Inspection on 24/03/06 for Apna House

This inspection was carried out on 24th March 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 14 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Apna House 10/08/07

Apna House 23/06/06

Apna House 06/10/05

Apna House 22/02/05

Apna House 26/11/04

Apna House 22/03/04

Similar services:

The Lodge Nursing Home

Bracken House

Sunnycroft

Field Farm House

Edgeview Nursing Home

Church Terrace Nursing & Residential Home

The Forbury

The Maples

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

CARE HOME ADULTS 18-65 Apna House 6 Park Avenue Hockley Birmingham West Midlands B18 5NE Lead Inspector Julie Preston Unannounced Inspection 24th March 2006 11:00 Apna House DS0000016857.V287597.R01.S.doc Version 5.1 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 Apna House DS0000016857.V287597.R01.S.doc Version 5.1 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. Apna House DS0000016857.V287597.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Apna House Address 6 Park Avenue Hockley Birmingham West Midlands B18 5NE 0121 551 5678 0121 554 4322 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) Apna House Ltd Miss Hina Parmar Care Home 13 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (13) of places Apna House DS0000016857.V287597.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Residents must be aged under 65 years That the home provides personal care only for 13 people for reasons of mental disorder, excluding learning disability or dementia. The home can accommodate three named residents over the age of 65 years, whilst the home can meet their needs. The home must ensure that these named individuals needs are reviewed regularly, and a record made of this review. The home can accommodate one named individual who has a dual diagnosis. That Mrs Parmer provides evidence of completion of NVQ level 4 in care and management by April 2005. 6th October 2005 4. 5. Date of last inspection Brief Description of the Service: Apna House is sited in the Hockley area of Birmingham. It is well served by public transport affording access to the locality, Birmingham city centre and surrounding areas. The home is close to shopping facilities including specific cultural provision. Nearby are temples, mosques and churches attendant to all faiths represented at the home. Care is delivered in a large, refurbished double fronted house having tarmac frontage, ramped and stepped access to the main entrance and a small patio/garden at the rear mostly laid with tarmac and some small raised lawns. The home provides care, rehabilitation and recovery services to up to 13 adults who are experiencing problems with their mental health. It was reported that service users whose first language is not English are able to converse with staff that will also advocate for them in their first language. The home currently accommodates male service users presenting a diverse range of mental health problems. Specific cultural needs are met through the provision of separate facilities for the storage and preparation of culturally appropriate food and adaptations to shower facilities for preparations prior to prayer. There are established links to other relevant professionals involved in mental health recovery services. Apna House DS0000016857.V287597.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over half a day and included discussion with service users about their experience of living in the home. A brief tour of the premises was undertaken and records relating to service users care and safety were examined. Medication storage and administration systems were observed. This report should be read in conjunction with the report made following the visit of 6th October 2005. What the service does well: What has 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. Apna House DS0000016857.V287597.R01.S.doc Version 5.1 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Apna House DS0000016857.V287597.R01.S.doc Version 5.1 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed. EVIDENCE: Apna House DS0000016857.V287597.R01.S.doc Version 5.1 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 9 Service users are supported to make decisions about their lives. Risk assessment has improved and generally, service users are protected by the home’s procedures. EVIDENCE: The home does not manage money on behalf of service users. Records were observed which showed that service users sign to confirm receipt of their personal allowances each week. Service users commented that they spent their money on clothes, cigarettes and haircuts. Staff at the home speak a range of languages that are consistent with service users first languages. Two service users said that they regularly made decisions about their lives, such as how to spend their money and when to get up and go to bed. Both stated that they would like to go out more frequently. This is further discussed in standard 12 of this report. Apna House DS0000016857.V287597.R01.S.doc Version 5.1 Page 9 Risk assessments were sampled and those seen were noted to have been developed since the last inspection to provide more information about the controls in place to minimise known hazards. One exception was that no assessments had been made for service users that travel independently. Immediate requirements were made that this takes place. Apna House DS0000016857.V287597.R01.S.doc Version 5.1 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 16 Service users have not been consulted about taking part in meaningful activities and spend considerable time within the home. Service users rights are respected within the home. EVIDENCE: Several service users commented that they often had nothing to do during the day and would like to go out more frequently. The inspector observed the daily records for three service users and found that over the five day period sampled, only one person’s records indicated that he had been out of the home. Records predominantly stated that service users had spent their time “relaxing in the lounge”. The registered manager did comment that she had devised an activity planning format that she proposed would be discussed with service users to find out the sorts of activities they wished to participate in. Staff were observed to work with service users in a manner considered to be both friendly and respectful. Apna House DS0000016857.V287597.R01.S.doc Version 5.1 Page 11 Some service users stated that they have keys to their bedrooms and the front door of the home. A member of staff commented that keys were offered unless the outcome of risk assessment identified this as a hazard to individual’s welfare. It was noted that some restrictions had been placed on service users, for example staff retain some service users cigarettes and lighters. Risk assessments were seen to be in place to support this practice, which had been signed by service users and reviewed on a regular basis. Apna House DS0000016857.V287597.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 20 Service users receive support to manage their personal care according to their needs and preferences. Service users health and safety is not always adequately promoted when personal care is delivered. Medicine management is generally good. The registered manager demonstrated willingness to further develop systems for the benefit of service users. EVIDENCE: Examination of service users personal care plans showed that their needs had been clearly recorded and included details of individuals’ preferences of routine with their personal care. Some personal care plans identified that the temperature of hot water should be tested prior to service users taking a bath or shower. The home maintains records of hot water temperatures, which were noted to be in excess of 43 degrees Celsius. Immediate requirements were made that this be addressed within twenty-four hours of this inspection. Consideration was noted to have been given to gender and culture within the personal care plans sampled, which is positive. Medication storage and administration systems were examined. Medicines were noted to be securely stored, although the temperature in the medication room Apna House DS0000016857.V287597.R01.S.doc Version 5.1 Page 13 was thought to be very hot, which may have an impact on some medicines that require storage below 25 degrees C. The medication administration records (MAR) sampled showed that stock had been entered upon receipt and no anomalies were found to indicate that medicines had not been administered as prescribed. Written protocols for the administration of PRN (as required) medication were observed. The MAR for one service user’s Depakote was missing from his records, however a copy of the MAR was sent to the CSCI after this inspection as it was discovered that a member of staff had removed it. The procedure for the disposal of medicines refused by service users was found to be inadequate. Staff reported putting unused medication down the toilet, which is not acceptable. Immediate requirements were made that the procedure be reviewed to ensure that the reasons for any unused medication are recorded and the medication returned to the pharmacy. Apna House DS0000016857.V287597.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 The home’s complaints procedure is in need of review to ensure that all service users are aware that their views will be listened to and acted on. EVIDENCE: The home has a complaints procedure, which was observed at this inspection. It was noted that the procedure did not include an agreed timescale for responding to complaints and there was no written reassurance that service users would not be victimised in the event of making a complaint. The procedure has not been presented in service users first languages and it is required that action is taken to address this. A log of complaints received by the home was seen to be in place, with appropriate responses recorded by staff. The CSCI has received no complaints about the home since the last inspection. Three service users told the inspector that they would approach the registered manager or a member of staff if they wished to make a complaint. Two service users said that they were not sure what to do about making complaints. Apna House DS0000016857.V287597.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 The home is generally clean and hygienic. EVIDENCE: Requirements made at the last inspection to control odour in the first floor bathroom and clean extractor fans had been met. It was noted that the ground floor shower room had been redecorated and re tiled. The carpet in the smokers lounge had not been replaced and is stained and burned. The registered manager stated that she is awaiting a date for this work to be undertaken. The home was generally clean and warm and this inspection. In one service user’s bedroom the mattress was noted to be soiled and stained. Immediate requirements were made that all mattresses be reviewed and new ones provided as necessary. The laundry room is situated in the cellar, which is protected by a keypad entry system to reduce the risk of service users falling down the steep stairs. It was reported that staff carry soiled linen down the stairs to be washed. A risk assessment of this practice is required to reduce the risk of falls and accidents. Subsequent practice must reflect the outcome of the assessment. Apna House DS0000016857.V287597.R01.S.doc Version 5.1 Page 16 Liquid soap and paper towels were observed in bathrooms and the laundry room and COSHH (Control of Substances Hazardous to Health) were seen to be securely stored. Apna House DS0000016857.V287597.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 Service users are supported by a competent team of staff. EVIDENCE: Service users made positive comments about the staff team on duty at this inspection and in particular the registered manager, who was described as “a very good lady” and “very kind”. One service user said that he really appreciated staff helping him to keep in touch with a friend who lives locally. Staff were observed sitting talking to service users and socialising with them. Observation of the staff rota showed that 1:1 support is provided at all times to a service user in accordance with his assessed needs. A number of service users do not have English as a first language. Staff were observed to have the skills to communicate with service users in their first languages. Apna House DS0000016857.V287597.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 The registered manager shows awareness of her role and commitment to developing the home for the benefit of service users. The systems in place for reviewing the quality of care provided in the home are poor and do not demonstrate that service users views are sought and acted upon. Health and safety practice within the home does not always protect service users who live there. EVIDENCE: The home has a registered manager who has been in post for four years and is currently undertaking her Registered Manager’s Award. The inspector was shown a confirmation letter, which stated that the registered manager has scheduled to undertake training in managing teams and mental health awareness. Apna House DS0000016857.V287597.R01.S.doc Version 5.1 Page 19 The registered manager demonstrated insight into her role and expressed commitment to developing the service further. Of the eight requirements made at the last inspection, six had been met in full, with two remaining unmet. The registered provider has not submitted copies of reports made following visits to the home to comment on the standard of care provided, to the CSCI. There is no system of quality assurance in place to ensure that service users views are sought to measure the success of the home in meeting its stated aims and objectives. This report has identified that hot water temperatures exceed the guidance for safe water delivery. The records examined for February 2006 showed a range of temperatures between 47-51 degrees Celsius, which places service users at risk of scalding. It was disappointing that no action had been taken to respond to this identified hazard. Fire safety records were examined, which evidenced that the fire alarm system had been tested and serviced on a regular basis. It was noted, however that the fire risk assessment had not been reviewed since 2004. This is of particular importance due to the number of service users that smoke in the home. Some development of risk assessment procedures is needed to ensure that known hazards to individual service users are controlled. Apna House DS0000016857.V287597.R01.S.doc Version 5.1 Page 20 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 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 X 2 X LIFESTYLES Standard No Score 11 X 12 1 13 X 14 X 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 X 2 X 3 X 1 X X 2 X Apna House DS0000016857.V287597.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard YA9 YA12 Regulation 13(4)(a-c) Requirement Timescale for action 29/03/06 26/05/06 3 4 YA42YA18 YA20 5 YA20 6 YA22 Risk assessments must be completed for service users that travel independently. 16(2)(m,n) Service users must be consulted about the activities they wish to participate in and the opportunity to do so must be provided. Daily records of care must reflect the activities offered. 13(4)(a-c) Hot water must be delivered at a temperature on or close to 43 degrees Celsius. 13(2) The registered manager must seek advice from the dispensing pharmacist about the storage of medicines at 25 degrees and practice must reflect the advice given. 13(2) Unused medicines must be returned to the pharmacy and a record maintained of the reasons for return. 22(1-8) The complaints procedure must be reviewed to include the timescales for response and a statement to confirm that no service user will be victimised for making a complaint. The procedure must be presented in DS0000016857.V287597.R01.S.doc 25/03/06 26/05/06 29/03/06 26/05/06 Apna House Version 5.1 Page 22 7 8 YA22 YA24 22(1) 23(2)(b) 9 10 YA30 YA30 16(2)(c) 13(4) 11 YA39 26(1-5) 12 YA39 24(1-3) 13 YA42 23(4)(c)v a format that service users understand. Service users must be advised of the procedure for making complaints. The carpet in the designated smoking lounge must be replaced. Unmet from last inspection. Mattresses must be replaced where they are dirty and stained. A risk assessment must be completed for the transportation of laundry to the laundry room. Practice must reflect the outcome of the assessment. The registered provider or their representative must undertake monthly visits to the home. These visits must be unannounced and a written report must be completed after each visit, the content of which should comply with the requirements as set out in this regulation. Copies of all reports must be available for inspection at the home and sent to the CSCI. Unmet from last inspection. The home must develop and implement a system of reviewing and improving the quality of care provided and must include a means of consultation with service users and their representatives. The fire risk assessment dated 2004 must be reviewed. Practice within the home must reflect the outcome of the review. 26/05/06 26/05/06 29/03/06 26/05/06 26/05/06 26/05/06 26/05/06 Apna House DS0000016857.V287597.R01.S.doc Version 5.1 Page 23 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 Apna House DS0000016857.V287597.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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