Inspection on 06/10/05 for Apna House

This inspection was carried out on 6th October 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 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 24/03/06

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 6th October 2005 12:00 Apna House DS0000016857.V257527.R01.S.doc Version 5.0 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.V257527.R01.S.doc Version 5.0 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.V257527.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Apna House Address 6 Park Avenue Hockley Birmingham West Midlands B18 5NE 551 5678 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.V257527.R01.S.doc Version 5.0 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. 22.02.05 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.V257527.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over four hours and involved discussion with service users and staff about the care and services provided in the home. Records relating to the way in which service users needs are met were sampled, including the records of a service user admitted to the home since the last inspection. Staff recruitment and training records were sampled as well as records relating to health and safety practice within the home. A brief tour of the premises was conducted. What the service does well: What has improved since the last inspection? What they could do better: Risk assessments and strategies to manage service users behaviour are in need of development. Apna House DS0000016857.V257527.R01.S.doc Version 5.0 Page 6 Some repairs and effective systems of odour control are needed to create a more pleasant environment for service users to live in. 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. 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.V257527.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Apna House DS0000016857.V257527.R01.S.doc Version 5.0 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 the following standard(s): 2 There are effective systems in place to assess the needs of prospective service users before they move into the home. EVIDENCE: Since the last inspection the home has admitted a new service user. The records of admission were examined and seen to contain an assessment of the person’s needs which had been completed by the registered manager as part of the home’s own written procedures. In addition, assessments by mental health care professionals had been incorporated into the admission process. A care plan and risk assessments were noted to include information about the service users mental health care needs and strategies to manage those identified. A record of visits made to the home prior to the service user moving in demonstrated that the person had received opportunities to meet other service users and staff and have an overnight stay as part of the admission process. Apna House DS0000016857.V257527.R01.S.doc Version 5.0 Page 9 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): 6, 9 Individual plans of care are well constructed and provide staff with information about service users needs, preferences and routines. Risk assessments that describe the controls in place to manage identified hazards have not been completed for some service users, which does not enable them to take responsible risks. EVIDENCE: Two care plans were examined. Both had been reviewed within the last five months. The care plans showed that the levels of support required by individuals in their day-to-day lives had been recorded. Preferred routines and personal goals were seen to have been incorporated into the plans. For example, one service user that had expressed an interest in attending college had been supported by staff to do so. Staff present at this inspection were able to demonstrate knowledge of service users individual needs that was consistent with the information in the individual plans sampled. Apna House DS0000016857.V257527.R01.S.doc Version 5.0 Page 10 Risk assessments for two service users were sampled. One file showed that detailed risk assessment of the person’s mental and physical health care needs had been conducted. Care practice observed during the inspection was reflective of the risk assessments in place. A number of protocols for managing identified risks to service users health and welfare had not been dated which made it difficult to establish that they were relevant to service users current needs. The second file was seen to identify risks to the service user, however there was no evidence of any controls in place to manage those recorded. This was discussed with the registered manager during the inspection, who made assurances that the risk assessments would be reviewed to incorporate this. At the last inspection in February 2005 it was noted that many service users smoke in their bedrooms and that risk assessments in relation to this practice were factually incorrect as they stated that bedroom furniture was flame retardant, when this was not the case. At this inspection evidence was provided that furniture and soft furnishings had been treated with flame retardant spray in all bedrooms. Apna House DS0000016857.V257527.R01.S.doc Version 5.0 Page 11 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): 13, 15, 17 Service users have regular opportunities to go out and use community-based resources and receive visits from their friends and relatives. Service users are offered a range of culturally sensitive meals, which they enjoy. EVIDENCE: At this inspection, service users were observed to go out to local amenities such as shops, leisure centres and places of worship. The daily records sampled for two service users showed that over a two week period both had been out each day to a variety of places including the cinema, social clubs and cafes and shopping in the city centre. One service user spoke about his enjoyment of attending a local working men’s club in the evenings, which he said he visited with friends from the home. Another service user commented that he regularly went out to the nearby shops on the Soho Road to buy CDs or for a walk in the local park. The registered manager advised that three service users were due to start courses at City College, which is situated close to the home. Apna House DS0000016857.V257527.R01.S.doc Version 5.0 Page 12 The home has a visitors policy, which it was reported is made available to service users and their friends and relatives. Three service users spoke about having family members visit them at the home and all said that their guests were made to feel welcome, often staying for a meal. The care plans sampled made reference to service users contact with their family and friends and the support required to maintain that contact. The home employs two cooks, both of whom were reported to have completed training in Basic Food Hygiene. Certificates were seen on file to support this. The menu for the week preceding this inspection was observed and noted to include a range of fresh fruit and vegetables and several choices of main meal at each sitting. The home provides culturally sensitive meals according to service users religious beliefs, which were seen to be recorded in the care plans sampled. The previous inspection in February 2005 identified that records of food consumed by service users with specific dietary needs were not being completed. Evidence was seen at this inspection that those records are now maintained. Two service users commented on the food at the home saying, “the food is good and I can eat where I want to” and “I love the food and I like using the little kitchen.” The home has a second kitchen, which is used by some service users to prepare snacks and drinks. One service user said that he liked going food shopping with staff and was included in menu planning with his peers. Apna House DS0000016857.V257527.R01.S.doc Version 5.0 Page 13 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): 19 There are established procedures in place to respond to service users health care needs. EVIDENCE: The two care plans sampled showed that service users health care needs are documented. For example, an eczema care plan was observed that described the support required by one service user to maintain good skin care routines. Staff present at this visit were able to describe how they supported this person, which was consistent with the information in the care plan. The records observed demonstrated that healthcare professionals such as consultant psychiatrists and community psychiatric nurses have continuing involvement with service users at Apna House. Health care appointments were seen to be recorded and included follow up action taken by the home in response to professional advice. For example, one service user diagnosed with asthma had been assisted to have regular check ups at the local asthma clinic. The home has responded to the assessed mental health care needs of one service user by providing additional staffing to reduce the risk of the person harming himself. Apna House DS0000016857.V257527.R01.S.doc Version 5.0 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): 23 In the main there are effective systems in place to respond to allegations or suspicions of abuse within the home. However, service users are not protected by agreed written strategies to manage incidents of challenging behaviour. EVIDENCE: The home’s adult protection policy was examined in detail at this visit and was seen to be consistent with the guidance issued by the lead agency for adult protection, Birmingham City Council. The home had made effort to find out about organisations that support people who have experienced abuse and listed the contact details for them within the policy. Staff training records sampled showed that all staff and some service users took part in conflict management training in September 2005 and that adult protection training was due in November 2005. The care plan for one service user that demonstrates challenging behaviour was observed to be in need of development to clarify the agreed strategies to manage the behaviour. The current plan, which was undated, did not identify any proactive or reactive management guidance and did not clearly describe the nature of the behaviour. Apna House DS0000016857.V257527.R01.S.doc Version 5.0 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): 24, 27, 28 Some repairs and effective systems of odour control are needed to create a more pleasant environment for service users to live in. There is sufficient shared space for the number and needs of people living in the home. EVIDENCE: The home was, in the main clean, warm and free from unpleasant odour at this inspection, with the exception of the small kitchen off the dining room and a first floor bathroom. The cupboards in the small kitchen were dirty and stained. This was pointed out to the registered manager who made arrangements for the cupboards to be cleaned whilst the inspection took place. The first floor bathroom contained a strong odour of urine, which was compounded by the fact that the extractor fan in the room was broken. The floor in the shower room on the ground floor was observed to be in need of retiling as many tiles were noted to be chipped and broken. The carpet in the designated smoking lounge was noted to be stained and burned and is in need of replacement. Apna House DS0000016857.V257527.R01.S.doc Version 5.0 Page 16 The registered manager advised that the ground floor hallways and some bedrooms were due to be recarpeted. Two service users confirmed that they had been involved in choosing the colour of the carpets for their bedrooms. Two bathrooms were observed. Both had appropriate door locks fitted that enable privacy but can be accessed from the outside in the event of an emergency. The home has two lounges, one of which is a designated smoking area, which leads directly onto the non-smoking lounge. At the previous inspection it was required that service users were consulted about the arrangements for smoking as there is no door separating the two rooms. This was seen to have been completed and was confirmed by service users present during the inspection. It was noted that additional extractor fans had been fitted in the smoking area to reduce the smell of cigarette smoke. Storage space was observed in the home for staff to keep their personal belongings whilst at work in an area that did not impact on the space used by service users. Apna House DS0000016857.V257527.R01.S.doc Version 5.0 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): 34, 35 Service users are protected by the home’s recruitment and selection procedures and are included in the recruitment of new members of staff. Service users benefit from a well trained team of staff. EVIDENCE: The recruitment records for two members of staff were examined. Both contained documents that proved the identity of the person and a completed application form and two references. There was evidence on file that Criminal Records Bureau (CRB) checks had been received by the home for both members of staff. The home has a written induction procedure for new staff. This was observed to have been completed over a four-week period and included the provision of information about service users needs and health and safety practice. It was reported by the registered manager and two service users that service users take part in interviewing prospective members of staff as part of the home’s recruitment and selection procedure. The training records for four members of staff were examined and showed that training in Basic Food Hygiene, First Aid, Health and Safety, Conflict Management and Infection Control had been provided. Apna House DS0000016857.V257527.R01.S.doc Version 5.0 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): 39, 42 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 has improved, however further development is needed to protect service users welfare. EVIDENCE: Regulation 26 of the Care Homes Regulations (2001) requires the registered provider or a representative to conduct monthly, unannounced visits to the home in order to report on the standard of care provided and seek the views of service users living there. The reports of visits made to the home by the registered provider were examined and showed that three visits had taken place since December 2004, which does not meet regulatory requirements. This issue was raised at the previous inspection in February 2005 and immediate requirements were made that the visits be completed and copies of the reports made sent to the CSCI. Apna House DS0000016857.V257527.R01.S.doc Version 5.0 Page 19 Since the last inspection considerable effort was seen to have been made to improve health and safety practice within the home. Fire doors on the ground floor had been fitted with magnetic devices to hold them open, which release when the fire alarm activates. Fire safety records were seen to demonstrate that the fire alarm system is tested and serviced on a regular basis and that a fire drill, which included participation by service users had been conducted in May 2005. There was no evidence that training in fire safety awareness had been provided since 2003 and immediate requirements were made that this be addressed for all staff. Risk assessments for the premises were observed to have been reviewed, with those not relevant to the home removed from the records. It was therefore disappointing to note that comments made in a service users daily records indicated that his bedroom door had been blocked overnight, which created a significant risk to his health and safety. Immediate requirements were made that this matter be investigated by the registered manager and the outcome reported to the CSCI by 13/10/05. Apna House DS0000016857.V257527.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score X 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X 2 3 X X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Apna House Score X 3 X X Standard No 37 38 39 40 41 42 43 Score X X 1 X X 2 X DS0000016857.V257527.R01.S.doc Version 5.0 Page 21 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA9 Regulation 13(4)(a-c) Requirement Protocols for managing identified risks to service users health and welfare must be dated to ensure they are relevant to their current needs and to aid the process of regular review. Immediate requirement. Risk assessments must be reviewed to clearly identify the controls in place to manage identified hazards to service users. Agreed strategies must be developed and implemented to respond to service users who demonstrate challenging behaviour and must be dated. The registered manager must make arrangements to control odour in the first floor bathroom and repair the extractor fan in this room. The floor tiles in the ground floor shower room must be replaced. The carpet in the designated smoking lounge must be replaced. The registered provider or DS0000016857.V257527.R01.S.doc Timescale for action 13/10/05 2 YA9 13(4)(a-c) 13/11/05 3 YA23 13(6) 13/11/05 4 YA27 16 2 k 23-2-c 13/11/05 5 6 7 YA27 YA24 YA39 23(2)(b) 23(2)(b) 26(1-5) 05/12/05 05/12/05 20/11/05 Page 22 Apna House Version 5.0 8 42 13(4) a-c 13(6) 9 42 23(4)(d) 18(1)(a)(c) 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. Immediate requirement. The registered manager must investigate the diary entry 28/9/05 for the service user whose door was blocked overnight and report the outcome to the CSCI. Immediate requirement. All staff must receive training in fire safety awareness. Immediate requirement. 13/10/05 05/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Apna House DS0000016857.V257527.R01.S.doc Version 5.0 Page 23 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. Extracts may not be used or reproduced without the express permission of CSCI Apna House DS0000016857.V257527.R01.S.doc Version 5.0 Page 24 - 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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