Inspection on 04/04/05 for Alison House

This inspection was carried out on 4th April 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 13/09/05

Alison House 20/09/04

Alison House 19/05/04

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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 Announced 4 April 2005 @ 09.30 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 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 Stationary 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 Version 1.00 Page 3 SERVICE INFORMATION Name of service Alison House Address 4 Hadleigh Road, London, N9 7BX Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208 805 3200 Mr Jessie Bueiisesu Espino & Mrs Angelina Lingal Espino Mrs Angelina Lingal Espino Care Home only (PC) 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia. (MD) of places Conditions of registration Date of last inspection There are 2 conditions of registration 20 September 2004 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 suport for three younger 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 loungediner, 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. ALISON HOUSE Version 1.00 Page 4 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 4 hours. 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. All three service users were in the home at the start of the inspection. Two service users later left the home to attend a day centre, and one service user remained for most of the inspection period. The inspection process included a full tour of the premises, reading service users’ care plans, and discussing with them, their experience of living in the home. At the last inspection, fourteen requirements had been made, thirteen of which had been met. One requirement was only partly met and has been restated in this report. The overall findings in this report are that service users’ needs are being met and they are enabled to lead relevantly independent lives. What the service does well: What has improved since the last inspection? Thirteen requirements of the fourteen made at the last inspection were fully met. There has been an improvement in the standard of décor and overall appearance of the home. ALISON HOUSE Version 1.00 Page 5 There is a better format for the assessment of service users’ needs, and their views about the service are sought and recorded. Care reviews are now carried out annually by care managers. Staff training and supervision has improved, and regular staff meetings are held. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. ALISON HOUSE Version 1.00 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 Standards Statutory Requirements Identified During the Inspection ALISON HOUSE Version 1.00 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 standard(s) 2 Progress has been made since the last inspection. Very positive relationships have been formed between the service users and the staff, which, together with well documented assessments and care plans, provide the basis for a good understanding of service users’ needs. EVIDENCE: All of the service users have lived at the home for several years. There is a consistent staff group, which consists of the extended family of the providers. The service users were asked about their individual needs. Two of the service users were very positive about their experience of living at the home and stated that their needs were being met. Better assessments of service users’ needs are carried out, following the introduction of new assessment forms, which now record all necessary information. More comprehensive guidance is now provided to guide staff on how best to meet service users’ needs. At the time of the inspection, one service user was experiencing mental health problems and said that she was not happy and did not want to stay in the home. This issue is further addressed under Standard 7.2. The service users’ care plans provide information about their needs. Records of annual reviews by care managers indicated that the service users’ needs were being met. One record stated, “Client’s view towards the care provision is good and I think the care arrangements are appropriate and no changes are needed”. ALISON HOUSE Version 1.00 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 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. The home facilitates and encourages service users to live as independent lives as possible, while ensuring their safety through appropriate risk assessments. EVIDENCE: The care plans reflected service users’ needs as they changed. Service users stated that they were consulted and were aware of the contents of their care plans. All service users had yearly reviews by care managers. Regular meetings are held with service users to decide on activities in the home, and service users said that they were able to make suggestions, which 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 key. They could stay out as late as they liked, but for safety reasons, were asked to let the manager know their whereabouts. ALISON HOUSE Version 1.00 Page 9 Risk assessments were recorded in the care plans. ALISON HOUSE Version 1.00 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 standard(s) 12, 13, 15, 17 Service users are enabled to develop and pursue independent lifestyles, and they are well integrated in the local community. Contact with friends and family is maintained and visitors are welcomed at the home. The food provided is good, plentiful, and offers choice and variety. EVIDENCE: Two of the service users attend the Psychiatric Rehabilitation Day Centre in Haringay, going by public transport. The day centre provides work-based activities and social skills. Entries are made in the service users’ daily records to show their attendance at the centre and other facilities. One service user 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 service users 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 service user, who has no relatives in the U.K., 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. ALISON HOUSE Version 1.00 Page 11 Service users said that they are always asked for their preference about food and often assist with the shopping for the home. They also participated in cooking their meals. The fridge and food cupboards contained appropriate amounts and types of food and there was fresh fruit in the kitchen. ALISON HOUSE Version 1.00 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 standard(s) 18, 19, 20, 21 Service users are able to adequately meet their own personal care needs, with minimal support from the staff. The healthcare needs of service users are being met with the support of the local G.P and community mental health teams. There is a safe system for the administration of medicines. The service users’ wishes for their funeral arrangements are known by the staff and are respected. EVIDENCE: All the service users are able-bodied and do not need physical support for personal care, but it was recorded in care plans when they needed to be reminded and encouraged to bathe. The service users’ records showed that they were seen by their consultant every six months. An urgent appointment was being sought for one service user who was unwell at the time of the inspection. There were records for each service user which showed when they were seen by the G.P. and attended dental, optical and other healthcare appointments. The case files showed that two service users receive medication by injection at a local clinic. One service user manages her own medication, for which she had an appropriate risk assessment carried out. ALISON HOUSE Version 1.00 Page 13 Staff records indicated that they have recently attended training in medication. The wishes of each service user about their death and funeral wishes are recorded in their files. ALISON HOUSE Version 1.00 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 standard(s) 22, 23 Service users were happy with the service provided and knew how to complain if necessary. There are adequate systems in place to protect service users 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 service users stated that they were happy with the service. The staff records showed that they had all attended a training course on adult protection, which was provided by Barnet Local Authority. ALISON HOUSE Version 1.00 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 standard(s) 24, 25, 26, 27, 30 The recent improvements in the decor of this home provide a pleasing, comfortable and relaxed environment. The home was generally clean and tidy but one bedroom needs a thorough clean, and one service user’s wardrobes need to be replaced. A protruding nail on the staircase could cause an injury. EVIDENCE: A full tour of the premises was carried out. The environment was friendly and welcoming and the service users said that they were pleased with their accommodation. The communal furniture in the lounge was attractive and comfortable. The conservatory now has an attractive tiled floor. The two bathrooms have new wall tiles, and soap and clean towels were provided. Generally the home was clean and tidy and there were no offensive odours. All of the bedrooms were visited. Two of the bedrooms were clean and attractively presented, and there were personal effects seen. However, one ALISON HOUSE Version 1.00 Page 16 bedroom needed a thorough clean and dusting. The wardrobes in this room were old and shabby and need to be replaced The pointed end of a screw nail was seen protruding through the wall on the staircase, which could cause injury. An immediate requirement was made to remove the nail. ALISON HOUSE Version 1.00 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 35, 36 There are sufficient staff on duty to meet service users’ needs. Progress has been made in implementing a programme of training for staff, who also now receive regular supervision. However, given the specific needs of the service users, training in mental health issues needs to take place. Staff are appropriately supervised. 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 member of staff on duty at the inspection was spoken to. Service users stated that the staff, all of whom are members of an extended family, were very caring and treated them well. Staff records indicated that training has been provided for staff in food hygiene, first aid and medication. There were records of regular supervision of staff, which reviewed their performance and identified training needs. Staff have not had training on mental health. ALISON HOUSE Version 1.00 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39, 41, 42 The home is generally well run, and improvements have been made in record keeping. The manager has a good understanding about areas that need improvement. For example; the safety and welfare of the service users needs to be protected by better fire equipment and fire drills. EVIDENCE: The manager is a qualified nurse and was able to provide 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 service users 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. Service users’ comments about the service are also recorded in minutes of residents’ meetings with staff. A safety certificate for the gas and central heating system was available. ALISON HOUSE Version 1.00 Page 19 The home has a portfolio of policies and procedures pertaining to the running of the home and the health, safety and welfare of service users A record of service users’ personal finances, showing money coming in and withdrawn, was available. Out-of-date eggs were stored in the fridge. These were immediately disposed of by the manager in the inspector’s presence. Although there were records showing that fire alarms are tested every week, no fire drills had been carried out. The fire extinguishers in the home were purchased locally and were domestic in type. However, there is no means of testing and/or servicing the equipment. Requirements have been made to address these issues. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No ALISON HOUSE Score Standard No 24 25 26 27 Version 1.00 Score 2 2 3 3 Page 20 6 7 8 9 10 LIFESTYLES 3 3 3 3 x Score 28 29 30 STAFFING x x 2 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x 3 Standard No 31 32 33 34 35 36 Score x 3 x x 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 x 3 x 3 2 x ALISON HOUSE Version 1.00 Page 21 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 24 Regulation 13(4)(a) Requirement Timescale for action 5/4/05 2. 3. 4. 5. 25 30 35 39 6. 42 The registered person must remove the bare screw nail from the staircase.This is an immediate requirement. 16(2)(c) The registered person must replace old wardrobes in a specific service users bedroom. 16(2)(j) The registered person must ensure that all bedrooms are thoroughly cleaned and dusted. 18(1)( )(i) The registered person must provide training on mental health issues for all staff. 24(1)(3) The registered person must canvass the views of the care professionals about the service. This requirement is restated. 13(4)(c) The registered person must ensure that out of date food is disposed of. 31/5/05 30/4/05 31/8/05 31/5/05 30/4/05 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. ALISON HOUSE Version 1.00 Page 22 Refer to Standard Good Practice Recommendations ALISON HOUSE Version 1.00 Page 23 Commission for Social Care Inspection 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. Extracts may not be used or reproduced without the express permission of CSCI ALISON HOUSE Version 1.00 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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