Care Home: Hope House

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What the care home does well As the home does not currently have anyone living there we do not have information to specify what the service does well in relation to outcomes for service users. What the service does well in relation to systems, processes and documentation can be found throughout this report. What has improved since the last inspection? As the home does not currently have anyone living there we do not have information to specify what has improved in relation to outcomes for service users. What has improved in relation to systems, processes and documentation can be found throughout this report. What the care home could do better: As the home does not currently have anyone living there we do not have information to specify what the service could do better in relation to outcomes for service users. What the service could do better in relation to systems, processes and documentation can be found throughout this report. Key inspection report CARE HOME ADULTS 18-65 Hope House 5-7 Sandford Close Wivenhoe Colchester Essex CO7 8JN Lead Inspector Ray Finney Key Unannounced Inspection 5th May 2009 09:00 Hope House DS0000017926.V377156.R01.S.doc Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Hope House DS0000017926.V377156.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Hope House DS0000017926.V377156.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hope House Address 5-7 Sandford Close Wivenhoe Colchester Essex CO7 8JN 01206 823647 F/P 01206 823647 jimohare147@btinternet.com 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 Ashraf Hussain Ahmed Hussain, Aktar Hussain Mr James Patrick O`Hare Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Hope House DS0000017926.V377156.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 5 persons) 4th September 2008 Date of last inspection Brief Description of the Service: Hope House is located on a residential estate situated in the small quayside town of Wivenhoe. The home is within walking distance to shops, pubs and cafes and a regular bus route provides access to Colchester. The home is registered to provide accommodation for five service users of either sex. Single bedrooms and two communal bathrooms are located on the first floor. A lounge and dining room on the ground floor. The service has been unoccupied since December 2006. Hope House DS0000017926.V377156.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reason for this inspection was to carry out a random inspection to verify the current occupancy of the service and to assess what progress has been made since the last inspection on 4th September 2008. This included looking at the key National Minimum Standards and the statutory requirements made at that time and assessing what improvements have been made. The inspection confirmed that at the time of the inspection there was no-one living at the home. During the visit, we carried out a full tour of the premises and had extensive discussions with the registered manager. We examined documentation including policies and procedures, formats for care plans and risk assessments, the Statement of Purpose and the Service User Guide. What the service does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Hope House DS0000017926.V377156.R01.S.doc Version 5.2 Page 6 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 Hope House DS0000017926.V377156.R01.S.doc Version 5.2 Page 7 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 As there are currently no service users living in the home, we are unable to make a judgement based on outcomes for people using the service. However, we are satisfied that there are robust processes in place to ensure anyone wishing to use the service will be provided with appropriate information and will have their needs appropriately assessed before moving in to the home. EVIDENCE: Since the last inspection visit, the manager has made considerable progress in updating the home’s documentation. The Service User Guide and Statement of Purpose have been updated. A few minor amendments are still to be made including deleting references to CSCI (Commission for Social Care Inspection) and inserting instead the details of the Care Quality Commission (CQC), the body that now have responsibility for regulation of the service. The manager stated that he will now make the alterations so that the documents will be accurate for any prospective service user. Other than these minor amendments, the Statement of Purpose and Service User Guide contain appropriate information to ensure anyone wishing to use the service is clear about what they can expect the service to provide. The manager has also updated the template that they will use for pre-admission assessments to assess whether they will be able to meet the needs of any individual wishing to move into the home. Areas covered in the assessment document include personal information, support required with personal care, general health as well as any Hope House DS0000017926.V377156.R01.S.doc Version 5.2 Page 8 specific conditions such as epilepsy, mental and emotional well-being, lifestyle choices such as smoking, drinking and food preferences, activities, finances and medication. There is a comprehensive section on identifying risk. The manager demonstrated a sound understanding of the importance of carrying out a thorough and comprehensive assessment for people with complex needs and behaviours associated with learning disabilities. Hope House DS0000017926.V377156.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 As there are currently no service users living in the home, we are unable to make a judgement based on outcomes for people using the service. However, the processes that are in place should ensure that standards relating to Individual Needs and Choices are addressed appropriately when people move in to the home. EVIDENCE: There is now an updated format in place for care plans. Although there is currently no-one living in the home, the manager has produced files with all necessary documentation, in readiness for completion when someone wishes to move in to the service. The manger discussed ways in which they can support people with complex needs in the decision making process. He demonstrated a commitment to offering a ‘service user led’ service. This will include supporting people to develop skills in decision making and understanding choices and responsibilities, including planning for risk taking. Hope House DS0000017926.V377156.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: 12, 13, 15, 16 and 17 As there are currently no service users living in the home, we are unable to make a judgement based on outcomes for people using the service. However, we are satisfied that the manager has the skills and knowledge to put processes in place that will meet individual needs and will ensure people who wish to move in to Hope House will have a lifestyle that meets their wishes and aspirations. EVIDENCE: The manager explained that it is important to look at lifestyle on an individual basis. He was able to demonstrate an awareness of how to ensure that people’s needs and wishes are met around education and occupation, activities and community access and daily routines. He demonstrated a robust understanding of the importance of using person centred planning for people with learning disabilities who have complex needs or behaviours that challenge the service. The person centred care plans examined contained an individual activity planner. Hope House DS0000017926.V377156.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 As there are currently no service users living in the home, we are unable to make a judgement based on outcomes for people using the service. However, we are satisfied from the evidence that we have seen that there are processes in place to ensure the Personal and Healthcare needs of people who wish to move in to Hope House will be met through the home’s support processes. EVIDENCE: The pre-admission assessment documentation and the care planning process contain formats for assessing people’s individual personal and healthcare needs and use this information to form a support plan for the person. From his many years experience working in the field of learning disabilities in healthcare settings, the manager was able to demonstrate a robust knowledge of personal and healthcare needs. Hope House DS0000017926.V377156.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 As there are currently no service users living in the home we are unable to make a judgement based on outcomes for people using the service. However, we are satisfied that the manager has put processes in place that will ensure people’s concerns and complaints are dealt with robustly and people wishing to live in the home are safeguarded from harm. EVIDENCE: Since the last inspection the manager has updated all the policies and procedures that were previously in place and they now all relate to Hope House. There is an appropriate Complaints Procedure in place. The complaints procedure is available in a pictorial format to assist people with communication difficulties understand the process better. At present the only member of staff in post is the manager. However, there is a recruitment process in place that includes Criminal Record Bureau (CRB) checks. The manager demonstrated a commitment to ensuring all new staff understand their responsibilities around keeping people safe. Hope House DS0000017926.V377156.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 As there are currently no service users living in the home, we are unable to make a judgement based on outcomes for people using the service. However, we are satisfied that Hope House provides a homely environment for anyone choosing to use the service. EVIDENCE: A full tour of the premises was carried out. There are good quality furnishings throughout the home including new leather sofas in the lounge and a new dining table and chairs. They have purchased new beds and bedroom suites for all individual rooms. People’s bedrooms have lockable cupboards. The kitchen is domestic in nature and is well maintained and clean. The environment is clean and well maintained and the décor has been completed to a high standard. The manager explained how individual rooms would be personalised to individual wishes and tastes when anyone moves in. There are policies and procedures in place around infection control. Hope House DS0000017926.V377156.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 As there are currently no service users living in the home, we are unable to make a judgement based on outcomes for people using the service. However, we are satisfied that the manager has put processes in place that will ensure people are supported by an appropriate team of staff. EVIDENCE: We discussed the recruitment process with the manager and examined the format of personnel records. The manager’s personnel file was well organised with a checklist on the front and included all the documentation required by regulation. There is a prepared training plan in place that has identified the basic training that all staff will be required to complete. The manager explained that he has identified a core staff team who are ready to come on board and who could be in post within a month dependent on return of CRB disclosures. When the home starts the process to admit a new service user the manager is ready to arrange all the required recruitment checks. Hope House DS0000017926.V377156.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 As there are currently no service users living in the home, we are unable to make a judgement based on outcomes for people using the service. However, we are satisfied that there are processes in place to ensure Hope House is managed in the interests of people using the service. EVIDENCE: The manager of the home has over 40 years experience in working with people with learning disabilities, has a professional nursing qualification and has also attained a management qualification. The manager has completed the manager’s registration process with the Commission. Through comprehensive discussions on the day of the inspection, the manager was able to demonstrate a good understanding of his responsibilities around the managing of a registered care service. He was also able to demonstrate a commitment to ensuring that the home is run in the interests of people using the service. The manager told us of the importance of “ensuring that there is an open, positive and all inclusive transparent approach to the management at all levels Hope House DS0000017926.V377156.R01.S.doc Version 5.2 Page 16 within the home”. We also discussed developing good communication strategies and the importance of listening to the views of people using the service. The manager demonstrated his understanding that a good Quality Assurance process should include an, “annual development plan to demonstrate that you are committed to moving forward” and “quality monitoring system based on the views of all”. No new requirements have been made as a result of this inspection. The requirements in the table on the following pages relate to requirements issued at a previous inspection. As there are no service users currently living in the home we are unable to judge whether they have been fully met and, therefore, will remain until a full key inspection of the service is carried out when it is fully operational. Action must be taken to meet requirements as they are made under the Care Standards Act 2000. Hope House DS0000017926.V377156.R01.S.doc Version 5.2 Page 17 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 X 2 X 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 X 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X X X X X X X X Version 5.2 Page 18 Hope House DS0000017926.V377156.R01.S.doc Are there any outstanding requirements from the last inspection? yes 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 YA2 Regulation 14 Requirement The manager must ensure that the procedure now in place for assessing people’s needs is used as part of the admission process for people wishing to move in to the home. The manager must ensure that the procedure now in place for compiling care plans that meet people’s assessed needs is used when people are admitted to the home. The manager must ensure that the process now in place for assessing risks is used as part of the assessment and care planning process when people are admitted to the home. The manager must ensure that the plans now in place for assessing people’s needs and wishes around activities are used when people are admitted to the home. The manager must ensure that the recruitment process now in DS0000017926.V377156.R01.S.doc Timescale for action 31/12/09 2. YA6 15 31/12/09 3. YA9 13 31/12/09 4. YA12 16 31/12/09 5. YA34 19 31/12/09 Hope House Version 5.2 Page 19 place is used when employing staff. 6. YA35 18 The manager must ensure that 31/12/09 the prepared training plan now in place is used when staff are employed to work in the home. 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 Hope House DS0000017926.V377156.R01.S.doc Version 5.2 Page 20 Care Quality Commission Care Quality Commission East Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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