Inspection on 07/06/06 for Alderney Street, 117

This inspection was carried out on 7th June 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Alderney Street, 117 08/01/08

Alderney Street, 117 22/06/07

Alderney Street, 117 09/01/07

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 08/07/2008.

CARE HOME ADULTS 18-65 Alderney Street, 117 117 Alderney Street London SW1V 4HE Lead Inspector Ann Gavin Unannounced Inspection 7th June 2006 09:30 Alderney Street, 117 DS0000065866.V292472.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 Alderney Street, 117 DS0000065866.V292472.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. Alderney Street, 117 DS0000065866.V292472.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alderney Street, 117 Address 117 Alderney Street London SW1V 4HE 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 7834 1161 020 7834 1161 Outlook Care Ms Shirley Kaydea Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Alderney Street, 117 DS0000065866.V292472.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th March 2006 Brief Description of the Service: 117 Alderney Street is a residential care home for 4 people with a learning disability and/or challenging behaviours. At the time of this inspection there were two women and two men living in the home. Alderney Street is owned by Westminster Council who lease the property to New Era Housing Group. The care and staff are provided by Outlook Care. The home is located between Pimlico and Victoria. There are local shops and other services close by. Transport links are very good with easy access to both tube and buses. The accommodation is in a large terraced house in Victoria, with wheel chair access and a lift serving all floors. Each resident their own room with communal areas. There is a small paved garden leading from the dining room. Alderney Street, 117 DS0000065866.V292472.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out from 10am to 5pm on Wednesday 7th June. The inspector met and talked with all four service users during the course of the day. All the staff on duty were spoken with both individually and as a group. The care of two service users were tracked, a selection of records seen and a tour of all public parts of the home and one service users bedroom were seen. The Manager was not in the home though scheduled to be on duty and none of the staff were aware of their whereabouts. There were 8 requirements made and the main concern was around the continual use of overtime resulting in shifts that are too long. Staff were repeatedly on the rota for a double day shift and working an afternoon shift after a waking night. One of the requirements of a previous inspection last year had been this same issue of too long shifts. The pattern had appeared to have changed to more acceptable shift patterns but the poor practise has returned. What the service does well: 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. Alderney Street, 117 DS0000065866.V292472.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 Alderney Street, 117 DS0000065866.V292472.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The outcome for this area is adequate. Alderney Street has clear admission policies. EVIDENCE: The admission policy was, according to the pre inspection questionnaire, reviewed in October 2004. Alderney Street last admission was in March 2006. The manager received a care plan and other information about the service user but there was a lack of information on their life story and their normal or preferred routine. The home have obtained this information. The service user has settled in well and told the inspector how happy they were. Alderney Street, 117 DS0000065866.V292472.R01.S.doc Version 5.2 Page 8 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): 6,7,9 The outcome for this area is good. Care plans are in place and reviewed regularly. Service users have risk assessments. EVIDENCE: Two service users care were tracked looking at their care plans, risk assessments and finances. The inspector met both service users. Staff supporting the service users were spoken with to gain a wide picture of their care. The care plans were in place and had been reviewed. The service users have been encouraged to be more involved in their care and planning activities. One of the service users had a form showing ‘things that I like that make me happy’ and ‘ things that I dislike and make me sad’. They also had a planning book showing areas of their life that is being completed. Both services users had risk assessments on both indoor and outdoor situations. All of the service users underwent fire training and held certificates. The new service user had a pictorial fire safety card. There were details of local advocacy services. A form of infringement was seen on one file relating to the lock on the front door for the safety of service users. Alderney Street, 117 DS0000065866.V292472.R01.S.doc Version 5.2 Page 9 The financial records were clear and the book balanced. Transport costs to venues remains a high cost for service users. Alderney Street, 117 DS0000065866.V292472.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 The outcome for this area was adequate. There are more planned activities for service users. EVIDENCE: The pre inspection questionnaire completed by the manager listed the recreational activities inside the home as darts, Lego, puzzles, drawing and painting. It would be good to see more of the artwork of the service users displayed within the home. There was evidence of more social activities for the service users. Three of the service users now attend a club every Monday evening. The other service user goes swimming on that night. There have been day trips and the home were preparing for a big party for the birthday of one of the service users. The service user new to the home now has a travelcard and an application for dial a ride and a taxi card. A pictorial timetable has been developed of their week. The day centre visited the home to assess the service user on the day of the inspection. Alderney Street, 117 DS0000065866.V292472.R01.S.doc Version 5.2 Page 11 This service user showed the inspector their room and was clearly delighted about their purchase of a music centre and the attractive furniture bought to display it. Service users are supported to maintain contact with their families. Staff are still building up a pictorial menu. Alderney Street, 117 DS0000065866.V292472.R01.S.doc Version 5.2 Page 12 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 The outcome for this area is good. All service users have a health file. The medication system is working well. EVIDENCE: A staff member spoke of how they supported the new service user in their personal care using encouragement enabling them to become more involved in their care. They are now choosing their own clothes and helping with various aspects of personal care which they had not done before. This care worker is cutting this persons hair as they do not wish, as yet, to go to a hairdresser. There is a planned weight loss programme which is helping them become more mobile. All the service users are weighed every Sunday and their weight monitored by their key worker. The GP is reviewing their medication. Another service user has various support plans in place and monitoring tools for their health care. There are links with the podiatrist and ok health checks. The medication cupboard and records were looked at and all was in order. Alderney Street, 117 DS0000065866.V292472.R01.S.doc Version 5.2 Page 13 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 The outcome for this area is good. There have been no complaints since the last inspection. The manager said that all staff have completed training in the protection of vulnerable adults. EVIDENCE: The complaints book held no complaints since the last inspection. The manager said that all staff have completed their training in the protection of vulnerable adults. Outlook Care has clear policies on the protection of service users. Alderney Street, 117 DS0000065866.V292472.R01.S.doc Version 5.2 Page 14 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): 24,30 The outcome for this area was adequate. The new service user’s room has is now more homely and the home was clean. EVIDENCE: The new service user was happy to show the inspector their room. The old furniture had been removed and the room rearranged. They have bought a new TV stand/ cabinet with a new sound system. The service user showed how they like to watch TV and listen to music. ‘I am very happy with my room’ The downstairs dining room has not yet been redecorated it was a repeat requirement. The manager would like the same decorator who completed the bathroom to carry out the work. They have been approached and should be able to carry out the work within the next few weeks. Once the redecoration is complete the service users can choose new items of furniture and artwork for the room to make it more appealing and comfortable for all. The home was clean. Alderney Street, 117 DS0000065866.V292472.R01.S.doc Version 5.2 Page 15 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): 32,34,35 The outcome for this area was poor. The staff are working too long hours. The home are using overtime constantly some staff are working a waking night followed by an afternoon shift this is unacceptable practise. Staff cannot meet service users needs with repeatedly long shifts. This was a requirement and an immediate requirement in the past and the practise has reappeared. The manager needs to appoint a staff member to the vacancy and make sure that staff work appropriate hours. The staffing records need to be complete. EVIDENCE: Since the new service users admission the staff have changed from a sleep in member of staff to a waking night. In the previous inspection the Manager said that they were managing the part-time vacancy with bank staff. Reviewing the staff rota it was clear that some staff have returned to a shift pattern that was a reason for an immediate requirement last year as unacceptably long shifts. The service users needs cannot be met if staff are constantly working long shifts from 7am till 9.30 pm with a waking shift the next day followed by a 3 – 9.30. Other staff were working an afternoon shift following a waking night. The rota shows that some staff who work part-time are working overtime regularly on the other days and usually double shifts. The standard of care someone can give within such repeatedly long hours is questionable. Alderney Street, 117 DS0000065866.V292472.R01.S.doc Version 5.2 Page 16 This is unacceptable and unsafe practise. The manager must request permanent staff for the vacant posts. The provider must review the staffing rota with regard to the length of shifts and use of overtime mindful that this was a previous requirement last year. Reviewing staff records highlighted that some of the staff did not have either two references nor any evidence of the references being verified when they were employed sometime ago by another organisation which owned the care home. There were no clear individual training records and one staff member did not have a supervision agreement. The information in the staff files needs to be complete and as set out in the standards. Alderney Street, 117 DS0000065866.V292472.R01.S.doc Version 5.2 Page 17 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): 37,39,42 The outcome for this area is adequate. The manager needs to be accountable to the home at all times they are on duty and demonstrate their management of the staff team. EVIDENCE: The Manager was not in the home although was due to be on shift from 9am. No contact had been received and the staff who did not know the managers whereabouts. A staff meeting was planned for 11 am and the manager arrived at 11.30 saying that they had been unwell and did try to ring the home at 7.30 am but did not leave a message. The manager must advise staff if they are not on the premises when they are on the rota. The Managers says that they have sent out the annual questionnaires to all service users families and are awaiting the returns. There have been regular unannounced visits to the home and copies of these reports have been sent to the commission. The fire points drills and emergency lighting were all carried out regularly. The fire brigade have given advice about the chain on the front door and the home Alderney Street, 117 DS0000065866.V292472.R01.S.doc Version 5.2 Page 18 has requested the work as suggested by the fire authority. There have been no notifiable incidents and the accident and incident book were also seen. Alderney Street, 117 DS0000065866.V292472.R01.S.doc Version 5.2 Page 19 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 3 STAFFING Standard No Score 31 X 32 2 33 X 34 2 35 2 36 2 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 2 X 3 X X 3 X Alderney Street, 117 DS0000065866.V292472.R01.S.doc Version 5.2 Page 20 Yes 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 Standard YA24 Regulation 23 Requirement The dinning room must be redecorated to an acceptable standard. Repeat requirement The manager must request permanent staff for the vacant posts The provider must review the staffing rota with regard to the length of shifts and use of overtime. (A requirement which was also made last year) The manager must revise the staff rota so that staff are not working a waking night and day shift. Immediate requirement All staff records must be complete and contain all that the standards require All staff must have a supervision agreement The manager must notify staff if they cannot be in the home for their designated shift. Immediate requirement The manager must advise the commission for their failure to advise the home of two and a half hour lateness and failure to arrive for the staff meeting. DS0000065866.V292472.R01.S.doc Timescale for action 31/07/06 2 3 YA33 YA33 18 18 31/07/06 12/06/06 4 YA33 18 12/06/06 5 6 7 YA34 YA36 YA37 17 18 18 31/08/06 31/07/06 10/06/06 8 YA37 18 10/06/06 Alderney Street, 117 Version 5.2 Page 21 Immediate requirement 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 Refer to Standard YA34 Good Practice Recommendations The provider should obtain references for staff who were employed when the home was owned by a previous provider so that all staff have two written verified references. Alderney Street, 117 DS0000065866.V292472.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Hammersmith Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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. Extracts may not be used or reproduced without the express permission of CSCI Alderney Street, 117 DS0000065866.V292472.R01.S.doc Version 5.2 Page 23 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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