Inspection on 25/08/06 for Aitken House

This inspection was carried out on 25th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Aitken House 08/02/06

Aitken House 03/06/05

Aitken House 07/10/04

Aitken House 22/04/04

Similar services:

Chesham House

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

Abbey Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Aitken House 28 Yarmouth Road North Walsham Norfolk NR28 9AT Lead Inspector Hilda Stephenson Unannounced Inspection 25th August 2006 10:30 Aitken House DS0000027309.V309978.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 Aitken House DS0000027309.V309978.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. Aitken House DS0000027309.V309978.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Aitken House Address 28 Yarmouth Road North Walsham Norfolk NR28 9AT 01692 404502 NO FAX # 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 Khemraj Joory Mrs Toongbhadra Joory Mr Khemraj Joory Care Home 20 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (19), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (1) Aitken House DS0000027309.V309978.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th February 2006 Brief Description of the Service: Aitken House is a two storey building situated in the town of North Walsham that accommodates up to 20 adults with mental health problems. There are 14 single and 2-shared bedrooms situated on both the ground and first floors. The communal rooms consist of one quiet lounge, and one lounge with an attached smoking area, with two small dining rooms situated off the kitchen. The home has a large garden that is laid to lawn with a wild life pond. There is ample parking to the front of the building. The home is owned and managed by Mr & Mrs Joory. The current fees are between £307 and £329 per week. Aitken House DS0000027309.V309978.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out using information from the providers, the service users as well as others who work at or visit the home. This report gives a brief overview of the service and the current quality judgements for each outcome group. What the service does well: What has improved since the last inspection? Several areas of the home have been redecorated since the previous announced inspection, with many of the original windows having been replaced, in keeping with the age of the building. The Proprietor has updated some of the policies that were recommended from the previous inspection ensuring that residents are protected from abuse and self-harm. Staff continues their learning skills with the majority of them having obtained the recommended NVQ training in care. Aitken House DS0000027309.V309978.R01.S.doc Version 5.2 Page 6 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. Aitken House DS0000027309.V309978.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 Aitken House DS0000027309.V309978.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4,5 Quality outcome in this area is good. Good clear written information is available to prospective residents. New residents are assessed and invited to visit the home prior to moving in. EVIDENCE: There have been no new residents admitted to the home since the previous inspection. The written guidelines given to prospective residents are clearly written with a copy of the last inspection report and results of the quality assurance survey included. Two residents were case tracked throughout this site visit checking records from time of admission to present day. Both residents were also spoken to. The home has developed a clear assessment format. Records of visits and details from other disciplines were contained within each individual care plan. A copy of the contract with an annual letter informing residents of any change of fees was also stored within the individual records. One of the residents stated ‘I have made my own decisions since I first visited the home, I wouldn’t go anywhere else’. Aitken House DS0000027309.V309978.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10 Quality outcome in this area is good. Residents make their own decisions on their day-to-day activities Care plans identify health, personal and mental health needs of the residents and with their input, these are reviewed regularly to continue to meet their needs. Residents know that information about them is appropriately handled. EVIDENCE: Informal residents meetings take place when they meet up for the arranged activities to discuss outings, social events, meals and activities. These are recorded in an informal manner and are available for residents to read. The proprietors are open to suggestions and any results are taken to the following meeting. Two care plans were examined and found to contain details of residents’ personal care, social, health and mental health needs. Residents are involved at the time the care plans are written by their key worker and are invited to attend regular reviews, to discuss development and changes with their care. Aitken House DS0000027309.V309978.R01.S.doc Version 5.2 Page 10 When talking with residents it was confirmed that they make their own decisions regarding their daily needs, with several going out during the day. The care plans contained individual risk taking with the relevant assessment details in place, which is good practice to ensure that both the resident and the staff are aware of their commitment to each other. Both residents confirmed that they related to their own key worker who fully supported them and assisted whenever they could. Within the care plans were records of support given by the visiting Community Psychiatric Nurses and GPs, although the majority of the time the residents visit the GP at the surgery. Aitken House DS0000027309.V309978.R01.S.doc Version 5.2 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 Quality outcome in this area is good. Residents live in a communal setting and meal times are included as part of their socialising. Private individual time is also recognised. Social activities are arranged during the week. EVIDENCE: Throughout the day, residents were observed having a sociable nutritious lunch, after lunch residents occupied themselves by reading, sitting in the garden, going out to the shops or listening to the radio. A number of residents who were spoken to were happy that they could do what they liked, with staff organising an activity in the evening which they could take part in if they wished. One visitor was spoken to and stated ‘the staff always have time to sit and talk, and make tea so I can have some quiet time with my brother’. Aitken House DS0000027309.V309978.R01.S.doc Version 5.2 Page 12 Past evidence from previous visits showed that the menu is arranged during residents meetings, with special parties and on spec barbecues arranged at short notice. Several residents either go out to work, college, shopping or to visit friends. Their individual interests are included within the care plan and staff encourage residents to continue with their social interests and hobbies. Several of the residents go out shopping and assist those residents who are less inclined to go out with their shopping needs. Some residents have part time jobs in the local town and one resident attends college. During the warmer summer months the residents have enjoyed several barbecues and taken part in an organised garden fete to raise funds for future outings. The home provides a selection of wholesome meals, several residents enjoy helping the staff by setting the tables for meal times and preparing vegetables and making drinks for other residents. Aitken House DS0000027309.V309978.R01.S.doc Version 5.2 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality outcome in this area is good. Residents are well supported by staff and visiting professionals. Medication is stored and administered safely. EVIDENCE: Residents confirmed that they speak regularly with staff either on their own or within a group to discuss their personal needs and social aspects of their life. The care plans contained records of visits from the Community Psychiatric Nurse who visits some of the residents to help monitor their mental health needs, with some attending appointments with a Consultant Psychiatrist. Any medical needs are arranged through the local GP surgery with residents visiting the surgery themselves. Aitken House DS0000027309.V309978.R01.S.doc Version 5.2 Page 14 Appropriate safe medication administration procedures are in place; these were demonstrated during this site visit. One of the residents who was case tracked self medicates, collecting medicines from the pharmacy and having secure storage within their own room. A random selection of medication administration records were checked and corresponded with medicines within the locked cupboard. The proprietors ensure that all staff receive appropriate medication training, with an updated training organised next month. Written procedures are in place and both the Proprietors are trained nurses who oversee and supervise when necessary. Aitken House DS0000027309.V309978.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality outcomes in this area are good. The home has a complaints system in place with evidence of resident’s views being listened and acted upon. Good safe procedures are in place to protect residents. EVIDENCE: The home has an active complaints procedure in place, encouraging residents and relatives to air their views. Informal discussions during activity sessions give residents an opportunity to discuss any issues in a group, and regular meetings with key workers give residents an opportunity if they prefer a more private discussion. During this site visit no complaints were received and no concerns were received from the comment cards received prior to this visit from residents. One comment from a visiting professionals comment card was investigated during this site visit resulting in no action being required. The home retains copies of past complaints with the action taken. The policy on the protection of adults was seen and signed by staff who had read it, evidence within staff files confirmed that staff have undertaken adult protection awareness training and this is also included in the induction programme. Both staff on duty demonstrated the whereabouts of the policy and the date they had last read it. Aitken House DS0000027309.V309978.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,28,30 The quality outcome of this area is good. Residents live in a home that is clean and tidy, with comfortable private and communal space. EVIDENCE: The maintenance records were seen. Since the last visit, one resident who was case tracked had their bedroom redecorated, confirming they had chosen the colour scheme and were happy with the results, it also contained satellite TV and a variety of personal possessions. All three communal rooms were clean and tidy, containing comfortable seating. Since the previous inspection the smoke room had been redecorated and had been converted into a small dining room with smoking residents going out to the garden or outhouse. Aitken House DS0000027309.V309978.R01.S.doc Version 5.2 Page 17 Several of the older style windows had been replaced in keeping with the age of the building, the kitchen had been redecorated and a new decking area had been erected with access from one of the lounges. Wheelchair users are accommodated on the ground floor with appropriate hoist and grab rail facilities within the bathrooms. The home has a pleasant accessible private garden. Aitken House DS0000027309.V309978.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36 The quality outcome is good. The home provides knowledgeable, competent staff to meet the needs of the residents. EVIDENCE: Rota showed adequate levels of staff, with extra brought in when outings or escorts were arranged. The home is owned by Mr & Mrs Joory, both are registered mental nurses and manage the home. Residents who were spoken to confirm that staff have time to talk in private, with one stating ‘my key worker is exceptional, she provides me with support and encouragement when I am feeling a little low’. Evidence of good practice was seen that the proprietor follows a clear recruitment procedure when employing new staff. The staff files were seen of both of the care staff that were on duty, confirming that training and supervision takes place on a regular basis. Training such as manual handling, first aid, medication, fire training and mental health awareness has been undertaken during this past year. The proprietors encourage their staff to undertake the recommended NVQ training with 80 having achieved this, which is good practice. Aitken House DS0000027309.V309978.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,40,41,42 The quality outcome of this area is good. Both proprietors manage the home with Mr Joory taking overall managerial responsibility. The home has adequate health and safety procedures in place. EVIDENCE: One of the proprietors visits each day. Mr Joory takes overall responsibility for the day-to-day management of the home. He is a trained mental health nurse, offering support to both residents and staff. The home has good health and safety procedures in place to ensure the safety of residents and staff. A random selection of the maintenance records were checked and kept up to date. Aitken House DS0000027309.V309978.R01.S.doc Version 5.2 Page 20 The requirements and recommendations from the previous inspection had been completed, and no requirements were issued during this site visit. The quality assurance survey had been completed with the latest results added to the service users guide. Good accurate record keeping shows that residents are involved in their own care and have access to their documents. The registration certificate showed that the home accommodates young adults and as five of the residents are now over the age of 65 years a variation has been made to reflect the ages, as all five wish to stay at Aitken House. The home has a pleasant atmosphere; residents appeared relaxed and comfortable within their surroundings. The staff are well motivated and confirmed that they receive regular support from the proprietors. Aitken House DS0000027309.V309978.R01.S.doc Version 5.2 Page 21 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 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 x 28 3 29 x 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 x 3 x 3 3 2 2 x Aitken House DS0000027309.V309978.R01.S.doc Version 5.2 Page 22 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. 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 Aitken House DS0000027309.V309978.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 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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