Inspection on 19/07/05 for Anthony Edwards House

This inspection was carried out on 19th July 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Anthony Edwards House 26/02/09

Anthony Edwards House 05/10/06

Anthony Edwards House 26/01/06

Anthony Edwards House 10/02/05

Anthony Edwards House 14/05/04

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Tudor Lodge

Stacey Street Nursing Home

Spring Lane Care Home

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Delrose House Ltd

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

CARE HOME ADULTS 18-65 Anthony Edwards House 27 Ritherdon Road London SW17 8QE Lead Inspector Louise Phillips Announced 19 July 2005 09:50am th 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. Anthony Edwards House G54-G04 S10166 Anthony Edwards V227996 190705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Anthony Edwards House Address 27 Ritherdon Road London SW17 8QE 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) 020 8672 6360 020 8767 3552 Riverhaven Miss Phyllis Brown Care home only (PC) 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (MD) of places Physical disability (PD) Physical disability over 65 years of age (PD(E)) Mental Disorder, excluding learning disability or dementia - over 65 years of age (MD(E)) Anthony Edwards House G54-G04 S10166 Anthony Edwards V227996 190705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 10th February 2005 Brief Description of the Service: Anthony Edwards House is a care home providing accommodation and support for up to six residents with mental health problems and hearing impairments. The home is situated in a pleasant residential area close to local shops, cafes, pubs and with good access to public transport links. The accommodation is provided over four floors with single bedrooms, lounge area, kitchen/ dining area and laundry facilities for use. The Registered Provider for the service is Riverhaven. Anthony Edwards House G54-G04 S10166 Anthony Edwards V227996 190705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day for approximately 6 hours. An interpreter was present for 2.5 hours to assist the inspector, where appropriate, when communicating with residents and staff. A tour of the premises took place and staff and care records were inspected. Five of the staff on duty and two of the service users were spoken to during the inspection. Two comment cards were received in respect of the service. One of these was from a relative/ visitor and one from a General Practitioner. These are referred to throughout the report. What the service does well: What has improved since the last inspection? There has been no Registered Manager at the home for approximately ten months and there has been an acting manager covering the post during this time. Despite there having been no permanent manager the home has worked well to improve in a number of areas and maintain a good consistency of service, which is of credit to the acting manager and staff team. Improvements have been made to the décor with all the bathrooms being refurbished and the hallways having been re-decorated, to ensure a more comfortable and homely environment for the residents. Anthony Edwards House G54-G04 S10166 Anthony Edwards V227996 190705 Stage 4.doc Version 1.40 Page 6 Progress has been made to the record-keeping systems, including the medication recording systems and the records relating to the training and supervision of staff. The content of staff files have been developed to include the relevant information and demonstrate that appropriate checks are carried out prior to staff starting work at the home. Following the previous inspection the home has also implemented a quality assurance format to seek the views of relatives and professionals involved with the home which can be used to further develop the service. 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. Anthony Edwards House G54-G04 S10166 Anthony Edwards V227996 190705 Stage 4.doc Version 1.40 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 Anthony Edwards House G54-G04 S10166 Anthony Edwards V227996 190705 Stage 4.doc Version 1.40 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 and 2 The home has a good Statement of Purpose that provides residents with relevant information about the service, however this needs to be amended to reflect organisational changes. The assessment of residents prior to their moving to the home is thorough and individualised to ensure that the home can adequately meet their needs. EVIDENCE: The home has produced a good Statement of Purpose that provides relevant information about the service aims, accommodation and is enhanced with photo’s of residents involved in activities provided by the home. A slight amendment was noted, where the document was observed to refer to a different Riverhaven home, which could cause confusion for potential users of the service. The acting manager stated that there has been a recent change to the organisation, where Riverhaven has merged with Servite Houses. It is required that the CSCI be formally notified of this and any change to the Registered Provider/ Responsible Individual. The Statement of Purpose must also be updated to reflect this change. The files relating to two residents were examined and found to contain a good quantity of assessment information from a number of healthcare professionals, eg. occupational therapist, social worker and community psychiatric nurse. It was observed that these had been used well to inform the home’s own assessment. Anthony Edwards House G54-G04 S10166 Anthony Edwards V227996 190705 Stage 4.doc Version 1.40 Page 9 The home has its own assessment format for potential residents that covers a number of activities of daily living such as mental health needs, eating and drinking, social interactions, hobbies and interests. The entries in the assessments for both residents was individualised and drawn from the professional assessments, information from the resident and information gained by staff during the assessment period (where the resident has spent time at the home). The assessment process and recording of this by the home is of a high standard and provides a good and thorough summary of assessed needs. The information covers each persons’ individual needs, bringing together all the assessment information into one readable, user-friendly format that enables the residents needs to be easily identified and appropriately planned for. Anthony Edwards House G54-G04 S10166 Anthony Edwards V227996 190705 Stage 4.doc Version 1.40 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 and 9 There is a clear and consistent care planning system in place to adequately provide staff with the information they need to meet residents’ needs. The areas of risk identified for each resident are minimised by a thorough risk assessment and management plan. EVIDENCE: During the inspection two residents files were examined and found to be wellformatted throughout. On opening each file the first page contains information about the resident and contact information of professionals involved in their care. This is then followed by a summary sheet that gives a snapshot of the support and care required for each individual in relation to their mental health, physical problems, interests and significant life events. The care plans for each resident have been drawn directly from the assessment records with all needs identified and adequately planned for. The format of the care plans is ideal as it is simple, easy to understand, individualised and easy to recognise each persons’ current needs. The care plans are reviewed monthly with the residents’ involvement and also a record maintained of the review meeting with their key worker. Anthony Edwards House G54-G04 S10166 Anthony Edwards V227996 190705 Stage 4.doc Version 1.40 Page 11 Record-keeping in the daily care notes is of a good standard, with clear information as to what the resident has done throughout the day, relating this to the care plan where applicable. The risk assessment format in use at the home uses a scoring system for assessing the severity of the identified risk along with the likeliness that it will occur. It was good to see that a thorough risk management plan had been developed for each area of risk, whether assessed as being high or low in severity. tt was further noted that the risk assessment and risk management plan for each resident was individualised to their actual history and current needs. Anthony Edwards House G54-G04 S10166 Anthony Edwards V227996 190705 Stage 4.doc Version 1.40 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) 11, 12, 13, 14 and 15 The home benefits from an activities co-ordinator who is proactive in supporting the social needs of the different residents. The residents are supported to develop themselves personally and occupationally, whilst also being encouraged to maintain links with family and friends. EVIDENCE: The home has an activities co-ordinator who works with residents across three homes run by the organisation. The activities co-ordinator spoke at length and with great enthusiasm about his role and the work that he does with residents. He discussed that he supports residents with a variety of activities dependant upon their needs and interests, and that the activities are structured on a group or one-to-one basis. The coordinator demonstrated a good understanding of the support input required for each resident at the home in relation to their personal development and social needs. These include acknowledging that an older resident generally likes to stay in the home and the input is to spend time talking with them. Another resident prefers to spend time on their own and going out to the shops alone. The activities co-ordinator discussed that he has spent time gradually Anthony Edwards House G54-G04 S10166 Anthony Edwards V227996 190705 Stage 4.doc Version 1.40 Page 13 developing a rapport with this resident which has worked well and resulted in them recently going out on a trip together. The activities co-ordinator stated that he would like to be able to provide more input to residents who prefer one-to-one time, but that this is not always possible due to structuring activities across the three homes. Other residents at the home are involved in structured weekly occupational activities that they receive payment for. During the inspection one resident was accompanied to an occupational centre by the activities co-ordinator. On their return the resident spoke with great excitement about having gained some part-time employment, and how the activities co-ordinator had supported them with this. A good record is maintained of the activities that residents have been involved in, the time spent on this and other residents who have participated. The records are enhanced with photographs of events that depict a variety of activities ranging from going to out to local pubs/ cafes for lunch, outings and day trips to the seaside. The home has an allocated budget for activities and the activities co-ordinator stated that he recently managed to apply for and secure additional funding to enable the residents to go on holiday to Torquay this year. The activities worker demonstrates a genuine commitment to his work and he proactively embraces the differing needs of the residents, structuring activities appropriately. The acting manager stated that residents have varying levels of contact with their friends/ relatives and that they are supported to maintain contact when they wish. This was confirmed by one resident who said that they regularly visit their family and that they are able to visit them at the home and can spend time in their room if they want more privacy. The comment card received from the relative/ visitor stated that they feel welcome in home and are satisfied with overall care provided to their friend/ relative. Anthony Edwards House G54-G04 S10166 Anthony Edwards V227996 190705 Stage 4.doc Version 1.40 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 and 20 The health needs of residents are well met with evidence of good links with multi-disciplinary team members. The home maintains good systems for the administration and record-keeping of medication to residents, however, the home must ensure that the prescribed medication is regularly reviewed to ensure that residents receive appropriate treatment. EVIDENCE: The personal care needs are identified in residents care plans which have been drawn from assessment information gained from various health and social care professionals. A record of all appointments with healthcare professionals is maintained in each file, along with records where these have been planned but the resident has declined to attend. A comment card received from a General Practitioner indicates that the home maintains good communication and works in partnership with them to address the physical needs of the residents. The comment card also indicates that they feel the home has a good understanding of the residents’ care needs, that their advice is incorporated into the care plan and they are satisfied with the overall care provided. Records in one residents file shows that their weight is being monitored due to concerns about them losing weight. It was identified in their assessment information that they suffer from hyperthyroidism (which can cause weight Anthony Edwards House G54-G04 S10166 Anthony Edwards V227996 190705 Stage 4.doc Version 1.40 Page 15 loss), yet their medicine chart prescribes that they are currently receiving Thyroxine tablets, which is given mainly for hypothyroidism. The Inspector has discussed this treatment with the Pharmacy Inspector for the CSCI and it is necessary that the home raise the appropriateness of this treatment with the prescriber. It is further required that all residents receive an assessment and review of their prescribed medication. The medication charts were seen to be appropriately maintained, with good record-keeping observed throughout. The acting manager stated that this is now checked at each handover period between shifts to ensure that all prescribed medication has been given and signed for. The home also maintains a record of sample signatures for all staff who administer medication. Anthony Edwards House G54-G04 S10166 Anthony Edwards V227996 190705 Stage 4.doc Version 1.40 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 The home has a good system of logging complaints and concerns of residents to enable them to be investigated promptly and within the timescales. EVIDENCE: The comment card received from the relative/ visitor – states that they are not aware of the complaint procedure. The complaints procedure for Riverhaven was observed on display in the dining area and is also included in the Statement of Purpose for the home. The complaints log is maintained on the office computer at the home. The acting manager described that the system of logging complaints this way enables the timescales for investigating the complaint to be achieved, as the software flags up when the timescales are due to be met. Anthony Edwards House G54-G04 S10166 Anthony Edwards V227996 190705 Stage 4.doc Version 1.40 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, 25, 26, 27, 28, 29 and 30 The décor throughout the home is of a good standard and presents as an attractive, homely and comfortable environment for the residents. There is good natural lighting and ventilation throughout the home. EVIDENCE: A tour of the building was carried out and the decor was found to be of a good standard throughout. Each resident has their own bedroom with one resident having an additional room close to their bedroom that they can use for activities and spending time with friends in private. The acting manager stated that this extra space was provided due to the residents’ bedroom being small. Since the last inspection all the bathrooms have been refurbished, and it was observed that these were individually decorated to look homely and pleasant. The hallways have also been re-decorated, which leads to a welcoming and homely feel on entering the home. The lounge and kitchen/ dining areas are comfortable and well-maintained. The décor in these rooms is bright and tasteful, which is enhanced by the Anthony Edwards House G54-G04 S10166 Anthony Edwards V227996 190705 Stage 4.doc Version 1.40 Page 18 natural lighting and ventilation provided by a number of windows in these areas. There is a part-time housekeeper who maintains the cleanliness of the communal areas and the home was found to be clean and hygienic, with a relaxed feel throughout. Anthony Edwards House G54-G04 S10166 Anthony Edwards V227996 190705 Stage 4.doc Version 1.40 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) 31, 34, 35 and 36 The recruitment practices at the home are thorough and protect service users. Staff are supported and appropriately supervised in their work. The staff team receive appropriate training to meet the needs of the service users. EVIDENCE: Two staff files were examined and found to contain the required information including Criminal Records Bureau check, references, identification and a statement of terms and conditions. Staff files also contain information relating to interview questions, a record of their responses, copy of application form, job description and correspondence regarding their recruitment. There is one new member of staff at the home who is currently going through the induction process which was seen to be planned over a four week period. The induction procedure covers a number of areas including orientation to the practices of the home, health and safety and awareness of the organisational policies. Records also indicate that staff receive monthly supervision from the acting manager. The training records for the team were examined and all staff were found to have completed recent training in medication awareness, health and safety, fire safety and food hygiene. The training records are appropriately Anthony Edwards House G54-G04 S10166 Anthony Edwards V227996 190705 Stage 4.doc Version 1.40 Page 20 maintained with an individual record of courses undertaken and copies of the certificates to evidence these. Anthony Edwards House G54-G04 S10166 Anthony Edwards V227996 190705 Stage 4.doc Version 1.40 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 and 39 The home has not had a registered manager in post for nearly a year. The home demonstrates that the views of relatives, professionals and any stakeholders of the service are proactively sought. EVIDENCE: Since September 2004 there has been no Registered Manager at the home and an acting manager has been covering the post during this time. The acting manager stated that a new manager has recently been recruited and is awaiting the completion of recruitment checks prior to starting work at the home. It is required that an application for registration is submitted to the CSCI once employment is commenced. Following the previous inspection the home has implemented a quality assurance format to seek the views of relatives and professionals involved with the service. The feedback is sought through a number of questions including if they feel welcomed at the home, if they find the staff helpful, and suggestions for improvement. The acting manager said that these had only recently been Anthony Edwards House G54-G04 S10166 Anthony Edwards V227996 190705 Stage 4.doc Version 1.40 Page 22 sent out and they are currently awaiting feedback, to use to enhance the quality of the service. The care plans indicate the involvement of residents in identifying their needs and planning their care. The acting manager stated that the home works closely with each resident to ensure that the service they receive is what they want with regard to activities, food and communication. This information is further gained from a monthly questionnaire that is sent to all residents, where they can feedback on the food, staff and activities. The acting manager stated that these responses are taken to the house meetings and acted upon following this. The acting manager said that the home has recently engaged the input of an advocate who has ‘closed’ meetings with the residents and then feeds back to the manager any issues raised on behalf of the residents. Anthony Edwards House G54-G04 S10166 Anthony Edwards V227996 190705 Stage 4.doc Version 1.40 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 2 3 x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 4 3 4 3 x x Standard No 31 32 33 34 35 36 Score 3 x x 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Anthony Edwards House Score 3 x 2 x Standard No 37 38 39 40 41 42 43 Score 2 x 3 x x x x G54-G04 S10166 Anthony Edwards V227996 190705 Stage 4.doc Version 1.40 Page 24 NO 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 YA1 Regulation 7(3)(c) Requirement The Registered Persons must ensure that the Commission is notified of any change of organisation, and the Statement of Purpose is updated to reflect this. The Registered Persons must ensure that all residents receive an assessment and review of their prescribed medication. The Registered Persons must ensure that an application for registered manager is submitted to the CSCI. Timescale for action 31/08/05 2. YA20 14(2) 31/08/05 3. YA37 9(1) 31/08/05 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. Refer to Standard Good Practice Recommendations Anthony Edwards House G54-G04 S10166 Anthony Edwards V227996 190705 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 Anthony Edwards House G54-G04 S10166 Anthony Edwards V227996 190705 Stage 4.doc Version 1.40 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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