Inspection on 22/08/06 for Alison House

This inspection was carried out on 22nd 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 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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

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 13/09/05

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 Key Unannounced Inspection 22nd August 2006 10:45 Alison House DS0000010601.V303664.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Alison House DS0000010601.V303664.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Alison House DS0000010601.V303664.R01.S.doc Version 5.2 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.V303664.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One specific service user who is over 65 years of age and has mental health needs may remain accommodated in the home. The home must advise the registering authority at such times as the specific service user vacates the home. 13th September 2005 Date of last inspection Brief Description of the Service: Alison House is a family run business; the staffing coming exclusively from family members. The homes stated aims are to provide care and support for three adults who have ongoing mental health problems. 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 on the first floor. The home also has a lean-to conservatory and a garden at the rear of the building. The fees for the eservice range from £350 to £400 per week. Alison House DS0000010601.V303664.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection, which took place over a period of three hours, was carried out as part of the Commission’s inspection programme and to check compliance with the key standards. The inspector gave the manager a presentation about the changes to the inspection process within the “Inspecting for Better Lives Process”. The manager, a member of staff, and all three residents were present during the inspection. The inspection process included a tour of the premises and talking to the residents about their experiences of living in the home. Residents’ files and other documents relating to the running of the home were examined. What the service does well: What has improved since the last inspection? Residents’ weights are regularly recorded, particularly when there is a concern. Staff have attended training in mental health issues. Some improvements have been made to the environment that were identified at the last inspection. A survey of residents’ views has been done to audit the quality of the service. Alison House DS0000010601.V303664.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. Alison House DS0000010601.V303664.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Alison House DS0000010601.V303664.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): 2, 3 The quality in this outcome group is excellent. This judgement has been made from evidence gathered both during and before the visit to this service. The residents and the professional services involved agree that the home continues to meet the residents’ needs. EVIDENCE: At the time of the inspection, no new service users had been admitted to the home. All three residents had lived in the home for a number of years. The residents all stated that they liked living there and the manager and staff were very attentive to their needs. There were copies of regular reviews by the Community Mental Health Team and care managers in the residents’ files, which confirmed that their needs were being met. One reviewer stated; “This placement continues to be appropriate and is ideal. The placement represents best value”. Alison House DS0000010601.V303664.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 The quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. The residents’ care plans set appropriate goals and are supported by the Community Mental Health Team. The care plans support residents to be as independent as possible. There is a good system in place for consultation with the residents about how they wish to live in the home. EVIDENCE: All the care plans showed that residents’ needs were assessed and care goals were set. Regular reviews of the plans included any changes in the residents’ needs. The objectives reflect the support provided for residents to be as independent as possible. Care plans also contained risk assessments relating to activities within the home and in the community. Alison House DS0000010601.V303664.R01.S.doc Version 5.2 Page 10 All service users had regular CPA, (Care Programme Approach) reviews by the Community Mental Health Team and 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. This was documented in the minutes of the meetings. 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. Residents described several areas of choice, including bedtimes going out when they wished and in one resident’s case, not to attend a day centre. Residents also accompany the manager to the supermarket where they can choose what they want to eat. Alison House DS0000010601.V303664.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, 15, 16 & 17 The quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. There are opportunities for personal development through attendance at day centres, other local facilities and in the home. The residents are well integrated with the community and they have an independent lifestyle. The residents are encouraged and supported to develop and maintain contacts with friends and relations. However, records about the food provided are poor, which could pose a risk that residents’ dietary needs may not be met. EVIDENCE: Alison House DS0000010601.V303664.R01.S.doc Version 5.2 Page 12 Two of the residents said that they occasionally attend a Psychiatric Rehabilitation Day Centre, going by public transport. This day centre provides work-based activities and training in 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. Residents are supported by the staff to cook and shop. All the residents have bus passes, which they said they use frequently to visit friends and relatives. However, the only visits recorded were by “official” visitors and a requirement is made that all visitors sign the visitors’ book. This is necessary for health and safety reasons. One resident said that she keeps in contact with her relations by phone. On the day of the inspection, another of the residents went out for the day with her boyfriend. She said that her boyfriend often visited her at the home and was able to see her in her room. 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 also said that the staff respect their privacy and always knock their door before being invited to enter. The residents said that once a month they all go out with the staff for a meal. Although there was a menu available, it was not clear what meals were actually provided. A requirement was made at the last inspection about this matter and is restated in this report. All three residents said they were happy with the meals provided and they had plenty to eat. Fresh fruit was seen in the kitchen. Alison House DS0000010601.V303664.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 & 21 The quality in this outcome group is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The physical and emotional healthcare needs of service users are generally well met with the support of the local G.P and community mental health teams. The residents are supported by the staff to provide their own personal care, and their wishes are recorded in the event of their death. The administration of medicines was not being recorded, which could result in medication not being taken safely, and the policy needs to include provision for self-administration of medication. EVIDENCE: All the residents are able to provide for their own personal care. One resident’s care plan states the need to encourage regular bathing. Each resident is seen by their consultant psychiatrist every six months, and they attend a clinic where they have medication administered by injection. Alison House DS0000010601.V303664.R01.S.doc Version 5.2 Page 14 There were records of appointments with the G.P. dentist, optician, and other healthcare professionals. There were records of monthly weight monitoring. One resident used to manage her own oral medication but at the time of the inspection, this situation had changed and was now administered by the staff. The inspector was concerned that there was no record of administration of medicines and an immediate requirement was made for appropriate recording forms to be obtained from the pharmacist. This has now been done. There was evidence that staff had been trained to administer medication. A requirement is made to amend the medication policy/procedure to include a section on self-administration of medicines for when it is appropriate for residents to do so. The case files contained information about residents’ wishes at the time of their death. Alison House DS0000010601.V303664.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 The quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. The residents are happy with the service provided and know how to complain if necessary. There are good 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 said they were well cared for and they were happy with their life in the home. No complaints had been recorded in the complaints book. The staff records showed that they had all attended a training course on adult protection, which was provided by the Local Authority. Alison House DS0000010601.V303664.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 & 30 The quality in this outcome group is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The home provides a pleasing, comfortable and relaxed environment for residents to live in and residents have their own personal possessions. However, some bedroom furniture and curtains are worn and need replacing. The windows are dirty and need cleaning. EVIDENCE: A tour of the premises was carried out, including visiting each resident in their bedroom. The environment is homely and welcoming and the residents said that they were pleased with their accommodation. The lounge furniture was attractive and comfortable. The bedrooms were clean and attractively presented, and there were personal effects such as televisions, photographs and ornaments. Some new bedroom Alison House DS0000010601.V303664.R01.S.doc Version 5.2 Page 17 furniture had been purchased, but a requirement is made for the bedroom furniture in one resident’s room to be replaced. Further requirements are made for the curtains in the downstairs bedroom to be replaced so that they fully close when drawn. The windows needed cleaning and a requirement is made about this issue, otherwise, the home was clean and tidy and there were no offensive odours. Alison House DS0000010601.V303664.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): 32, 35 The quality in this outcome group is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. There are sufficient staff available to meet residents’ needs but the staff rota does not properly reflect staffs’ duties. Staff have attended training appropriate to the needs of residents. EVIDENCE: No new staff had been recruited in the past year. All of the staff are members of the proprietors’ family or are related to her. The staff rota was examined, which stated that there is always one member of staff on duty. This is satisfactory since service users are often out for most of the day. There is a sleep-in staff at night. However, the rota was not accurate or kept up to date. The manager was not identified as being on duty and the sleep-in person was not identified for night duty at the time of the inspection. A requirement is made for the staff rota to accurately reflect all staffs’ duties. Alison House DS0000010601.V303664.R01.S.doc Version 5.2 Page 19 The residents said that the staff, were very competent to care for them, and treated them well. It was noted that since the last inspection, the staff had attended training on mental health. Alison House DS0000010601.V303664.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 & 42 The quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. The manager has appropriate qualifications and experience and the home is generally well run. Accurate accounts are kept for residents’ personal finances, and they are able to have an input to the effective running of the service. There are good systems for ensuring the health and safety of the residents. EVIDENCE: The manager is a qualified nurse and she provided training and other records as evidence of her competency to manage the home. Alison House DS0000010601.V303664.R01.S.doc Version 5.2 Page 21 The inspector was shown a completed service users’ survey that indicated a high level of satisfaction with the service. Minutes were seen of meetings between the manager, staff and residents which showed their involvement in the day-to-day running of the home. There were records of two residents’ personal finances, which were up to date and accurate. Certificates of safety were seen for gas, electric, fire and emergency lights. The fire alarms were tested weekly and no health and safety hazards were detected at the inspection. The home has a current certificate of insurance. Alison House DS0000010601.V303664.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 3 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 2 25 3 26 2 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 X 33 2 34 X 35 3 36 X 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 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 3 X 3 X 3 3 X Alison House DS0000010601.V303664.R01.S.doc Version 5.2 Page 23 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. 2. Standard YA15 YA17 Regulation 17(2) Sch 4 17 Sch 3(3m) Timescale for action The registered person must 31/10/06 ensure that all visitors to the home sign the visitors’ book. The registered person must 31/10/06 ensure that records of menus are maintained to show the meals actually provided for residents. This requirement is restated from the last inspection. The previous timescale was 31/10/05 The registered person must 23/09/06 obtain appropriate forms to record the administration of medicines. (This has now been done). The registered person must 31/10/06 amend the medication policy and procedure to include a section on self-administration of medicines for when it is appropriate for residents to do so. The registered person must 30/11/06 replace the worn bedroom furniture in one resident’s room. The registered person must 31/10/06 ensure that the windows throughout the home are cleaned. Requirement 3. YA20 13(2) 4. YA20 13(2) 5. 6. YA25 YA26 16(2)(c) 16(1) Alison House DS0000010601.V303664.R01.S.doc Version 5.2 Page 24 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.V303664.R01.S.doc Version 5.2 Page 25 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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