Inspection on 06/12/07 for Alison House

This inspection was carried out on 6th December 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 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 2 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 14/05/07

Alison House 22/08/06

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 6th December 2007 10:00 Alison House DS0000010601.V354201.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.V354201.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.V354201.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 alison-house@hotmail.co.uk 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.V354201.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. 14th May 2007 Date of last inspection Brief Description of the Service: Alison House is a family run business; the care staff 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 toilet, are located on the ground floor. There are two other bedrooms on the first floor, and a staff bedroom, which is also the office. There is another toilet and bathroom upstairs. There is a lean-to conservatory and a garden at the rear of the building. The fees for the service range from £350 to £400 per week. Alison House DS0000010601.V354201.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was completed in a period of three hours. The inspection was carried out as part of the Commission’s inspection programme and to check compliance with the key standards. There were no staff on duty during the inspection other than the manager with whom I spoke about the requirements from the last inspection. I met the three residents and spoke to them about their experiences of living in the home. Before this inspection, the manager sent an AQAA to the Commission, (Annual Quality Assurance Audit), which is a self-assessment audit of how the home meets the National Minimum Standards. Against each standard, the manager is asked to provide evidence about what the home does well, what they could do better, how they have improved in the last 12 months and what their plans are for improvement. I discussed this document with the manager and pointed out the areas where the information could be improved. I visited all areas of the premises and I examined residents’ files and other documents relating to the running of the home. What the service does well: What has improved since the last inspection? All visitors to the home sign the visitors’ book, which is necessary in the case of fire or other emergencies. Authorisation has been obtained from the G.P for a specific resident to administer their own medicines, and disposable hand towels are now provided in the bathroom and toilet to prevent infection. Alison House DS0000010601.V354201.R01.S.doc Version 5.2 Page 6 The staff rotas accurately identify the staffs’ actual shifts, and staff receive regular supervision. The manager has taken steps to ensure that tasks are properly delegated, so that the home is efficiently run in her absence and staff are aware of where important documents are kept so that residents’ welfare and safety are maintained. The portable appliances in the home have been tested to ensure residents and staff are not at risk from electric shock. 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. The summary of this inspection report can be made available in other formats on request. Alison House DS0000010601.V354201.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.V354201.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&3 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including interviewing the residents. The people who live in the home say they like living there, 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, who are women, have lived in the home for a number of years. One person is over the age of sixty-five, but she is able to access all areas of the home, including stairs, without difficulty. The people who live in the home told me that they liked living there and the manager and staff were very attentive to their needs. The three residents attend appointments with their consultant psychiatrist at least six-monthly to monitor their mental health and to ensure that their needs are being met by the service. Care managers from the local authority carry out annual reviews of the residents’ care. Just after this inspection, the manager sent me copies of the recent care reviews for all three residents. These state that the care manager is satisfied about the appropriateness of the home for these residents. Alison House DS0000010601.V354201.R01.S.doc Version 5.2 Page 9 Alison House DS0000010601.V354201.R01.S.doc Version 5.2 Page 10 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 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including looking at residents’ care plans. People who live in the home have care plans that set out their individual health, personal and social care needs, which are generally met. The care plans support residents to be as independent as possible. Meetings are held to consult the residents about how they wish to live in the home. EVIDENCE: The care plans showed that the residents’ physical, social, mental health and personal care needs had been assessed. There is guidance about how these needs were to be met and there was evidence that the plans were reviewed regularly. The residents have signed their care plans to show their involvement and agreement with the process. The objectives in the care plan reflect the stated aims of the service for residents to be as independent as possible. Alison House DS0000010601.V354201.R01.S.doc Version 5.2 Page 11 The people who live in the home have a quite independent lifestyle in accordance with their personal preferences. Regular meetings are held with the people who live in the home to decide on activities, and the residents told me that their suggestions were acted on. This was documented in the minutes of the meetings. The 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. The residents also said they were able to choose what to eat. Alison House DS0000010601.V354201.R01.S.doc Version 5.2 Page 12 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): 12, 13, 15, 16 & 17 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including speaking to residents and looking at records. The residents enjoy their independent lifestyles, which suit their social and recreational expectations and personal preferences. They are supported to maintain contact with family and friends, and their choice of activity is respected. The residents are satisfied with the food provided, which is wholesome and varied. EVIDENCE: Two people attend a Psychiatric Rehabilitation Day Centre, which 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. On the day of this inspection, one of the residents was out Christmas shopping. All the residents have bus passes, which they use frequently to visit friends and relatives. Alison House DS0000010601.V354201.R01.S.doc Version 5.2 Page 13 A daily record is made of each resident’s activities/outings, which are sometimes organised on a group basis; for instance, there was a trip to London Zoo, and regular outings to restaurants with the manager. Visitors to the home sign the visitors’ book. One resident said that she keeps in contact with her relative by phone; one person visits her family every week, and the other resident receives visits from her family twice a year. There is a television and board games in the lounge, and the residents have their own televisions and radios in their rooms. All three residents to whom I spoke, said that they were encouraged to live as independently as possible and they had their own front door and bedroom keys. They said they could stay out as late as they liked, but for safety reasons, were asked to let the manager know their whereabouts. The residents said that they enjoyed the meals that are provided and once a month they all go out with the staff to a restaurant. None of the residents practices a religion and no one requires any specific ethnic food. One resident has a regular boyfriend who used to stay in the home overnight, but I was informed that this is no longer the case. There was a record of the meals actually taken by the residents each day. This showed that a good variety of wholesome food was provided, and the residents told me they were happy with their meals. Fresh fruit was available, and I saw residents making hot drinks for themselves during the inspection. Alison House DS0000010601.V354201.R01.S.doc Version 5.2 Page 14 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 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a 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. One person is safely administering their own medication, which promotes their independence. EVIDENCE: The residents are able bodied and they provide for their own personal care, but occasionally need prompting by staff to be attentive to this issue. At the time of this inspection, all the residents were healthy and appeared well cared for. There is a book for each resident containing records of their hospital and G.P appointments, as well as appointments with other healthcare professionals. There was a record of annual health checks by the G.P and all residents had received the flu’ vaccine. A record is kept of the residents’ weight each month. Alison House DS0000010601.V354201.R01.S.doc Version 5.2 Page 15 All the residents have regular CPA, (Care Programme Approach) reviews by the Consultant Psychiatrist who also reviews their medication. Two residents receive medication by injection, which is administered at a nearby clinic. One resident is self-medicating. Following the last inspection, this practice has been authorised by the G.P, a record of which is in the person’s case file. The manager periodically monitors that this is being done safely, and the resident told me she was happy with this arrangement. Alison House DS0000010601.V354201.R01.S.doc Version 5.2 Page 16 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 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including speaking to residents. The residents are happy with the service provided and know how to complain if necessary. The staff have attended training in the protection of residents from possible harm or abuse. EVIDENCE: The home has an appropriate complaints procedure and a book for logging any concerns. No complaints were recorded in the complaints book, and the manager stated that no complaints had been received from the residents since the last inspection. In discussion with the residents, I was satisfied that they were happy living in the home and that if they had any concerns, they knew how to complain and they were confident the manager would address this seriously. All the staff have attended training in adult protection procedures. Alison House DS0000010601.V354201.R01.S.doc Version 5.2 Page 17 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, 25, 27, 28 & 30 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including visiting all areas of the home. The residents live in a homely, clean and comfortable environment and the people who live in the home like their accommodation. The home is generally well maintained, but some minor repairs are needed to improve the environment for the residents. EVIDENCE: I visited all areas of the home including visiting two bedrooms with the residents’ permission. The environment was homely and welcoming and the residents said that they were pleased with their accommodation. The lounge and dining room furniture was attractive and comfortable. The bedrooms were clean and attractively presented, and there were personal effects such as televisions, photographs and ornaments. New bedside lockers Alison House DS0000010601.V354201.R01.S.doc Version 5.2 Page 18 had been purchased since the last inspection. Each resident has a key to their bedroom, but choose not to lock their doors. Since the last inspection, disposable hand towels have been provided in the upstairs bathroom and toilet, which improves hygiene. The plaster on the wall of the conservatory had been repaired, but was not to a proper standard. The proprietor must ensure that this work is done to a professional standard. The home was clean and tidy and there were no offensive odours. Alison House DS0000010601.V354201.R01.S.doc Version 5.2 Page 19 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 & 36 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including looking at staff records and discussion with the manager. The residents’ needs are met by sufficient numbers of staff who are competent to support them. The staff receive regular supervision to support them in their roles as carers. EVIDENCE: Only the manager was on duty at the time of the inspection, and no new staff had been recruited. All of the staff are members of the proprietors’ immediate family or are related to them. The proprietor’s daughter is a registered nurse who works at the home at weekends. One other member of staff attained National Vocational Qualification level 2 in July this year. At least one member of staff or the manager is always on duty. This minimal level of staffing is satisfactory, given the independence of the residents, who are usually out for most of the day. There is a sleep-in member of staff on duty at night, and the manager is always available on call. Since the last inspection, an accurate rota is maintained that shows who is on duty at all times. Alison House DS0000010601.V354201.R01.S.doc Version 5.2 Page 20 The residents said that all the staff were very caring and they were made to feel part of the proprietors’ family. I saw records that showed that staff supervision was taking place regularly. Alison House DS0000010601.V354201.R01.S.doc Version 5.2 Page 21 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 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including discussion with the manager and looking at the records. Improvements have been put in place for ensuring that the service is properly managed when the manager is away. This ensures that the residents’ needs are being met and important documents are available for inspection. The residents are consulted about their views of the service they receive and they are able to suggest areas for improvement, but the storage of food must be improved to safeguarded the health and safety of the people who live in the home. EVIDENCE: The manager is a qualified nurse and she has many years of experience of caring for people with mental health needs. The manager sent an improvement plan to the Commission after the last inspection. This was in response to the Alison House DS0000010601.V354201.R01.S.doc Version 5.2 Page 22 issues I identified that at the last inspection that needed to be addressed. In particular, the manager told me that she has taken steps to ensure that the home will be run efficiently in her absence, including ensuring that all staff where made aware of the location of important records and documents relating to the service. I discussed the AQAA document with the manager and pointed out areas where the information could be improved. I saw minutes of meetings between the staff and the residents, where their suggestions for improvements were recorded and acted upon. They had also completed a questionnaire this year, which was evidence that they were consulted about their views of the service. The residents’ survey showed a high level of satisfaction with the care they received. When I arrived at the home, I found that the temperature was cold, but when I pointed this out, the manager put the heating on and the home became pleasantly warm. The manager said that she would ensure the central heating would always be on when necessary. The portable appliances have been tested following a requirement at the last inspection. There were certificates of safety for gas, electric, fire and the emergency light systems. The fire alarms are tested weekly and the home has a current certificate of insurance. I noticed that there was an open packet of ham in the fridge that was not labelled with a “ use by date”. This could pose a risk of food being unsafe for consumption. Alison House DS0000010601.V354201.R01.S.doc Version 5.2 Page 23 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 2 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 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 X 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 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X Alison House DS0000010601.V354201.R01.S.doc Version 5.2 Page 24 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 Regulation 23(2)(b) Requirement The damaged plaster in the conservatory must be repaired. This requirement is amended and restated from the last inspection. The previous timescale was 31/08/07. All opened food in the fridge must be dated and labelled to prevent the risk of food being eaten that is unsafe. Timescale for action 31/01/08 2. YA42 13(4)(c) 10/01/08 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.V354201.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 Alison House DS0000010601.V354201.R01.S.doc Version 5.2 Page 26 - 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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