Care Home: Hazel House

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What the care home does well The service provides good outcomes for the people who currently live at home. The statement of purpose clearly sets out the philosophy and objectives of the home. The home understands the importance of having sufficient information when choosing a care home. Admissions to the home are made on the basis of a detailed assessment. This ensures the best outcomes for people who live at the home. Care plans provided specific guidance on how the person living at the home wished to be supported. The home has involved the individual in the planning of care that affects his lifestyle and quality of life. Risk assessments were found to cover all areas that affected the person`s daily life. Risks are managed positively to help the person who lives at home to lead the life he wants. The menu is prepared weekly with the people who live at home. A variety of meals are provided that reflect their individual preferences. Care plans outlined the support the people require to maintain their independence when being supported with personal care. Personal support is responsive to the varied individual needs and preferences of people who live at the home. We found that records for the administration of medication were complete. People`s medication administered in a way that ensures their continued well being. The complaints policy is available in a pictorial and easy read format. The people who live at the home had been supported to share their concerns. The home has an open culture that allows people to express the views and concerns in a safe and understanding environment. The people told us that they could challenge and raise concerns about the way they were treated. People feel safe and well supported by an organisation that has their protection and safety as a priority. Training records confirmed that all staff has all the statutory required training. All staff receives relevant training that is focused on delivering improved outcomes for people. A system is in place to monitor the quality of the service provided by the home. Ongoing quality assurance is carried out to make sure that the home provides improved outcomes for people. The registered manager makes sure that the safety risks to people living at the home and staff is identified. People living at the home are aware of safety arrangements and have confidence in the safe working practices of staff.Hazel HouseDS0000071106.V363863.R01.S.docVersion 5.2Page 7 What has improved since the last inspection? This is the home`s first key inspection. Therefore, there are no areas for improvement that had been identified prior to this key inspection. What the care home could do better: No areas for improvement have been identified at this inspection. CARE HOME ADULTS 18-65 Hazel House 57 Fox Lane London N13 4AJ Lead Inspector Tony Brennan Unannounced Inspection 15th May 2008 10:00 Hazel House DS0000071106.V363863.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 Hazel House DS0000071106.V363863.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. Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hazel House Address 57 Fox Lane London N13 4AJ 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) 07847 025 291 tseechurn@btconnect.com Connifers Care Limited Bickram Soobdhan Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Learning Disability - Code LD The maximum number of service users who can be accommodated is: 7 N/A Date of last inspection Brief Description of the Service: Hazel House is a private care home. It is part The Conifers Care Ltd. This organisation owns a number of homes. The home is registered to provide care for seven people who have learning disabilities. The home consists of a large house in a quiet street in Palmers Green. There are seven large single bedrooms. The home has new furnishings and fittings. The bedrooms are appropriately furnished. It has communal space consisting of a kitchen, dinning room and a lounge. Designated smoking areas are provided. The home has a large well maintained garden for the use of people who live there. The home is located close to shops and other community facilities. There are good public transport links with Palmers Green railway station in easy walking distance. The home aims to support people with learning disabilities maintain and enhance their level of independence and integration into the local community. The fees are between £1450 and £1966 pounds a week. This report is available through the internet. Copies may also be obtained from the provider of this service. Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This announced key inspection was undertaken as part of the annual inspection programme. This is the first key inspection since Hazel House was registered with the Commission. Prior to the inspection the home had completed its annual quality assurance assessment. The annual quality assurance assessment provided us with information about the home and how it was seeking to provide the best outcomes for people. As part of this inspection we looked in detail at how the home safeguards people. We discussed this with staff, the registered manager and people living at the home. We looked the home’s safeguarding policy, and records relating to how the home dealt with safeguarding issues. We have recorded our findings in the relevant outcome areas. The inspection took place over one day. We were assisted by Bickram Soobham, the registered manager, with the inspection. Comment cards were received from residents and relatives. We spoke with three of the people who live at the home, and three members of staff. We observed care practice and interaction between staff and people living at the home. We toured the building and examined a number of records relating to the care, health and safety and management of the home. At the end of the inspection feedback was given to the registered manager. We would like to thank the staff that assisted us by answering questions about the running of the home. We would also like to thank the people who live at the home who discussed their views of the service they receive. What the service does well: Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 6 The service provides good outcomes for the people who currently live at home. The statement of purpose clearly sets out the philosophy and objectives of the home. The home understands the importance of having sufficient information when choosing a care home. Admissions to the home are made on the basis of a detailed assessment. This ensures the best outcomes for people who live at the home. Care plans provided specific guidance on how the person living at the home wished to be supported. The home has involved the individual in the planning of care that affects his lifestyle and quality of life. Risk assessments were found to cover all areas that affected the person’s daily life. Risks are managed positively to help the person who lives at home to lead the life he wants. The menu is prepared weekly with the people who live at home. A variety of meals are provided that reflect their individual preferences. Care plans outlined the support the people require to maintain their independence when being supported with personal care. Personal support is responsive to the varied individual needs and preferences of people who live at the home. We found that records for the administration of medication were complete. People’s medication administered in a way that ensures their continued well being. The complaints policy is available in a pictorial and easy read format. The people who live at the home had been supported to share their concerns. The home has an open culture that allows people to express the views and concerns in a safe and understanding environment. The people told us that they could challenge and raise concerns about the way they were treated. People feel safe and well supported by an organisation that has their protection and safety as a priority. Training records confirmed that all staff has all the statutory required training. All staff receives relevant training that is focused on delivering improved outcomes for people. A system is in place to monitor the quality of the service provided by the home. Ongoing quality assurance is carried out to make sure that the home provides improved outcomes for people. The registered manager makes sure that the safety risks to people living at the home and staff is identified. People living at the home are aware of safety arrangements and have confidence in the safe working practices of staff. Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 8 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 Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 9 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): 12345 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The statement of purpose is an accurate description of the service provided. People’s needs are assessed prior to admission to the home to ensure they receive the care and support required. People understand how the home will meet their needs. EVIDENCE: The statement of purpose clearly sets out the philosophy and objectives of the home. The Commission has recently registered this home. As part of this process a statement of purpose was developed for this service. The statement of purpose was available in an easy read format. The registered manager explained that it can also be made available to people in a picture format if they needed it. We found that the needs of the people case tracked were within a range of those specified in the statement of purpose. The statement of purpose also identified the skills and staffing resources that are available to meet the needs of people living at the home. The home provides a statement of purpose that is specific to the individual service, and the residents who live there. The statement of purpose confirmed that staff would support people to express their religious beliefs. The statement of purpose emphasise peoples right to Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 10 be involved and active in their communities. We discussed the issue of equalities and diversity with the registered manager. He demonstrated that he would respond positively to people’s diversity. As is outlined in the following outcome areas these resources generally meet the needs of people living at the home. All Comment cards received from people and their relatives confirms that they had been told about the home and what it provides. We found that a detailed service users guide is available for people. It was available in an easy read form that was assessable to all the people living at the home. One person said, “they told me about the home.” The annual quality assurance assessment stated that people were told of their right to receive a service that promoted their equality and diversity. A person who lives in the home commented on this, “ staff encouraging me to live how I want.” People coming to live at the home have sufficient information about the home, so that they are confident their individual needs and preferences will be met. Comment cards received from people who live at the home confirmed that they felt that their needs were understood and met. The annual quality assurance assessment highlighted that a full needs assessment is carried out to establish whether the home can meet the prospective residents needs. The registered manager explained that initial assessments are carried out with the involvement of the person. We found that the initial assessments for the two people case tracked were detailed. For example, the initial assessment for one person case tracked included information from medical professionals. The initial assessment highlighted behavioural issues. Staff were able to describe how they met the needs of the two people. A person who lives at the home told us, “ Staff understand me.” Admissions to the home are made on the basis of a detailed initial assessment that make sure the needs of prospective residents can be met. The annual quality assurance assessment stated that people are encouraged to make daily visits and have overnight stays at the home prior to them coming to live there. The manager explained this allows staff and people living at home to develop a relationship with the new resident. A person who lives at the home said, “I came and stay few time to see what it was like here.” Comment cards from people living at the home and relatives confirm that they had visited the home before deciding to come and live there. The two people case tracked told us that they had made a number of visits to the home before finally choosing to live there. We found there were notes of these visits, and they had been discussed as part of people’s regular care planning meetings. People are supported to make an informed decision about whether the home can meets their needs. People living at the home told us that they had been given a contract. This had been agreed with them prior to their admission. We found that the contracts clearly outlined their rights and responsibilities. People told us staff Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 11 had discussed the contract with them. The contracts were available in an easy read format. This meant that it was assessable to people who live at the home. Copies of these contracts were signed by people living at the home to show they agreed and understood them. A person told us, “ They told me how they would help me.” People have agreed and understand how the home will meet their needs. Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 12 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 8 9 10 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Care plans provide detailed guidance on how the needs of people are to be met. People are consulted about their preferences and how they wished to be supported. People are supported to make decisions about their lives and they know staff will maintain the confidentiality. Risks to people are assessed to ensure their safety and independence. EVIDENCE: The care plans for the two people case tracked were detailed and Person centred. This meant that care plans were based on how people wish to be supported by staff. In the annual quality assurance assessment it was stated that care plans are drawn up in partnership with people who live at the home, their families and professionals. The care plans for the two people case tracked were personalised and detailed how their needs would be met. The Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 13 registered manager explained that staff were being trained in person centred planning. Care plans were found to provide detailed information on the support provided to meet the needs of individuals. Care plans were personalised and referred to the cultural needs of people. This included whether or not they wish to take part in religious activities. We found that care plans had been developed with the involvement of people living at home. We observed that staff took time to understand people and do things in the way they had been asked. The home involves individuals in the planning of care that affects their lifestyle and quality of life. Details of the people’s behaviour that might challenge the service were identified in their risk assessments and care plans. Actions to address and manage these behaviours were outlined in detail. This included giving guidance on how to respond to specific behaviours. One of the people case tracked had been consulted about how he wished to be assisted to manage his behaviour. Staff spoken to understood the specific needs of the person with regards to managing challenging behaviour. Behaviour that may challenge the service is addressed sensitively to support and maintain people’s well being. Risk assessments were found to cover all areas that affected the people’s daily life. Risk assessments identified the specific risk facing people. Risk assessments were detailed based on the history of previous risk-taking on the part of people living at the home. These are reflected in care plans. Risk assessments had been reviewed. Changes to the level of risk had been addressed. Staff were able to describe how they prevented risks to make sure that people were safe and were supported to exercise control over how they live. Risks relating to behavioural issues were identified. We observed that staff engaged with people in an appropriate adult way. Comprehensive risk assessments that are reviewed regularly are in place to ensure the safety and independence of people. People told us that they felt that staff kept confidential issues private. There were clear policies on how confidentiality must be maintained. Both observation and discussions with staff showed us that they were sensitive and aware of the importance of maintaining people’s confidentiality. People told us they had seen their records and had discussed their needs with staff. People know that their confidentiality will be maintained at all times. Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 14 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): 11 12 13 14 15 16 17 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are supported to engage in a range of activities that meet their needs. People have community contacts and are supported to maintain personal relationships. People are supported to have a nutritious diet that reflects their personal choice. EVIDENCE: The annual quality assurance assessment explained that people were encouraged to take part in a range of activities. Records showed that people were being supported to find appropriate college courses. People told us that they were participating in courses and activities. People had been supported to make use of local facilities such as shops, the Gateway club and the park. Staff told us they regularly assist people to plan bus routes and offer to escort Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 15 them to new activities. We observed two people who live in the home discuss and plan trip to the shops. Staff supported them to do this. People spoken to gave examples of activities. These included going for walks, listening to music and going to the local café. A person said, “I like going to the out for a walk.” People spoken to told us that they had been consulted and could choose from a range of activities. The care plan of one of the people case tracked showed us that he liked listening to music. We observed that in his bedroom he had a CD player and a large selection of CDs. He told us, “ I like to listen to my music. Staff understands this.” People who live at the home are involved in meaningful daytime activities of their own choice, according to their individual interests and capabilities. Daily notes and care plans confirmed that people were regularly involved in activities both in and outside of the home. This included household tasks such as shopping, washing and general cleaning. One of the people we spoke to told us he had also been cooking meals with the support of staff. We saw that people living in home were involved in preparing the main meal of the day with staff support. People who use the service are involved in the domestic routines of the home to further develop their daily living skills. The annual quality assurance assessment confirmed that People were enabled to develop contacts in the local community. Daily records showed that people were supported to maintain contacts with family and friends. A person spoken to confirmed that he regularly went and visited members of his family. People who use the service have an opportunity to develop and maintain important personal and family relationships. The menu is prepared at a regular meeting of people living at the home. We saw minutes of these meetings that confirmed people’s suggestions for meals were recorded. People spoken to confirmed that they had been involved in preparing the menu. We found that the menu is varied and reflected the cultural and dietary needs of individuals. A person said, “The food is ok.” We observed that people were able to have a hot drink when they wish. A variety of meals are provided that reflect the individual preferences of people who live at the home. Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 16 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 20 21 People who use this service experience good outcomes in this area. This judgement has been made using available evidence, including a visit to this service. People are supported with their personal care needs to maintain their independence. People are able to access the medical care they need. People are not protected by safe procedures for handling medication. EVIDENCE: Care plans outlined the support people require to maintain their independence when being assisted with their personal care. We spoke with people who explained that staff provided support and encouragement to maintain their personal hygiene. The annual quality assurance assessment confirmed that where necessary people would be supported with their personal hygiene. Staff explained that they remind and encourage people if they need to support them with their personal care. Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 17 Comment cards from people were all positive about the care provided by the home. Staff were able to explain the personal support needs of people living at the home. One person told us, “ Staff are very helpful.” Personal support is responsive to the varied individual needs and preferences of people who live at the home Medical needs had been identified as part of the initial assessment and were referred to in care plans and risk assessments. Daily notes recorded that people had access to the opticians, dentists and chiropodists. People said they had been consulted about end of life issues. We found this was recorded in their care plans. People are supported to access the healthcare they need. Peoples health needs are addressed to ensure their well being. We found that records for the administration of medication were complete. Records of medication received and returned were also complete. We checked the records of medication for the two people case tracked. They were receiving all the medicines that had been proscribed for them by their doctor. People told us that they had agreed to medication being administered by staff. This was recorded in their care plans. The home has developed an effective medication policy that ensures records of the administration of medications are maintained to keep people safe. There is clear guidance on the use of medication as part of managing peoples challenging behaviour. This outlined when it was appropriate to use this medication. It clearly stated the types of behaviour that would indicate when it was appropriate to use medication. Medication is only used to manage peoples behaviour when it is clearly required to meet their needs. Daily notes showed that health professionals had been consulted to ensure that people were receiving the medicines they needed. Training records and discussions with staff confirmed they had training on the safe administration of medicines. Staff are trained to administer medication safely. Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 18 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 23 People who use this service experience good outcomes in this area. This judgement has been made using available evidence, including a visit to this service. People can be confident that their complaints are listened to and acted upon. Adult protection procedures protect people from abuse. EVIDENCE: The complaints policy explained how to make a complaint and how it would be dealt with. The policy is available in both easy read and pictorial formats. This makes it more accessible to people who live at the home. Copies of the complaints policy were available around the home for people to consult. People told us they had been given a copy of the complaints policy. They said that as part of the regular house meetings issues are discussed and resolved. Staff explained that people are encouraged to discuss their views of the service. A person spoken to said, “ I know who to tell if something isnt right.” The home maintains a record of any complaints. We saw that this showed there had been no issues since the home opened. The home has an open culture that allows residents to express the views and concerns in a safe and understanding environment. Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 19 As part of this inspection looked in detail at how the home safeguards people against potential abuse. We found that there is a detailed policy. This had made available in both easy read and pictorial formats. We spoke with people who live in the home they told us that they felt safe. One person told us, “ if theres a problem you can talk to staff.” people spoken to know that they could approach the registered manager if they had any concerns about the way they had been treated. The registered manager explained that as a result of ongoing training he had reviewed the policy to make sure that people were effectively safeguarded. We saw that a copy of host local authority (Enfield) procedure and guidance on handling safeguarding issues was available for staff to consult. There were copies of a leaflet that explained clearly how Enfield safeguarding procedures protected people who use services. Copies of this were available for people in the home. Staff were able to explain how they would respond to an allegation of abuse. Staff told us they had read the homes policy on safeguarding people. They understood the need to report any incidents or concerns they might have about safeguarding issues. Training records and discussions with the registered manager showed that 98 of staff had already completed the host of local authority’s training on safeguarding adults. This training had covered the forms of abuse and staff responsibilities regarding whistleblowing. Staff spoken to were aware of their responsibility to report any bad care practice to the registered manager and the host local authority. The registered manager explained that whistleblowing is also discussed as part of the homes induction of new staff. The registered manager explained that he regularly discusses with staff issues regarding safeguarding in their team meetings and individual supervisions. Records of these meeting showed that safeguarding issues had been discussed. The registered manager said that he uses these meetings to monitor how staff understand safeguarding issues. There have been no adult protection issues since the registration of the home. People living in the home feel safe and well supported by an organisation that has their protection and safety as a priority. Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 20 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 2 5 26 27 28 29 30 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who live in the home are always provided with a safe and homely environment that is personalise to meet their needs. The home is clean and hygienic. EVIDENCE: The house is a seven bedroomed Edwardian house on two floors. The home is located in a residential street in Palmers Green. There is a spacious garden at the rear of the home. The home is well served with local transport, shops, parks and other community facilities. The dining area is spacious, and we saw that staff and residents eat together. There is a spacious modern kitchen for the use people living at the home. People told us they were able to access all Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 21 parts of the home. The home’s environment meets people’s needs and aspirations. Comment cards from people and their relatives all stated that they felt the home was well decorated and provided a safe environment. Three bedrooms have en suite facilities. These consist of a bath with shower attachment, toilets and washbasin. On the second floor there is a bathroom and separate toilet for the person whose bedroom does not have an en suite. People told us that the provision of bathrooms and toilets met their needs. People spoken to were pleased with their bedrooms. They had chosen items of furniture for their rooms. People are encouraged to personalise their bedrooms. We observed that people’s bedrooms have been decorated and furnished in ways that reflected their personal preferences. Appropriate measures are in place to prevent cross infection. The home has detailed policies on the prevention of cross infection. The annual quality assurance assessment stated that staff had training on infection control. We found that training records confirm this. Staff spoken to understood how to work to minimise the possibility of cross infection. Staff confirmed that they had access to disposable gloves and aprons. Liquid soap and paper towels were available throughout the home. A proactive infection control policy makes sure that the risk of infection for people is minimised. Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 22 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): 31 32 33 34 35 36 People who use this service experience good outcomes in this area. This judgement has been made using available evidence, including a visit to this service. Sufficient staff, with the necessary skills and support are available to meet the needs of people. People are fully protected by the home’s recruitment procedures. EVIDENCE: We found that the rota showed that a consistent staffing level was maintained. The manager explained that five staff are on throughout the day and one staff on duty at night. The registered manager explained this would be kept under continuous review to make sure that there are always sufficient staff to meet peoples needs. Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 23 People spoken to confirmed that there were enough staff to meet their needs. Daily notes showed that staff was on duty to provide escorts to appointments. We observed that support with activities was available. Staff spoken to told us that they felt sufficient staff were available to support peoples needs. We saw that sufficient staff are provided at busy times of the day, and to meet the changing needs of people. The service has plentiful staff available at all times to support the needs, activities and aspirations of people living at the home. New staff are given a full induction. Records were available to confirm that staff had been on the necessary induction training. All areas of statutory require training had been provided. Discussions with staff showed that they had a detailed knowledge of the needs of people who live at home. Records showed that training had been provided on autism, the mental capacity Act and mental health awareness. The registered manager explained further training person centred care is being planned. The training plan was in place this detailed how future training needs would be met so that staff continue to develop their skills. People are supported by staff that have the necessary skills to understand and meet their needs. Training records showed that over 50 of staff has either level 2 or 3 in the National Vocational Qualification in care. As part of this training staff had covered equality and diversity issues. People told us that they felt staff understood how to meet their needs. Staff have the relevant experience in working with people who have learning disabilities. The home ensures that all staff receives relevant training that is focused on delivery of improved outcomes for people using the service. We looked at two staff files. These contained all the necessary documentation to ensure that these members of staff were safe to work with people who live at the home. Their employment records were checked. Two references and a POVA first/CRB checked had been obtained prior to them starting work at home. This showed that the home followed a clear recruitment procedure that ensures the safety of people. The staff group reflect the cultural backgrounds of people. People living in the home said they felt that staff could be trusted. Robust recruitment procedures are followed to ensure the safety and well being of people. Staff spoken to explained that they had received regular supervision. They told us this helps them to understand and meet the needs of people. We found supervision records showed that staff were supported to understand and improve outcomes for people living in the home. The registered manager explained that appraisals would be carried out to monitor staff and make sure they provide care and support people need. Staff are supported so that they are able to meet the needs of people. Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 24 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 38 39 40 41 42 43 People who use this service experience good outcomes in this area. This judgement has been made using available evidence, including a visit to this service. Effective management systems are in place to make sure that people’s will being and safety is promoted. People’s views of the service are sought and used as the basis for improvement. People who live at home and staff’s health and safety is always promoted and safeguarded. EVIDENCE: As part of the registration process the registered managers qualifications had been checked and found to providing the necessary skills to manage a service were people with learning disabilities. The registered manager explained that he is a registered nurse. He has experience of working with people with mental health and learning disability needs. He has a number of years experience of Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 25 these areas. Training records showed that the registered manager has completed the registered manager award. The manager has a clear understanding of the key principles and focus of the service. Staff and people living at the home told us that the registered manager was approachable. Staff meeting minutes showed that he involves staff in the running of the home. The registered manager is supported by a number of senior workers. Staff were clear about their roles and how this contributes to supporting people who live at the home. Effective management systems are in place to provide the best outcomes for people living in the home. As part of the registration process Connifers Care Limited had to show that it had the financial management systems in place to maintain viability of the home. The registered manager explained how finances are managed. There are appropriate accounting procedures in place to make sure that the homes resources are used in the best interests of people. The home has the necessary insurance cover. We saw that there were insurance certificates to confirm this. Financial systems make sure that the home’s resources are used in the best interests of people. The annual quality assurance assessment contained clear, relevant information that was supported by a range of evidence. The annual quality assurance assessment told us about the changes that the registered manager plans to make to improve the service. A system is in place to monitor the quality of the service provided by the home. The registered manager explained that he carries out quality monitoring on a regular basis. People are consulted about how the home is run. Minutes were seen of meetings held with people to discuss the quality of the service provided. People said that they are encouraged to discuss their views of the service. Action to improve the service had been agreed with people who live at the home. Theres a strong emphasis on being open and transparent in all areas of the running of the home. All the procedures and policies were found to be in place. The manager explained that policies are regularly reviewed. This was highlighted in the annual quality assurance assessment that showed that policies had been reviewed. The home has the necessary records in place. People told us they had seen their records and were appropriate had been involved in providing information on their needs. The registered manager explained that important changes in peoples records were discussed with them. Appropriate procedures and recording systems make sure peoples needs are met. The registered manager ensures that the safety risks to people living at the home and staff are identified. Measures are put in place to provide a safe living and working environment. Records showed that fire equipment was tested regularly and maintained. Drills were taking place. The fire risk assessment provides details of potential risks of fire. All health and safety policies were available. Certificates for gas and electrical testing were in date. COSHH guidance is in place and chemicals were stored safely. People living at Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 26 the home are aware of safety arrangements and have confidence in the safe working practices of staff. Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 27 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 3 3 3 4 3 5 3 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 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 3 3 3 3 Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 28 N/A 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Hazel House DS0000071106.V363863.R01.S.doc Version 5.2 Page 30 - 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. 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