Care Home: Hazeldene

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What the care home does well Comments form surveys on what the home does well were as follows: Keeps [the person] and [their] clothes immaculate, teach [them] to bath everyday. [they] are taken regularly to church and this is important to [them]. When [they] come to see us [they] are smartly dressed and it is evident that [their] needs are taken care of. Puts the residents first- adapting quickly to meet any changing needs as they arise. Outcomes for people who live in the home are good with evidence of individualised care and choice. What has improved since the last inspection? The majority of requirements made at the previous inspection have been met. There has been significant improvement in fire safety within the home. Meeting for staff and people who live in the home are now held regularly. Appropriate risk assessments are in place and there is good detail on minimising risk. What the care home could do better: More work is needed on Quality Assurance within the home, to make sure that people who live there are listened to. Staff supervision has improved, but this needs to be achieved on a regular basis, to make sure that competent staff supports people.Staff receive appropriate training when they commence employment, refresher training must be offered at suitable intervals to make sure that staff have the necessary skills to meet peoples needs. The update Statement of Purpose needs to be forwarded to CSCI to evidence that it accurately reflects the service provision. CARE HOME ADULTS 18-65 Hazeldene 1 Dunbar Avenue Norbury London SW16 4SB Lead Inspector Janet Pitt Unannounced Inspection 29 October 2007 12:40 th Hazeldene DS0000028107.V350115.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 Hazeldene DS0000028107.V350115.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. Hazeldene DS0000028107.V350115.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hazeldene Address 1 Dunbar Avenue Norbury London SW16 4SB 020 8679 1462 T/F 020 8679 1462 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) Mr Jacob Lee Mr Jacob Lee Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Hazeldene DS0000028107.V350115.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st July 2006 Brief Description of the Service: Hazeldene is a five bedded small care home registered with the Commission for Social Care Inspection to cater for young adults with a learning disability. Situated in a residential street in Norbury, the home is well placed for public transport links to local amenities and shopping. There are five single bedrooms with one located on the ground floor. Communal areas consist of a spacious lounge, dining area and rear garden with paved area. Sufficient numbers of bathroom and toilet facilities are located near service users bedrooms and communal areas. The proprietor of the home, Mr Cliff Lee, is also the registered manager for the home and works most days. Fees at the time of the site visit were £600 per week. Hazeldene DS0000028107.V350115.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector undertook this unannounced inspection. Care documentation, staff files and health and safety records were examined. A tour of the premises was undertaken. The inspector was able to speak with two people who live in the home. The provider/manager was present throughout the site visit. Seven surveys were received from people who live in the home and their representatives. Comments from these have been included throughout the report. What the service does well: What has improved since the last inspection? What they could do better: More work is needed on Quality Assurance within the home, to make sure that people who live there are listened to. Staff supervision has improved, but this needs to be achieved on a regular basis, to make sure that competent staff supports people. Hazeldene DS0000028107.V350115.R01.S.doc Version 5.2 Page 6 Staff receive appropriate training when they commence employment, refresher training must be offered at suitable intervals to make sure that staff have the necessary skills to meet peoples needs. The update Statement of Purpose needs to be forwarded to CSCI to evidence that it accurately reflects the service provision. 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. Hazeldene DS0000028107.V350115.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Hazeldene DS0000028107.V350115.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who chose to live in the home have sufficient information about service provision and whether their needs will be met. There is a Statement of Purpose, which has recently been revised. Comprehensive needs assessments are undertaken on people who live in the home. EVIDENCE: All survey respondents’ apart from one indicated that they had sufficient knowledge of the home prior to moving in. The one exception was because it was an emergency admission, but this person was satisfied with the service provision. Examination of assessments made by the provider/manager showed that past and present behaviour patterns were documented. The assessments detailed hopes and aspirations of people as well as care needs. Each person has an admission profile which recorded personal information such as next of kin, religion, relationships and risks. Hazeldene DS0000028107.V350115.R01.S.doc Version 5.2 Page 9 The provider/manager stated that he would forward a copy of the updated Statement of Purpose to CSCI. Hazeldene DS0000028107.V350115.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each person who lives in the home has an individual plan that is regularly reviewed. Staff support people to live as independent life as possible and risk is minimised. EVIDENCE: One survey respondent commented: ‘[They] are more settled and happy at Hazeldene than …any other placement since leaving school.’ Personal plans were seen to be person centred and involved people in decision making. Some people choose to have their own key. One person has been supported to go shopping and there was a detailed risk assessment in place regarding this person’s safety and budgeting skills. The plans were seen to be reviewed and amended, if necessary at regular intervals. People who live in the home were involved in this process. Hazeldene DS0000028107.V350115.R01.S.doc Version 5.2 Page 11 One person was at home at the time of the site visit, it was observed that they were consulted on what they wished to do during the day. The provider/manager said that the building works that were nearing completion were to provide suitable office space for documentation to be kept securely. At the time of the site visit records were kept safely, but the room was cramped. Hazeldene DS0000028107.V350115.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People that live in the home are able to plan their day and maintain contact with the local community. Relationships are respected and supported. Menus are flexible to meet the needs of the people who live in the home. EVIDENCE: The manager reported that all people who live in the home are consulted about the weekly menu, but this is subject to change if they decide to have a different meal. Shopping is an activity carried out with people who live in the home and records show that they are supported to help in the preparation of meals. Survey respondents and minutes of meetings indicated that meals were to their liking. Food likes and dislikes were covered in their personal plans. One person who lives in the home has a relationship and is able to spend time with them in private. Each person who lives in the home is able to access Hazeldene DS0000028107.V350115.R01.S.doc Version 5.2 Page 13 specific ‘Men’s Health’ or ‘Women’s Health’ groups that cover aspects of relationships and health checks. Discussions are held regarding subjects such as appropriate touch, parts of the body and keeping safe. Opportunities to interact with peers are made available if a person wants this. One person attends church and is able to meet other young adults. The provider/manager reported that some people who live in the home choose to attend day centres. Monthly meetings for people in the home are held. The minutes showed that topics covered included holidays, staff/resident relationships, activities and visiting family and friends. These meetings are held in the evening to enable all people to attend. Hazeldene DS0000028107.V350115.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in the home can be confident that their physical and emotional needs will be met in a dignified way. They are protected from harm by medication procedures within the home and access to external agencies. EVIDENCE: Personal plans detailed intervention by other health professionals when required. People who live in the home are able to access specialist outpatients clinics and there are good records of communication between the clinic and the home. One person had received emotional counselling for childhood issues. Consistency of supporting people with personal care and ageing of people who live in the home were discussed in staff meetings as evidenced by the minutes. This shows that staff are aware of the need to make sure that people are supported appropriately and staff approach promotes individualised care. None of the people who currently live in the home are able to handle their own medications. They are protected from harm by the procedures in the home. Hazeldene DS0000028107.V350115.R01.S.doc Version 5.2 Page 15 People who live in the home were seen to be tidy and well presented. Care had been taken to make sure people had on co-ordinating clothes that reflected their tastes and age. Comments from surveys included: ‘If [they] are unwell, [the home] tell me when [they] go to the doctor.’ ‘The only concern we have is that [their] toes nails are left to grow very long[they] are unable to cut them….and the home seems to have difficulty in arranging for [their] feet to be cared for.’ This needs to be addressed by the home. Hazeldene DS0000028107.V350115.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure clearly indicates how concerns will be handled. People who live in the home are able to express their views freely. Some work is needed on Adult Protection, but this does not place any person at risk. EVIDENCE: The provider/manager reported that there have been no complaints or Safeguarding Adults investigations since the previous inspection. The complaint policy was seen to be satisfactory. The Safeguarding Adults policy needs to be reviewed in line with the local authority’s policy, which has recently been re-launched. Staff must attend refresher training to make sure they are aware of current procedures. It was evident from the surveys received and speaking with people who lived in the home that they felt able to raise any concerns and were confident that issues would be acted upon. Hazeldene DS0000028107.V350115.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Hazeldene provides a comfortable home in which to live. People are able to have their own possessions and are consulted on the décor. EVIDENCE: People live in a home that is domestic in style and provides a ‘homely’ atmosphere. Each person has their own bedroom, which is decorated and personalised to reflect their individual taste. There are suitable communal areas and the dining room is able to accommodate all the people if they choose to take a meal together. The home was clean and tidy on the day of the site visit and free from offensive odours. People are able to access a well-tended garden. Hazeldene DS0000028107.V350115.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who live in the home are confident in the abilities of staff that care for them. However this needs to be evidenced in a thorough recruitment process and appropriate training for staff. EVIDENCE: Comments from surveys included: ‘The staff are committed to meeting all the needs of the residents. I am kept informed of any change immediately. They communicate concerns quickly and effectively.’ ‘The members of staff we have met give the impression of being caring and competent.’ Staff files were examined. People in the home need to be confident that the recruitment process protects them from harm. The home must make sure that all staff have a Criminal Records Bureau check that originates from the home. Past employment history must be explored and there should be at least two references, one of which is from the previous employer. Hazeldene DS0000028107.V350115.R01.S.doc Version 5.2 Page 19 It is recommended that information on previous cautions as well as convictions is requested on the application form. Each staff files examined had a contract and job description present. Staff training records showed that mandatory refresher training was needed in areas such as Adult Protection, food hygiene and moving and handling. Supervision of staff had improved since the previous inspection, but this needs to be carried out regularly. There were adequate numbers of staff available to make sure people’s needs could be met. Hazeldene DS0000028107.V350115.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in the home are able to be involved in the day-to-day running. Some work is needed to make sure that Quality Assurance systems evidence this. Health and safety of people who live in the home is safeguarded by routine fire drills and checking of systems. EVIDENCE: The provider/manager has appropriate qualifications and experience to run the home. Improvements have been made in meeting requirements from previous inspections but more work is needed in some areas. Fire drills are now taking place at least four times a year and people who live in the home are involved. The provider/manager reported that the fire assessment would be finalised once the building works are completed. A fire Hazeldene DS0000028107.V350115.R01.S.doc Version 5.2 Page 21 engineer will also check the fire alarm system. Records show that that fire system is checked as required. The provider/manager has not yet completed the Quality Assurance plan, but expects to finish it soon. He stated that questionnaires had been sent out to stakeholders and representatives of people who live in the home and responses are due in soon. This needs to be continued to make sure that the home continues to operate in line with people’s wishes. Hazeldene DS0000028107.V350115.R01.S.doc Version 5.2 Page 22 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 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Hazeldene DS0000028107.V350115.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA34 Regulation 19 Requirement Staff files must include all the information required by the Schedules. This will make sure that people are confident that there is a good recruitment process in place. Staff must receive appropriate mandatory training at regular intervals. This will make sure that trained and competent staff supports people. Timescale for action 30/03/08 2 YA35 18 (1) (c) 30/03/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard YA1 YA23 YA34 Good Practice Recommendations It is recommended that a Statement of Purpose is forwarded to the CSCI. It is recommended that the home obtains the most recent Safeguarding Adults policy from the local authority. It is recommended that information on previous cautions as well as convictions is requested on the application form. DS0000028107.V350115.R01.S.doc Version 5.2 Page 24 Hazeldene 4 YA39 It is recommended that a copy of the Quality Assurance Assessment is forwarded to the CSCI Hazeldene DS0000028107.V350115.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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. 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