Inspection on 02/05/08 for Alison House

This is the latest available inspection report for this service, carried out on 2nd May 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Alison House 23/01/07

Alison House 20/06/06

Alison House 15/03/06

Alison House 11/10/05

Alison House 09/02/05

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOME ADULTS 18-65 Alison House 16a Croxley Road London W9 3HL Lead Inspector Wynne Price-Rees Key Unannounced Inspection 2nd May 2008 10:00 Alison House DS0000055306.V362121.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 Alison House DS0000055306.V362121.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. Alison House DS0000055306.V362121.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alison House Address 16a Croxley Road London W9 3HL 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) 020 8960 0990 ginder.kundi@westminster-pct.nhs.uk Westminster Primary Care Trust Ginder Kundi Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Alison House DS0000055306.V362121.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home with nursing - Code N 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: 5 23rd July 2007 Date of last inspection Brief Description of the Service: Alison House is a care home for up to five clients, of either gender, with learning disabilities providing short-term and respite care. The fees are covered by Westminster Primary Care Trust (PCT) There is one bed allocated for an emergency placement. It is operated by the Westminster Primary Care Trust, who lease the building from the Westminster Society for people with disabilities and was registered on 7th December 2004. The facility is located in the Maida Vale area and is within easy access of local shops, other amenities and transport links. It provides ground floor accommodation and there are six single bedrooms available. A condition of registration is that one bedroom that measures 8.7 square metres is not allocated to a wheelchair user. There are currently twenty-nine people using the service that have been assessed to receive respite care. Alison House DS0000055306.V362121.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 stars. This means the people who use this service experience good quality outcomes. The inspection was unannounced and took seven hours to complete over two days, starting on 02/05/08 and ending on 07/05/08. During the course of the inspection two people who use the service were spoken with and one gave some views of the service they receive. This was because the people using the service have very limited verbal communication skills and therefore views normally taken were based on care practice observation and response of people using the service to them. The Care Manager and Deputy were on annual leave during the first inspection day and the Deputy was present on the second. During the inspection staff were also spoken with, care practices observed, records and procedures checked and a premises tour undertaken. Four files of people who use the service were case tracked during the inspection. All key standards were inspected and the information was triangulated with that gathered since the previous key inspection, compared with the self-assessment AQAA information returned by the home and this formed the basis of the new quality rating. What the service does well: The home provides a very good respite service that gives relatives a break and in one instance enables a relative to visit a person who uses the service and normally lives in hospital. The service is delivered by a dedicated, well trained and skilled staff team that care practice observation showed clearly have the best interests of the people who use the service as a priority, enabling them to Alison House DS0000055306.V362121.R01.S.doc Version 5.2 Page 6 choose and pursue a lifestyle within a safe, risk assessed environment. The home has a happy and enjoyable atmosphere that was reflected by the response of people who use the service when being welcomed into the home by staff. They were clearly happy to be there. This goes to the extent of putting a notice on each designated bedroom with the person’s name and picture prior to arrival so they know that is their room and feel at home. The home functioned efficiently despite the Care Manager and Deputy not being present on the first inspection day. The records inspected were up to date, clear and easy to use. 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. Alison House DS0000055306.V362121.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 Alison House DS0000055306.V362121.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): 2. Quality in this outcome area is good. People who use the service are fully assessed prior to a service being provided and they and their relations are able to visit to see if the service is what they need and want as part of the assessment procedure. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four people who use the service moved into the home, for a short stay, on the first inspection day and one person left. Moving in and out went smoothly with everyone being greeted and made to feel at home. The staff focus was on making people feel comfortable and meeting any immediate needs or wishes with responsibilities such as record keeping being continued after this was achieved. Care practice observation demonstrated that all staff present including cleaning staff were familiar with the people using the service, people knew them and time was taken to have a chat making the process easier. The four people moving in came at different times of the day depending on activities they were attending as part of their normal living routines at home. All were current people using the service and a sample of four files demonstrated that in-depth assessment information was held on each file that was regularly updated. The PCT Care Management Panel forwards assessment information, the home then makes a home visit to do their own assessment Alison House DS0000055306.V362121.R01.S.doc Version 5.2 Page 9 that is completed jointly with the person to receive the service; their relatives and they are invited to make about ten tea visits to see if they like it. On the first visit three staff are on duty to continue the assessment within the home’s environment. Further information is also gathered from day centres attended. Once the process is completed the home decides if needs and wishes can be met and the person if they want to use the service. Alison House DS0000055306.V362121.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. All people who use the service have enabling care plans that include required health care, up to date risk assessments and expenditure is correctly recorded. They are given the opportunity and support required to make their own decisions. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Whilst meeting with people who use the service during the inspection, the following comments were made about their daily lives and activities available to them. “I like it here”. “I’m going to the park tomorrow”. Alison House DS0000055306.V362121.R01.S.doc Version 5.2 Page 11 The four files case tracked demonstrated that staff follow a person centred care planning process based on individual likes, dislikes, preferences and needs of people who use the service. These are identified during the assessment process, visits to the home and when people use the service. To make this work affectively the home identifies the most appropriate forms of communication including facial expression responses to different situations and activities. The care plans enabled people who use the service to make supported choices, through setting goals that are regularly re-viewed, underpinned by risk assessments and evidenced by daily entries. These included regular goals they would achieve at home as well as input whilst staying at Alison House. Under one heading entitled “What I like to do” there was an entry stating “ I have lots of energy and like to get out and about otherwise I get bored if I stay in too much”. A programme of activities had been set up for the person using the service to make sure they wouldn’t get bored. They said they were looking forward to visiting the park the day after the inspection. Alison House DS0000055306.V362121.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. People who use the service are enabled to pursue activities and interests they do at home and in the community. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As the home provides respite and short-term care people who use the service continue to participate in the activities they would whilst at home. If someone attended college or a day centre they would do so whilst staying at Alison House. There are good lines of communication with day centres and this helps to update care plans through identifying changing needs or any new interests. People who use the service make good use of local amenities with visits to shops, cafes, parks and local pubs depending on interests and lifestyles. They also go to the cinema at Whiteleys in Bayswater and museums. One person who uses the service has a particular interest in trains, has their own train DVD and frequently visits Paddington station. Alison House DS0000055306.V362121.R01.S.doc Version 5.2 Page 13 People who use the service also participate in tasks around the home, to promote life-skill development as much or as little as they wish. These include helping with preparing a meal, washing up, watering plants and sorting laundry. Other home-based activities offered are painting, keyboards, music, dominoes, puzzles and DVDs. The home has requested multi-media equipment and is currently identifying sources of funding. As a respite unit relatives are able to visit as often and whenever they wish providing it doesn’t interfere with other people using the service. A weekly food shop is carried out once it has been checked who is going to use the service. Based on the care plans and knowledge of what meals people like a loose menu is put together taking likes and dislikes into account. This is flexible and can change from day to day if people fancy something different. People who use the service also go out for meals or have takeaways if they prefer. All people who use the service have a finance book that records money brought with them, purchases made, receipts and balance. Alison House DS0000055306.V362121.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. People who use the service receive the personal support they need, their emotional and health needs are met and medication is appropriately administered and recorded. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The four files case tracked demonstrated that individual personal care and health support needs are included in the assessment and care planning process. This includes treating people with dignity and respect whilst delivering personal care and is part of core staff induction training. As this is a respite service people who use the service keep their own GPs, have access to community based health care services as required such as physiotherapists and district and community nurses that visit as well as the nurses on the staff team. Clinicians from the partnership board also visit. There is a medication administration policy and procedure in place with only those qualified to do so administering medication. A record of medication on arrival and departure is also kept. The medication administration records were Alison House DS0000055306.V362121.R01.S.doc Version 5.2 Page 15 checked for those on medication and found to be accurately and correctly recorded. No controlled drugs are kept on site. All support staff have recently received medication training. Alison House DS0000055306.V362121.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): Quality in this outcome area is good. People who use the service and their relatives are able to make complaints that are listened to, documented and acted upon with outcomes recorded. They are protected from abuse and harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a complaints policy and procedure that is made available to people who use the service or their relatives either in written or pictorial format to make it easier to understand. A complaints book is kept that details complaint nature, by whom, who is investigating and outcome. Due to significant communication difficulties the complaint focus is more on relatives, although staff try to address this within individual communication packages. There has been one complaint recorded in the last year that was fully investigated with outcome. There were also four compliments recorded and numerous thank you cards. Staff receive adult protection training as part of core induction and receive an annual refresher. They are aware of what constitutes abuse and action to take if encountered. There are no current adult protection issues and all staff have been CRB checked prior to commencing employment. Alison House DS0000055306.V362121.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. People who use the service are provided with a safe, well-maintained and decorated environment to live in that they enjoy. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s physical environment is safe and matches its stated purpose. A premises tour showed it is reasonably furnished in a comfortable and homely way. An effort is made to customise bedrooms to the person using the service where possible by encouraging them to bring in small items with them from home, giving them the room they would prefer so that they settle in more easily and putting their name and picture on the door. Each room has a ceiling mounted hoist to help mobility, contains a pictorial information pack and a TV. Two rooms have ensuite showers. There is also a small back garden and lounge area that is big enough to accommodate the people using the service when carrying out activities. Alison House DS0000055306.V362121.R01.S.doc Version 5.2 Page 18 The fridge and freezer temperatures are checked and recorded daily and opened food products dated. The home is currently proposing to build a new separate laundry particularly as an infection control report highlighted this area as of concern. Alison House DS0000055306.V362121.R01.S.doc Version 5.2 Page 19 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. 33 and 34. Quality in this outcome area is good. Efficient, qualified & capable staff, who have been appropriately vetted are in sufficient numbers to meet the needs of people using the service ensuring that they are well supported and enabled to follow the activities and lifestyle of their choice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care practices observed and the records kept demonstrated the home is staffed by an efficient, capable and well-trained staff team. This was particularly apparent on the first inspection day when staff were making new arrivals feel comfortable at the home and it was running smoothly without the Care manager or Deputy being present. Everyone knew their roles and responsibilities and carried them out in friendly, caring and professional way. Whilst focused on the needs of the individual they were also aware of those of others. The rota showed staff are in sufficient numbers to meet residents’ needs at all times and the staff on duty matched the rota information during the Alison House DS0000055306.V362121.R01.S.doc Version 5.2 Page 20 inspection. There are four registered nurses employed and three full time support workers all of whom have passed an NVQ level 2 qualification. Currently there is one staff vacancy that has been advertised. All staff are employed by Westminster PCT and are subject to the organisation’s recruitment policy and procedure that meets the requirements of the standard with no staff starting work until they have been POVA and CRB cleared. If the home needs cover from an agency they first seek assurances from the agency, in writing that any agency staff have been appropriately vetted before they are used. Staff confirmed they receive thorough core induction training and have access to a rolling training programme. They were happy with the type and quality of training that the organisation provides. The home is targeting specific training for core competency service needs that is being developed with the PCT Training and Education Department. Funding has been agreed for this and a staff training needs questionnaire is to be distributed. Quarterly minuted supervision is taking place and this is another method of identifying training needs, along with the annual appraisals. Staff said they felt well supported by the home’s management team, organisation in general, able to progress their careers and listened to. Alison House DS0000055306.V362121.R01.S.doc Version 5.2 Page 21 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. The home is well managed in the best interests of people who use the service enabling them to pursue their lives the way they wish. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Care Manager has met the registration criteria of the CSCI and has suitable management experience to carry out their responsibilities efficiently. They have also obtained the NVQ level 4 Management and Care award. The organisation has a thorough quality assurance system that contains measurable performance indicators and trigger levels that are regularly reviewed. Contract monitoring visits take place three monthly, business planning meetings monthly and the individual service agreements set down what people who use the service and their relatives can expect, including any Alison House DS0000055306.V362121.R01.S.doc Version 5.2 Page 22 requirements particular to them. This is reviewed six monthly. Satisfaction questionnaires are also sent out frequently to relatives and they are invited to regular social functions such as coffee mornings so their views can be gained. The Care manager and Deputy operational systems are audited monthly. Part of the system includes monthly Regulation 26 unannounced visits and whilst the Deputy Care Manager confirmed they are taking place visit reports were not available delivered. There is a written policy regarding safe working practices and up to date moving and handling risk assessments. The boiler is being replaced during May 2008 and alternative services are being provided for people who use the service whilst this takes place, after consultation with them and their relatives. The COSHH, RIDDOR, gas certificate and accident and incident book were up to date. Fire risk assessments take place annually with the next due this month, building risk assessment took place in January 2008, fire fighting equipment was checked in April and alarms in March. The electrical circuit was tested in May and PAT tests take place annually or if someone brings electrical equipment in. The hoists were serviced in April. The fire alarm is tested weekly although the logbook has not been updated since 22/03/08. Alison House DS0000055306.V362121.R01.S.doc Version 5.2 Page 23 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 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 2 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 X 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 2 X X 2 X Alison House DS0000055306.V362121.R01.S.doc Version 5.2 Page 24 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard YA30 YA39 YA42 Regulation 16 (2) (e) & (f) 26 (4) © 23 (4) © (v) Requirement The home must provide adequate laundry facilities. Written records of regulation 26 visits must be made available for inspection on file. When the fire alarm is tested it must be recorded in the fire alarm logbook. Timescale for action 01/03/09 01/07/08 01/06/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Alison House DS0000055306.V362121.R01.S.doc Version 5.2 Page 25 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 Alison House DS0000055306.V362121.R01.S.doc Version 5.2 Page 26 - 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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