were familiar with the home and residents were used. Two social and health care professionals told us that the service always sought advice and acted on it to meet peoples social and health care needs. The other said that it usually did. Two professionals indicated that staff working in the home usually had the skills and experience to support peoples needs. Three of the five people living in the home told us that staff always listened to them and acted on what they say and one person told us that staff usually did. One member of staff completed a survey. They told us that all of the checks including references and Criminal Records Bureau disclosures had been obtained before they commenced work at the home. They told us that their induction had covered everything they needed to know about the job when they started and that they received training, which was relevant to their role, helped them understand the needs of individual people and kept them up to date with new ways of working. They also told us that the ways in which information about the people they supported was Annual Service Review Page 6 of 8 shared with staff and the home manager usually worked well and that there were usually enough staff to meet the individual needs of all the people who lived in the home. The manager told us of the arrangements for managing the home. They told us of the improvements made to the service and their commitment to sustain improvements and provide good outcomes and experiences for people who live in the home. We asked people who completed surveys to tell us what the home did well and any areas for improvement. Residents told us that The home is clean and tidy. One person said staff Help you when you have problems. Another person said They look after service users needs and best interests. One member of staff said the service Gives us lots of training and support, is good to the service users. Listens to their opinions and tries hard to meet their needs. Treats them with respect and as individuals. Neither residents or staff identified any areas where the service could be improved. Social and health care professionals told us what they felt the service did well. One person told us When working with individuals some good work is evident. Another said The home reports well on patients progress and support difficult or high profile clients. They also said that the home provides an excellent rehabilitation service for clients. They told us where they felt the service could improve. One person said that there Could be more experienced, better informed staff when the manager or deputy manager were not there. Another person said that the home Could do more one to one work with individual residents to aid rehabilitation and help them move on to supported accommodation as a first step towards regaining independence. This style of working does not appear to be provided within the home. After reviewing all of the information available at the time of this review we judge that the home continues to provide good outcomes for people who live there. What are we going to do as a result of this annual service review? We are not going to change our inspection plan, and will do a key inspection by 12th November 2011. However we can inspect the service at any time if we have concerns about the quality of the service or the safety of the people using the service. 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