Inspection on 13/09/05 for Alison House

This inspection was carried out on 13th September 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

Alison House 21/04/09

Alison House 01/10/08

Alison House 06/12/07

Alison House 14/05/07

Alison House 22/08/06

Alison House 04/04/05

Alison House 20/09/04

Alison House 19/05/04

Similar services:

Clovelly House Residential Home Ltd

Abbey Road [53]

Cherry Tree House

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

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

CARE HOME ADULTS 18-65 Alison House 4 Hadleigh Road London N9 7BX Lead Inspector Tom McKervey Unannounced Inspection 13th September 2005 10:30 Alison House DS0000010601.V249222.R01.S.doc Version 5.0 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 DS0000010601.V249222.R01.S.doc Version 5.0 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 DS0000010601.V249222.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Alison House Address 4 Hadleigh Road London N9 7BX 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 8805 3200 020 8211 8098 Mr Jessie Busenpeso Espino Mrs Angelina Linga Espino Mrs Angelina Linga Espino Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Alison House DS0000010601.V249222.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home must advise the registering authority at such times as the specific service user vacates the home. One specific service user who is over 65 years of age and has mental health needs may remain accommodated in the home. 4th April 2005 Date of last inspection Brief Description of the Service: Alison House is a family run business; staffed exclusively by extended family members. The homes stated aims are to provide care and suport for three younger adults who have ongoing mental health problems. One resident is over the age of sixty-five, however a condition of registration is provided for this. The home is situated in Edmonton, just off the main Hertford Road. A range of shops and amenities is nearby, and there are good public transport links. The lounge- diner, one bedroom and a bathroom with toilet, are located on the ground floor. Two other bedrooms and a staff bedroom are located on the first floor. The home also has a lean-to conservatory and a garden at the rear of the building. Alison House DS0000010601.V249222.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over two hours, fifteen minutes. The purpose of the inspection was to determine what progress had been made since the last time the service was inspected, and to identify any shortfalls. The manager and one member of staff were present throughout the inspection, and there were no visitors. The inspection process included a full tour of the premises, reading residents’ care plans, and documents relating to the management of the service. All three service users were spoken to during the inspection. What the service does well: What has improved since the last inspection? What they could do better: Requirements have been made to address a specific resident’s weight loss, and the need for staff to have training in mental health issues to enable them to Alison House DS0000010601.V249222.R01.S.doc Version 5.0 Page 6 be more aware of, and able to meet the more specific needs of the residents. There needs to be better recording of the meals eaten by residents. The quality assurance audit of the service has to be completed by canvassing the views of the care professionals, and two issues about the maintenance of the property must be addressed. 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. Alison House DS0000010601.V249222.R01.S.doc Version 5.0 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 DS0000010601.V249222.R01.S.doc Version 5.0 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&3 There is good information about the service to enable prospective service users to make decisions about the home’s suitability. Very positive relationships exist between the residents and the staff, which enables good understanding of residents’ needs. EVIDENCE: The Statement of Purpose and Service Users Guide provide full information about the service. All of the service users have lived at the home for several years, and there is a stable staff group, which provides consistency and familiarity for the residents. The residents were very positive about their experience of living at the home and stated that their needs were being met. Records of annual reviews by care managers indicated that the service users’ needs were being met. One record stated, “Client’s views towards the care provision are good and I think the care arrangements are appropriate and no changes are needed”. Alison House DS0000010601.V249222.R01.S.doc Version 5.0 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 Care plans provide guidance for staff about how best to meet service users’ needs. There is a good system in place for consultation with the service users about life in the home. EVIDENCE: Two care plans that were sampled, showed that residents needs were assessed and care goals were set. Regular reviews of the plans included any changes of residents’ needs. All service users had yearly reviews by care managers. Regular meetings are held with residents to decide on activities in the home, and they said that their suggestions were acted on. For example, a suggestion by one service user was recorded; “I would like all of us to have dinner together occasionally, as sometimes we are not all in at the same time”. All the service users stated that they are encouraged to live as independently as possible and have their own front door and bedroom keys. They could stay out as late as they liked, but for safety reasons, were asked to let the manager know their whereabouts. Alison House DS0000010601.V249222.R01.S.doc Version 5.0 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): 11, 12, 13, 16 & 17 The residents are well integrated with the community and they are supported to live as independently as possible. However, records about the food provided are poor, and there is a risk that a specific resident’s dietary needs may not be met. EVIDENCE: Two of the residents said that they occasionally attend the Psychiatric Rehabilitation Day Centre in Haringay, going by public transport. The day centre provides work-based activities and social skills. One resident prefers not to attend a day centre, but has chosen to go out each day to a local café where she meets people in the same age group. All the residents have bus passes, which they said they use frequently to visit friends and relatives. There were records of these visits and of people coming to the home. One resident said that she keeps in contact with her relations in America by phone. Service users said that once a month they all go out together for a meal. There was only one week’s menu available for inspection, and it was not clear what choices about food were available, or what meals were actually provided. Alison House DS0000010601.V249222.R01.S.doc Version 5.0 Page 11 A requirement is made in relation to this issue. However, residents stated that they were satisfied with their meals. Alison House DS0000010601.V249222.R01.S.doc Version 5.0 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 & 21 The healthcare needs of service users are generally well met with the support of the local G.P and community mental health teams, and the system for the administration of medicines is safe. However, there is poor monitoring of a specific resident’s weight, about which there is a concern. EVIDENCE: All the residents are able to provide for their own personal care. Each resident is seen by their consultant psychiatrist every six months, and they attend a clinic where they have medication administered by injection. There were records of appointments with the G.P. dentist, optician, and other healthcare professionals. However, it was recorded in a resident’s case files, there was a concern about loss of weight, but there was no evidence of the weight being monitored, or a special diet being provided to address this concern. A requirement is made to address this matter. The medication taken by residents was recorded in a book. One resident manages her own oral medication, for which an appropriate risk assessment had been carried out. The case files contained information about residents’ wishes at the time of their death. Alison House DS0000010601.V249222.R01.S.doc Version 5.0 Page 13 Alison House DS0000010601.V249222.R01.S.doc Version 5.0 Page 14 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 residents are happy with the service provided and know how to complain if necessary. There are adequate systems in place to protect residents from possible harm or abuse. EVIDENCE: The Service Users Guide includes a complaints procedure and service users were able to describe how to make a complaint. The residents stated that they were happy with their life in the home. The staff records showed that they had all attended a training course on adult protection, which was provided by Barnet Local Authority. Alison House DS0000010601.V249222.R01.S.doc Version 5.0 Page 15 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 home provides a pleasing, comfortable and relaxed environment for residents to live in. EVIDENCE: A tour of the premises was carried out, including visiting each bedroom. The environment was friendly and welcoming and the residents said that they were pleased with their accommodation. The lounge furniture was attractive and comfortable, and the conservatory has an attractive tiled floor. All of the bedrooms were visited. They were clean and attractively presented, and there were personal effects seen. There was a broken fence panel in the garden, and the woodwork at the front of the premises needs repainting. A requirement is made about these issues. The home was clean and tidy and there were no offensive odours. Alison House DS0000010601.V249222.R01.S.doc Version 5.0 Page 16 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, 33, 35 & 36 There is a sufficient number of staff on duty to meet service users’ needs, and the staff are appropriately supervised. However, given the specific needs of the service users, training in mental health issues has still not been provided. EVIDENCE: The staff rota showed that there is always one member of staff on duty, which is satisfactory since service users are often out for most of the day. There is a sleep-in staff at night. The residents said that the staff, all of whom are members of the proprietors’ extended family, were very competent to care for them, and treated them well. No new staff had been recruited in the past year. There were records showing that staff received regular supervision. It was noted that the care staff had still not had any training on mental health, which was a requirement at the last inspection. This requirement is restated. Alison House DS0000010601.V249222.R01.S.doc Version 5.0 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 home is generally well run and the systems for ensuring the health and safety of residents are satisfactory. EVIDENCE: The manager is a qualified nurse and she provided training and other records as evidence of her competency to manage the home A quality assurance audit has been partly completed. Questionnaires about the service from the residents and some relatives were seen, which showed that service users were generally happy with the service provided. However, the views of the professionals involved in the service had not been canvassed. A requirement from the last inspection in relation to this issue, is restated. Residents’ comments about the service are also recorded in minutes of their meetings with staff. A safety certificate for the electrical, gas and central heating systems were seen. Portable electrical appliances had been tested and a current insurance liability certificate was in place. There were records showing that smoke alarms were tested every week, and a fire drill had been recently carried out. Alison House DS0000010601.V249222.R01.S.doc Version 5.0 Page 18 A record of the residents’ personal finances, showing money coming in and withdrawn, was seen. Alison House DS0000010601.V249222.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 X 3 X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 X 3 X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 3 X 3 3 CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Alison House Score 3 2 3 3 Standard No 37 38 39 40 41 42 43 Score 3 X 2 X X 3 X DS0000010601.V249222.R01.S.doc Version 5.0 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 17 Regulation 17 Sch 3(3m) 12(1)(a) Requirement The registered person must ensure that records of menus are maintained to show the meals actually provided for residents The registered person must ensure that a specific resident’s weight is regularly recorded, and an appropriate diet is provided to meet their health needs. The registered person must replace the broken fence panel and repaint the exterior woodwork at the front of the home. The registered person must provide training on mental health for all staff. This requirement is restated from the last inspection. Previous timescale of 31/8/05 not met. The registered person must canvass the views of care professionals about the service. This requirement is restated from the last inspection. Previous timescale of 31/8/05 not met. Timescale for action 31/10/05 2 19 31/10/05 3 24 23(2)(b) 31/12/05 4 35 18(1)(i) 31/12/05 5 39 24(1)(3) 31/12/05 Alison House DS0000010601.V249222.R01.S.doc Version 5.0 Page 21 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 DS0000010601.V249222.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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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