Inspection on 09/01/07 for Alderney Street, 117

This inspection was carried out on 9th January 2007.

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 no outstanding requirements from the previous inspection report, but made 4 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 07/06/06

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 9th January 2007 09:30 Alderney Street, 117 DS0000065866.V322180.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.V322180.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.V322180.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 info@outlookcare.org.uk Outlook Care Ms Shirley Kaydea Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Alderney Street, 117 DS0000065866.V322180.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th June 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.V322180.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 on the 9th and 17th January 2007. It was carried out in this way in order to meet the acting manager on the second visit but this was not possible due to a need to change their shift. The inspector met three service users, four staff and a tour of the communal areas of the home was led by one of the service users who also showed their bedroom. The care of two service users was tracked and a selection of records seen. All the requirements from the previous inspection had been met and four requirements were made on this inspection. The service users and staff were open and welcoming to the inspection What the service does well: What has improved since the last inspection? What they could do better: Alderney Street needs to continue developing ways of communicating with service users and involving them in their home. The current staff do not reflect the culture of the service users and any future staff recruitment must take account of this. Alderney Street, 117 DS0000065866.V322180.R01.S.doc Version 5.2 Page 6 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. Alderney Street, 117 DS0000065866.V322180.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 Alderney Street, 117 DS0000065866.V322180.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): 2,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Outlook Care has clear policies and procedures for admitting service users. There were contracts in each of the service users files that were seen. EVIDENCE: Outlook Care has clear policies and procedures on the assessment of prospective residents. There have been no new admissions since the last inspection. Two service users files were seen and both contained a personal contract. Alderney Street, 117 DS0000065866.V322180.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are detailed and are reviewed every three months. Risk assessments to support service users in both indoor and outdoor activities are in place. EVIDENCE: Two service users care were tracked looking at their care plans, risk assessments and finances. Time was spent with one of the service users who was home on both days. They showed the inspector around the home, shared the activities they were doing. The other service user was around later on the first day but was wanting to be alone so no it was not possible to spend any time with them. Staff were observed giving this service user the space they needed. Care plans are updated every three months. There were clear guidelines for both physical and emotional needs of service users. Alderney Street, 117 DS0000065866.V322180.R01.S.doc Version 5.2 Page 10 One service user has challenging behaviour and guidelines were in place and clear. Staff spoken with showed their knowledge of this service user and were observed following the guidelines. There were risk assessments for service users, which covered both indoor and outdoor activities. They had been updated. The temporary manager has introduced a brief profile of each service user for agency staff to use. There are regular service users meetings, which look at outings, menus and any changes within the home. The minutes were seen. They are now completed using symbols to make them more accessible for service users. It may be that these could be kept in a display folder for service users to look at. Alderney Street, 117 DS0000065866.V322180.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. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are more planned activities with service users. Staff are using more symbols and signs to help increase service users participation and choice. These need to continue to develop and be kept updated. EVIDENCE: One of the service users, who has been in the home since March has a pictorial weekly planner. This needed to be updated to reflect that they have been attending college. (The key worker had updated the plan by the second day of the inspection) The plan includes day centres, college; taxi rides meals out and other leisure activities such as music, walks, and games. They are now completing a world music course at college and attending a day centre. They were observed Alderney Street, 117 DS0000065866.V322180.R01.S.doc Version 5.2 Page 12 relating well to staff being generally more relaxed and involved in the home, which is a refection of the encouragement that the staff has given them. The staff spoke about a recent trip to the theatre with three of the service users. Other activities that have increased are trips to the cinema, outings, as well as evidence of more indoor entertainment being available. One of the service users enjoys doing the household shopping. They have an aversion to food so the staff are encouraging them gradually to look at the food they will still eat such as milk and possibly macaroni cheese. Another service user has a good relationship with the local greengrocers and enjoys buying the fruit and vegetables there with support. The staff prepare the meals and encourage the service users to be more involved in preparing food. One service user pointed out the cupboard they take their breakfast cereal from. The old menus seen did appear to have more fruit and vegetables. Staff spoke of the difficulty in encouraging service users to eat more fruit and vegetables therefore they are slowly introducing more into the meals provided. At the last inspection staff were developing a pictorial menu. On neither day was there a pictorial menu seen. Staff said that the foods chosen did not have a picture as yet. There was a pile of photographs of food cut out of magazines on the top pf the fridge. It may be that staff could use the digital camera to take photographs of the foods that service users like or have enjoyed or ones, which they have not found pictures of. The staff said that they support the service users to plan the menus using large cookery books with colourful photographs. Alderney Street, 117 DS0000065866.V322180.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20,21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each service user has an assessment of their personal and healthcare needs. Guidelines are in place and are regularly updated. However whoever completes these needs to ensure that they have put the date and their name. EVIDENCE: The files of two service users had clear guidelines about the level of personal support required as well as their healthcare needs. Each service user has a separate healthcare file. There are clear guidelines for specific healthcare issues that have been updated when circumstances have changed. Though it is important that the person completing the updates puts their name and the date. The staff have all been trained in the specific healthcare needs of the service users and have grown in confidence in their ability to manage the set procedures and guidelines. One staff member who has recently transferred from being an agency worker said that they understand that they will not Alderney Street, 117 DS0000065866.V322180.R01.S.doc Version 5.2 Page 14 undertake nights until they have completed the specific training for this service users needs. Each service users file contains a ‘death and dying’ form which outlines service users and their families wishes regarding funeral arrangements- type and place of burial or cremation. People who live at Alderney Street are weighed every week. This has been particularly helpful for two service users one who eats only food supplements and one person who’s been on a controlled weight loss programme for health reasons. On the first visit these had stopped being recorded on the 26th October. On the return visit the weights had been recorded for every week from the 26th October. Medication records were checked for all service users. The system is clear and well organised. The medication cupboard was well kept with opening dates on all bottles and creams and any medication outside of the boxes dispensed by the chemist. All staff have completed the initial medication training and a number of staff are now developing their medication training through a distance learning course. One of the staff on duty showed how they always keep an updated copy of the BNF (British National Formulary) within the home for reference. Alderney Street, 117 DS0000065866.V322180.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. All staff have completed training in adult protection. There is a system for complaints and compliments. This needs to be developed so that service users can express their views of the service EVIDENCE: There is a clear complaint system though the forms are not in an accessible format for the service users. The manager needs to develop a way to support service users to express their compliments and ‘complaints’. Outlook Care has clear policies on the protection of service users. All staff at Alderney Street have completed their training in adult protection. Observing practise showed that they managed confidently and clearly a service users challenging behaviour following the set guidelines giving the service user space and ensuring other service users were ok. Alderney Street, 117 DS0000065866.V322180.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Alderney Street is now more homely and comfortable. The home was clean and fresh. EVIDENCE: A tour of all the communal areas with one of the service users and staff showed that the home reflects more the life of the people who live there. The downstairs dinning room has been redecorated. There are throws over the sofas softening the look and making the room more comfortable. The service user took delight in showing the dartboard that is new. There was a deflated red balloon hung in the dinning room on both occasions. The staff said that this was one of the service users who wished it to remain. The hall and sitting room had photographs of recent activities and a framed photograph of each of the service users. The most recent service user to arrive did not have their photograph displayed. The staff on duty said that the service user had removed it to their room. On the second visit a new photograph was in place in the lounge along with that of the other people in the home. Alderney Street, 117 DS0000065866.V322180.R01.S.doc Version 5.2 Page 17 The service user showed their room and the addition of a chair which they use for watching their TV. They were happy with the room and the décor. Their favourite colour is red which was reflected in the chair and picture on the wall. The room was more spacious and more comfortably arranged. The office was more ordered and organised with information clearly displayed. The staff pictorial rota was empty on the first visit but did display the photographs of the staff on duty on the second visit. The staff may wish to consider creating larger photographs to use and to consider whether all the information regarding laundry days needs to be displayed especially as the staff on duty said that both the service users and the staff know the designated days for each person in the home. There are large holes along the wall of the hall to the kitchen staircase. Temporary repairs have been done but full repairs need to be completed. The service user giving the tour showed the bathroom they use which has a shower and now has a shower chair following an assessment by an occupational therapist. The care staff ‘s duties include keeping the home clean. How this is divided is part of the shift plans. Service users are being encouraged to be more involved in caring for the home. Service users help with their laundry. The home was clean and fresh. Alderney Street, 117 DS0000065866.V322180.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35,36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff rotas have been revised and are monitored to ensure double shifts are avoided and that staff take time off. There is regular supervision and extra permanent staff. Future recruitment needs to reflect the culture of the service users. EVIDENCE: Since the last inspection the staff shift hours and patterns have changed. There is now guidance to avoid planned double shifts that is monitored by the management team. There has been an increase in the permanent staff hours, one support worker now works 37.5 hours instead of 18.5. Two regular staff have been provided from the agency one part time one full time. One agency staff has become a permanent member of staff since the beginning of December. They said they have worked within the home for a couple of years so know the service users well. They have had received their induction but needs to complete specific training on the needs of one service user before beginning nights. The staff said that the new rota is working well. They know that they must take their time off and the requests for overtime is Alderney Street, 117 DS0000065866.V322180.R01.S.doc Version 5.2 Page 19 equal among all. Staff can work one of their days off and up to one week of their annual leave as bank staff. The deputy manager said that they have changed the staff meeting to the 19th to discuss the change in nighttime rota. The waking night will be dropped and the rota will return to being one sleep in staff at night. A alarm system is being set up for the service users who can have seizures at night and the staff will monitor these. If necessary they will revert to a waking night as well. A copy of the rota had not been included in the pre inspection questionnaire and the ones obtained on the inspection, which covered a four week period in December was handwritten in pencil with various changes. The staff rotas seen being prepared were typed and this should be the norm. Staff now put on a separate sheet the extra shifts they would like to work. Four staff were spoken with and the records of three staff looked at. The staff spoke of receiving regular support and supervision. The acting manager has divided up the supervision of staff with the deputy manager and together they are working through staffs’ annual appraisals. Each of the files showed evidence of supervision with records of notes taken. All had a supervision contract. There was a separate file for training records, which showed the mandatory updates undertaken and records of other training. The current staff do not reflect the culture or ethnicity of the service users and all efforts must be made in future recruitments to ensure this is one of the priorities. Alderney Street, 117 DS0000065866.V322180.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff spoke highly of the acting manager (in lieu of maternity leave). All requirements have been met from the last inspection. All health and safety records were up to date and a new keypad system to secure the front door is now in place. EVIDENCE: The inspection took place over two days in the hope of meeting the acting manager but their shift had to change due to the change in waking night and the team meeting. The staff met spoke highly of the acting manager and the further changes they have introduced. Staff say that they are clear about what their expectations of staff are, good at training and have organised the office so that all know where everything is held. Alderney Street, 117 DS0000065866.V322180.R01.S.doc Version 5.2 Page 21 The deputy manager was on duty the second day of the inspection and had access to the staff files. They were able to talk through the new systems, how the rota is working and the plans to try out the alarm and discuss all concerns with the staff before the withdrawal of the waking night. Outlook Care has a quality assurance system and annual questionnaires have been sent out to families though the feedback was not available. The deputy manager said that they will look again at how to help service users express their compliments and complaints with the home. The fire records were well maintained and all fire points and emergency lighting regularly tested. There was a fire risk assessment carried out in March and the London fire brigade advised the home on the fitting of a keypad rather than a chain to secure the door. This is working well and ensures the safety of the service users. The accident and incident book was seen and all relevant incidents were reported to the Commission with the appropriate action taken. Alderney Street, 117 DS0000065866.V322180.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 2 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 X 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 2 3 3 3 X 3 X X 3 X Alderney Street, 117 DS0000065866.V322180.R01.S.doc Version 5.2 Page 23 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. Standard YA19 Regulation 14 Requirement All guidelines and updates must have the name of the person who completed it together with the date. The manager must develop an accessible way for service users to express their views of the service The manager must make sure that the repairs to the walls along the stairs are carried out. All new staff recruited should reflect the service users ethnicity and culture. Timescale for action 28/02/07 2. YA22 22 31/07/07 3. 4. YA24 YA33 23 18 31/07/07 28/02/07 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 Alderney Street, 117 DS0000065866.V322180.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 Alderney Street, 117 DS0000065866.V322180.R01.S.doc Version 5.2 Page 25 - 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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