Inspection on 20/04/05 for Alpha House

This inspection was carried out on 20th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Alpha House 22/05/07

Alpha House 12/04/06

Alpha House 02/12/05

Alpha House 18/01/05

Alpha House 22/04/04

Similar services:

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

Clovelly House Residential Home Ltd

Abbey Road [53]

Cherry Tree House

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

CARE HOME ADULTS 18-65 Alpha House 28 Warlingham Road Thornton Heath Croydon CR7 7DE Lead Inspector Lee Willis Announced 20 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. Alpha House G53_G03_25769_AlphaHouse_181379_200405.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Alpha House Address 28 Warlingham Road Thornton Heath Croydon Surrey CR7 7DE 020 8665 0092 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) Dr Edward Newton Osei Appah Ms Felicia Aseidua Appah Care Home 3 Category(ies) of Mental Health registration, with number of places Alpha House G53_G03_25769_AlphaHouse_181379_200405.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 19/01/05 Brief Description of the Service: Alpha House is a home registered with the Commission to provide personal care and accommodation for up to three younger adults aged 18 and 65 with a past or present mental illness. The property itself is a small terrace house located in the surburban heart of Thornton Heath and is well placed for accessing local rail and bus links, and other community based amenities, including shops, cafes, a park and library. The site is compact, with a small patio garden for service users to enjoy at the rear of the property. The home is built over three floors and comprises of four single bedrooms, one of which is a staff sleep-in room, a communal lounge and recently refurbished kitchen. All three of the service users bedrooms have recently been redecorated and fitted with ensuite toilet and hand washing facilites. The ground floor bedroom has also been provided with an ensuite shower. The top floor bedroom is the living quarters for a member of staff who continually works nights in the home and is out of bounds for the service users. Since the last inspection the entire interior fabric of the building has been redecorated and modernised. Alpha House G53_G03_25769_AlphaHouse_181379_200405.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and started at 9.30am. It took place over six and a half hours during the morning and early afternoon of Wednesday 20/04/05. People living at the home had all been made aware that the inspection was due and one service user met shared his experiences about life at Alpha House. The Commission also received one completed questionnaire from an individual who lived at the home about the quality of the service they were being provided. The comments made by the service users were in the main positive and their help with the inspection process is appreciated. The homes manager and the one member of staff who was on duty at the time of the visit were also interviewed. The duration of the inspection was spent examining records, touring the building, and as mentioned above, speaking to one individual who lived at the home, the manager and a member of staff. There have been no additional or complaints visits carried out on the service in the last inspection year (April’04 to 2005), although the homes co-owners and the manager were all invited to attend a meeting at the Commissions Croydon offices in March’05 and provide an action plan setting out how they intended to raise the standard of service being provided at the home and address poor practice issues identified in previous inspections reports. Comments will be made on progress shown by the home to resolve many of these outstanding issues in the main body of this report. What the service does well: What has improved since the last inspection? Since the homes last unannounced inspection in January 2005 there has been a ‘significant’ reduction in the number of concerns the Commission had about the service that needed to be improved. Far fewer errors in records were noted and the manager has clearly put a lot of time and effort into improving service Alpha House G53_G03_25769_AlphaHouse_181379_200405.doc Version 1.30 Page 6 users care plans and risk assessments associated with daily living, ensuring staff have sufficient information to meet the needs of the people living at Alpha House. Significant improvements to the physical environment of the home have also been made in the past twelve months with all the bedrooms fitted with ensuite toilet and washing facilities, new flooring laid in all the communal areas, old units and equipment replaced in the kitchen, all the interior doors replaced with fire resistant ones, and the rear garden cleared to make way for some plants. An activities co-ordinator now visits the home once a week and arranges music and movement classes. The amount of information and literature displayed in the home regarding the availability of local social, leisure and recreational resources has also improved since the last inspection. 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. Alpha House G53_G03_25769_AlphaHouse_181379_200405.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Alpha House G53_G03_25769_AlphaHouse_181379_200405.doc Version 1.30 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 standard(s) 1,2 & 5 Limited progress has been made to improving the contents of the Service users guide and the Statement of purpose to ensure these documents accurately reflect the range of facilities and services being provided by the home. It is essential these documents are revised to ensure prospective service users and their representatives have the information they need to make an informed choice about where to live. Not all the service users have been supplied with contracts setting out the terms and conditions of occupancy, which must be agreed between the home and each service user. Each service user must have a copy of their written and signed contract as evidence that they and/or their representatives are not only familiar with their terms and conditions of occupancy, but more importantly agree with its contents. EVIDENCE: Neither the service users guide or homes Statement of purpose are sufficiently detailed to enable anyone reading these documents to determine what facilities and services are being provided by the home. The one service user spoken to was able to confirm that they had not been provided with an updated version of either of these documents. Nevertheless, the manager was able to locate all the information that needed to be contained in these documents from other Alpha House G53_G03_25769_AlphaHouse_181379_200405.doc Version 1.30 Page 9 sources from within the home on request. Previous inspections have highlighted the need for both the homes Statement of purpose and guide to contain more specific information about the range of needs the care home intends to meet, the number and relevant qualifications of the staff team, and the actual services and facilities provided. Despite some progress being made to address this on-going issue both the homes Statement of purpose and guide still need to be amended further. Individual records are kept for each of the service users and inspection of all three of these records revealed that only the homes most recent admission had been supplied with a signed and costed contract setting out their terms and conditions of occupancy. This contract contained all the relevant information, including fees charged, what they covered, the cost of ‘extras’, and periods of notice to be given in the event of the placement being terminated. However, only blank copies of the homes standardised contract formats were available in respect of the other service users, which had not been signed or costed. This shortfall was highlighted in the homes previous reports and action needs to be taken as a matter of urgency to address this issue. Alpha House G53_G03_25769_AlphaHouse_181379_200405.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 & 10 Progress has been made on improving arrangements to ensure care plans and assessments of risk are sufficiently detailed to guide staff on the actions to be taken to meet the residents identified personal, social and health care needs. No attempt to arrange an independent audit of the homes accounts has been made. The homes accounts need to be open and transparent to minimise the risk of service users being financially abused. EVIDENCE: Individual plans of care are available for each of the service users and although they remain basic significant progress has been made since the homes last inspection to ensure that all aspects of service users personal, social and health care needs are assessed and planned for. The new care plan format was in place for all three of the residents and contained up to date information about each of their food preferences and social interests. One service user spoken to was able to describe their social and leisure interests, which matched the information recorded in their amended care plan. In addition, the service user confirmed that they had recently been invited to attend a meeting Alpha House G53_G03_25769_AlphaHouse_181379_200405.doc Version 1.30 Page 11 to review their care plan and agree the aforementioned changes. All three of the service users care plans have been reviewed at least once in the past six months. One service users care plan is reviewed on a quarterly basis in accordance with the Care Programme Approach (CPA) and always involves the individual’s mental health care co-ordinator. Individual records of all the financial transactions involving the home and the residents continue to be appropriately maintained, although no attempt has been made to arrange an independent audit of the homes accounts. This situation was highlighted at the homes last two inspection visits when requirements were made for action to be taken to ensure the homes accounts records are independently audited/monitored from time to time. Records revealed that the two ‘significant’ incidents that had occurred in the past twelve months, which had adversely affected the health and welfare of the service users, had both been dealt with appropriately at the time of there occurrence. There has been one unexplained absence of a service user in the past twelve months and written procedures are now in place to enable staff to respond promptly to this type of incident. In addition, as required in the homes previous reports records now show that the home is taking a more proactive stance to minimise potential risks and hazards associated with service users daily living. Assessments undertaken by the home in the past twelve months set out detailed guidance for staff to follow to minimise identified risks associated with service users smoking in their bedrooms, travelling independently in the wider community, unexplained absences, consuming excessive amounts of alcohol, using sharps, missing medical appointments and not taking their medication. The homes confidentiality policy has been revised to include more specific details about how staff are expected to treat information given to them in confidence by the service users. Information held by the home about service users is kept in a locked filing cabinet in the lounge. Alpha House G53_G03_25769_AlphaHouse_181379_200405.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15,16 & 17 Meals are nutritionally well balanced, nicely presented, and provide daily variation and interest for the people living in the home. Some progress has been made on improving arrangements to identify service users social, leisure and recreational interests are provide them with far greater opportunities to take part in age appropriate activities both inside the home and in the wider community. Alpha House G53_G03_25769_AlphaHouse_181379_200405.doc Version 1.30 Page 13 EVIDENCE: Having been on a tour of the premises and spoke to one service user about their social and leisure interests it was evidence that some progress had been made by the home to satisfy needs. A variety of leaflets and guides about the availability of local community based recreational activities were found on the small coffee table and notice board in the lounge. In addition, the home now employs an activities coordinator who visits the home once a week to organise music and movement classes. A record of the activity provided and whether or not service users participate is kept. One service user reported their appreciation of the new activities co-ordinator and said, “he liked the country music they played”. Service users still have the option of going to South Croydon to join in activities and day trips arranged for the older clientele of Mary’s home, the proprietors other care establishment. None of the service users went away on holiday in 2004, although one had been on at least three-day trips to central London and the coast. In accordance with Standard 14.4 and therefore ‘best’ practice the recommendation highlighted in the homes previous report that the proprietors should seriously consider either paying for or at least contributing to the total cost of a seven day annual holiday or the equivalent in day trips for each of the service users. Recently amended copies of the homes visitor’s policy were available on request. The one service user met said he was not aware of any restrictions on ‘reasonable’ visiting times. It was evident from conversations with one service user and the manager that there are no fixed rising or bed times, and that service users can choose to eat their meals either in the lounge or in their bedrooms. Service users can smoke in their bedrooms, but not in bed, and the homes smoking policy has been revised to include this rule. One resident met said “he liked living at Alpha House because unlike his previous place staff never pestered him to join in activities he didn’t want to and left him alone to spend as much time as he wanted in his own company”. The same service user also said “staff always provided him with a daily newspaper, which he liked to read in the mornings”. The food provided was sampled and found to be tasty, well prepared, hot and plentiful. All of the service users spoken with commented favourably about the quality and variety of the meals they were served. Alpha House G53_G03_25769_AlphaHouse_181379_200405.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20 & 21 Suitable arrangements are in place to ensure staff are able to meet service users individually assessed emotional health care needs. Limited progress has been made on improving procedures for dealing with medicines in the home and staff still need to receive accredited training in the safe handling of medication in a residential care setting. These shortfalls have the potential to place the service users at risk and represent a serious breach of the good practice guidelines set down by the Royal Pharmaceutical Society of Great Britain. A template to record service users wishes concerning dying and death has now been established. These documents must be completed to ensure staff handle the death of a service user with respect and as the individual would wish. EVIDENCE: Service users confirmed that staff continue to support them keep in contact with their General Practitioner and community based psychiatric professionals. Individual case files record contact with health care professionals and the outcome of these appointments. Alpha House G53_G03_25769_AlphaHouse_181379_200405.doc Version 1.30 Page 15 The staff use a well known monitored dosage system to manage medicines in the home. No recording errors were noted on medication administration sheets sampled at random. However, the Commission has expressed previous concerns about the lack of progress made to ensure arrangements are in place for the safe disposal of ‘unwanted’ medication. Disappointingly, this visit highlighted that no progress had been made on this matter. Documentary evidence of the managers training in the safe handling of medication in a residential care setting was available on request, although the other staff members Certificates of attendance were not. Some progress has been made in establishing a template to record service users wishes regarding terminal illness and death, although the majority remain incomplete. Service users and their representatives should be involved in planning for and dealing with growing older, terminal illness and death and the outcome of these discussions recorded. Alpha House G53_G03_25769_AlphaHouse_181379_200405.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Residents are confident that their concerns will be listened to, taken seriously and acted upon in accordance with the homes written complaints procedures. The homes vulnerable adult protection, whistle blowing and dealing with aggression procedures have all been amended since the last inspection to enable staff to take appropriate action, as and when required, to ensure the service users are, so far as reasonably practicable, prevented from being abused or placed at risk of abuse. EVIDENCE: The homes complaints record contains no new entries since it was last inspected in January 2005. The home has a detailed complaints procedure, which contains all the information required by the National Minimum Standards and the associated Regulations (2001). A copy of the procedure still needs to be included in the service users guide (See Requirement No#1). The one service user spoken with commented that he found the staff team, including the manager, to be very approachable, and willing to listen to any concerns he may have. As previously required in the homes last inspection report the home has now established far more comprehensive adult protection and whistle blowing procedures to ensure staff respond properly to any suspicion or allegations of abuse. Staff training certificates sampled at random revealed that the manager and her staff team will all need to attend refresher courses to up date their recognising, preventing and reporting abuse skills. Alpha House G53_G03_25769_AlphaHouse_181379_200405.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26 & 28. Significant improvements to the physical environment of the home have been made to the property in the past twelve months to ensure the service users live in a more homely and comfortable environment. With all the bedrooms now provided with ensuite toilet and washing facilities the service users privacy is assured. Service users ability to control the heating in their bedrooms remains unnecessarily restricted and must be addressed. Alpha House G53_G03_25769_AlphaHouse_181379_200405.doc Version 1.30 Page 18 EVIDENCE: Since the last inspection the service providers have continued with their extensive structural and redecoration programme of the premises. The one service user met during the inspection said they were “delighted with the recent changes and in particular the new ensuite facilities in the bedrooms”. In the past year all three bedrooms have been provided with ensuite toilets and in the case of the ground floor bedroom, an ensuite shower has also been fitted. In addition, the flooring in all the communal areas, including the lounge, kitchen, hallway and stairs have been replaced, along with the old storage units and cooker in the kitchen. Significant improvements have also been made to the garden, which has recently been cleared to make way for some new plants and shrubs. The service users are still unable to take full advantage of the garden, as there is no furniture for them to sit on at present. A fire office representing the London Fire and Emergency Planning Authority (LFEPA) last carried out an inspection of the premises in April’05. The service providers and the Commission await the findings of their report, although the manager is aware that the home is required to make arrangements to install an alarm system. Progress made on matters relating to the homes fire safety and prevention arrangements will be assessed at the next inspection. Since the last inspection action has been taken to replace all the homes interior doors, including the kitchen door, with more suitable fire resistant ones. Three fire resistant doors tested at random all closed flush into their frames to form an effective smoke seal. Arrangements for an environmental health officer to visit the home at the end of May 2005 have been made and the findings of their visit will also be assessed at the homes next inspection. A set of multicoloured chopping boards must be obtained for the kitchen and used in accordance with basic food hygiene standards. As part of a tour of the premises two bedrooms were viewed with the residents permissions. Both rooms were decorated to a ‘reasonable’ standard and as previously mentioned, had both been recently fitted with new ensuite toilet and washing facilities. The Commission has expressed previous concerns about the homes radiator covers, which prevent service users controlling the heating in their bedrooms. It was disappointing to note that no progress to resolve this issue had been made since the last inspection Alpha House G53_G03_25769_AlphaHouse_181379_200405.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35 & 36 Limited progress has been made to ensure that documentary evidence is available from the home to demonstrate that the manager and her staff team are sufficiently qualified and competent to ‘effectively’ meet the emotional health care needs of the service users, who have all experienced past or present mental ill health. The homes procedures for the recruitment of staff appear to be robust and provide the necessary safeguards to ensure that so far as reasonably practicable service users are not placed at risk of harm or abuse from individuals who are clearly ‘unfit’ to work with vulnerable adults. Service users are benefiting from having a well-supported staff team who are now both receiving supervisions with their manager at regular intervals. Alpha House G53_G03_25769_AlphaHouse_181379_200405.doc Version 1.30 Page 20 EVIDENCE: It remains the case that it is unclear what level of expertise within the field of mental health can be claimed for the home and its staff team; knowledge and training seems more by chance than based the individual needs of the service users. Nevertheless, arrangements are now in place for both members of staff to receive specialist mental health training by September 2005. Progress on this matter will be assessed at the homes next inspection. Documentary evidence was available on request to show that the manager and her staff team have all recently attended a basic food hygiene course and that one member of staff has achieved a National Vocational Qualification (NVQ) in care – Level 2. The manager said that the homes only other permanent member of staff was enrolled on an NVQ course in care, which begins in July 2005. The manager was able to confirm that she had successfully completed a first aid course in 2004, although no training certificates were available in respect of her staff team. This lack of documentary evidence of staff training has been highlighted as a major shortfall in previous inspection reports. The home continues to operate an ‘on call’ system to cover emergencies by relying on care staff working in another of the proprietors homes in South Croydon. It was evidence from the homes duty roster that no attempt to formally recognise these arrangements had been made despite the home being required to establish a clear policy document on the matter at the last inspection. All the staff files were examined, including the managers, and all three contained up to date Enhanced Criminal Records checks. In addition, records indicate that both staff have had one supervision with their manager in the last two months in accordance with the standards. This practice was confirmed by the one member of staff spoken to at the time of this inspection. One service user spoken with said, “the staff and the manager were all very nice and that he did not have any preferences about who looked after him”. The manager and staff member on duty at the time of this visit were observed interacting with the service users in a very informal, but nevertheless respectful manner, throughout the course of the day. Alpha House G53_G03_25769_AlphaHouse_181379_200405.doc Version 1.30 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 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) 37, 39, 40 & 42 The current manager has no formal qualifications and has limited experience working with people with past or present mental ill health. The service users and staff team would all benefit from the manager up dating her existing knowledge and skills, specifically in the area of mental health, to enable her to discharge her responsibilities more fully. Progress has been made by the home to establish a quality assurance system, which now needs to be implemented and the results published to ensure any poor practice issues are identified and action taken to resolve them. Unnecessary risks to the health and safety of the service users and staff must be identified, and as far as is reasonably possible eliminated, a fire risk assessment of the building needs to be undertaken and staff suitably trained in fire safety prevention. Alpha House G53_G03_25769_AlphaHouse_181379_200405.doc Version 1.30 Page 22 EVIDENCE: The current manager has been in operational day-to-day control of Alpha House since it opened over five years ago. The manager is on course to achieve a National Vocational Qualification in Management and Care – level 4 by July 2005. It is essential for the manager to obtain this award as she does not currently hold any professional qualifications or have any specialist experience working with people with past or present mental ill health, other that the time she has spent at Alpha House. Concerns had been previously expressed regarding the lack of in-house audits, which means the manager is unable to assess the quality of the service being provided. On this visit it was evident that some progress has been made to address this issue. A questionnaire and quality assurance policy is now in place, although it has yet to be put into practice. Previous inspections revealed that service users rights and ‘best interests’ were not being safeguarded by the homes policies and procedures, which did not cover every aspect of their care. Documents sampled at random revealed that progress on this matter has been made with the creation of a significant number of new policy and procedure documents that are relevant to the service. A record was available to show that staff now sign and date new and amended policies as proof that they have read and understood the contents. The home was found to be well maintained and, generally, to promote a safe environment. Two areas of concern were noted. The first related to the absence of fire risk assessments for the building. The manager was aware of this shortfall following a recent inspection by a fire safety officer and has agreed to obtain a copy of the London Fire and Emergency Planning Authorities risk assessment guidance. The second issue concerned the lack of staff fire safety training. Up to date Certificates of worthiness were available on request in respect of the homes gas installation, electrical wiring, portable electrical appliances and legionella tests. Alpha House G53_G03_25769_AlphaHouse_181379_200405.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 1 3 x x 1 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 1 x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 1 x 2 x x Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 1 1 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Alpha House Score x 3 1 1 Standard No 37 38 39 40 41 42 43 Score 2 x 2 3 x 1 x Version 1.30 G53_G03_25769_AlphaHouse_181379_200405.doc 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 1 Regulation (1) (2), Sch 1 Timescale for action The homes Statement of purpose 1st June must contain far greater detail 2005 about the range of needs the home caters for; staff qualifications; arrangments made for consulting service users about the homes operation; fire precaution arrangments, and the complaints procedure. A copy of the amended version must be supplied to the Commission and each of the service users. Previous timescale of 1st July 2004 not met. The service users guide must 1st June include a copy of the homes 2005 most recent inspection report, or at least make reference to its avialability; a summary of the complaints procedure, and service users views about the care they receive at the home. A copy of the amended guide must be supplied to each of the service users and the Commission on its completion. Previous timescale of 1st August 2004 not met. Written, signed and costed 1st June contracts setting out agreed 2005 Version 1.30 G53_G03_25769_AlphaHouse_181379_200405.doc Page 25 Requirement 2. 1 5(1)(d), (e) & (2) 3. 5 5(1)(c) & 17(2), Alpha House Sch 4.8 4. 7 12(5)(a), 17(1 2) & 20 13(2) 5. 20 6. 20 13(2), 18(1) & 19 Sch 2.4 7. 21 12(1) (4) , Sch 3.3(m) (n) 8. 23 13(6), 18(1) & 19 Sch 2.4 9. 10. 24 26 13(3), 16(2)(g) 12(2) terms and conditions of occupancy must be given to each of the service users. Previous timescale of 15th May 2004 not met. An independent audit of the homes accounts must be carried out from time to time. Previous timescale of 30th October 2003 not met. Procedures for the safe disposal of ‘unwanted’ medication must be developed for staff to follow. Previous timescale of 30th October 2003 not met. Documentary evidence of accredited medication training undertaken by all the homes staff must be avialable for inspection on request. Previous timescale of 30th October 2005 not met. Service user’s preferences with regard to the measures that should be undertaken if they are taken seriously ill, or pass away, must be sought and recorded confidentially in their care plans. Previous timescale of 30th October 2003 not met. The manager and her staff team all need to up date their existing knowledge and skills and attend suitable training in recognising, preventing and reporting abuse. Documentray evidence of this training must be available for inspection on request. Multicoloured chopping boards must be avialable in the kitchen. Service users must be able to access the temperature controls on their radiators to ensure they are able to adjust the heating in their bedrooms. Previous timescale for action of 1st September 2004 not met. 1st June 2005 1st June 2005 1st June 2005 1st June 2005 1st August 2005 1st June 2005 1st June 2005 Alpha House G53_G03_25769_AlphaHouse_181379_200405.doc Version 1.30 Page 26 11. 32 12(1), 18(1)(a), 19 Sch 2.4 12. 32 13(4), 18(1) & 19 Sch 2.4 13. 33 17(2), Sch 4.7 & 18(1) 14. 15. 16. 39 42 42 24 13(4) & 23(4) 23(4)(d) & Sch 2.4 All staff must receive ‘suitable’ training in understanding and working with people with a past or present mental illness. Documentary evidence of this training must be avialable for inspection on request. Previous timescale for action of 1st August 2004 not met. Sufficient numbers of staff must be suitably trained to ensure that at least one qualified first aider is on duty in the home at all times. Documentary evidence of this training must be available for inspection on request. Previous timescale for action of 1st June 2004 not met. The manager must establish clear procedures regarding the homes emergency on call arrangments and ensure the duty rosters refelct this situation. Previous timescale for action of 15th May 2004 not met. The homes quality assurance system must be implemented and the results published. Fire safety risk assessments must be carried out in respect of the building. All persons working at the home must receive suitable training in fire safety. Documentary evidence of this training must be made avialable for inspection on request. 1st September 2005 1st July 2005 1st June 2005 1st June 2005 1st June 2005 1st June 2005 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. Refer to Standard 14 Good Practice Recommendations Each servcie user should have the opportunity to go on a Version 1.30 G53_G03_25769_AlphaHouse_181379_200405.doc Page 27 Alpha House 2. 3. 24 37 weeks holiday or the equivilant in day trips each year. The service provders should consider paying for or at least contributing to the cost of these holidays/day trips, which should be reflected in each service users terms and conditions of occupancy. Recommendation highlighted in homes last report and not considered. The rear garden should be provided with furniture to enable service users to take full advantge of the previously under utilised space. The manager should obtain an NVQ level 4 in management and care by July 2005. Alpha House G53_G03_25769_AlphaHouse_181379_200405.doc Version 1.30 Page 28 Commission for Social Care Inspection 8th Floor, Grosvenor House 125 High Street Croydon CR0 9XP 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 Alpha House G53_G03_25769_AlphaHouse_181379_200405.doc Version 1.30 Page 29 - 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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