Inspection on 05/07/07 for Hanna Schwalbe Home

This inspection was carried out on 5th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hanna Schwalbe Home 20/02/06

Hanna Schwalbe Home 16/06/05

Hanna Schwalbe Home 09/12/04

Hanna Schwalbe Home 24/05/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Hanna Schwalbe Home 48 Leeside Crescent Golders Green London NW11 0LA Lead Inspector Stephen Boyd Key Unannounced Inspection 5th July 2007 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 Hanna Schwalbe Home DS0000010431.V336699.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hanna Schwalbe Home DS0000010431.V336699.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hanna Schwalbe Home Address 48 Leeside Crescent Golders Green London NW11 0LA 020 8458 3810 020 8922 7454 judymkisharon@hotmail.com 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) Kisharon Management Committee of Hanna Schwalbe Home Mrs Judy Meshulam Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Hanna Schwalbe Home DS0000010431.V336699.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th September 2006 Brief Description of the Service: Hannah Schwalbe is a registered care home for eight male adults with learning disabilities. It is part of a range of community services managed by Kisharon, a charitable trust providing both education and care for Orthodox Jewish children and adults who have a learning disability. The home is a large corner house located in a quiet road close to the shops and local amenities of Golders Green. The main communal areas are located on the ground floor of the home and include a large lounge and a kosher kitchen/diner. The managers office occupies a corner of the lounge area. There is a secluded garden area and a shed at the end of the garden, which can be, used for activities and also houses the washing machines. Most of the service users attend Kisharon College on a daily basis and have close links with their families and the local community. Information about the home including service users’ guide and the CSCI Inspection reports are available from the home by contacting the providers. The weekly fees of the home depend on the assessed needs of service users but currently range from £700.00 to £800.00 per week. Hanna Schwalbe Home DS0000010431.V336699.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place in one day in July. I was pleased to meet with the homes registered manager, Mrs Judy Meshulam who provided assistance throughout the inspection. Only one person living at the home was there during the inspection as other residents were at a day facility. I spoke with the deputy manager and another member of staff and observed interaction between staff and the one person at home. A tour of the premises was undertaken and various records, policies and procedures were perused. Following the inspection, some relatives of people living at the home were contacted by telephone to ascertain their views on the care their particular relatives receive at the home. What the service does well: What has improved since the last inspection? What they could do better: This inspection has amended and restated the two requirements outstanding from the previous inspection report. Care plans need to have more detailed comments written when reviewed and the plans themselves should be shared with relatives/representatives with them signing to acknowledge this has been done. The quality assurance system at the home needs to ensure an action plan is written based on the collation of responses from those people surveyed. Two new requirements are made as a result of the inspection. Firstly the medication system needs to have a coding system introduced to denote Hanna Schwalbe Home DS0000010431.V336699.R01.S.doc Version 5.2 Page 6 reasons why medication may not have been administered. Secondly, the policy and procedure in respect of protecting vulnerable adults from abuse needs to be updated and clearly separate from policies in relation to children. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hanna Schwalbe Home DS0000010431.V336699.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hanna Schwalbe Home DS0000010431.V336699.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living at the home have had a comprehensive assessment of their needs carried out, covering all the areas listed in the national minimum standards for younger adults. EVIDENCE: The home has not admitted any new people since the previous inspection. Prospective new residents would have details of needs provided in the first instance from social workers and families. A visit would be made to their home to complete an assessment and if it seemed likely a person could have their needs met, they would have introductory visits to the home. Hanna Schwalbe Home DS0000010431.V336699.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7, AND 9 People who use this service experience adequate outcomes in this area. . This judgement has been made using available evidence including a visit to this service. People living at the home have care plans, which are based on their assessed needs. However, some work needs to be done to improve reviews and peoples awareness of plans. People living at the home are helped to make appropriate choices and decisions where they are able. People are supported to take risks in their lives with good assessments of risks in place. EVIDENCE: People living at the home have plans of care, which are holistic in their approach. They outline the needs people have, how these needs can best be met, who should be involved and what the expected outcome of planned interventions are. Plans are regularly reviewed, however, it was still the case that the review tended to say “no change” thus not giving a flavour of how well or not the plans were progressing. Relatives had not signed plans to indicate Hanna Schwalbe Home DS0000010431.V336699.R01.S.doc Version 5.2 Page 10 they had knowledge of them and therefore a requirement is given regarding making these improvements to the care planning process. Observation of the one person at home during the inspection and discussion with staff and relatives indicated that people living at the home could make choices and decisions regarding their lives with assistance as needed. It was clear that for example, people could have any items of personal interest in their rooms. People living at the home had risk assessments carried out on activities and issues within and outside of the home, for example swimming and cooking activities. A risk/benefit approach was taken with strategies in place to minimise risk and maximise opportunity. Hanna Schwalbe Home DS0000010431.V336699.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16, and 17 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People at the home benefit from a wide range of activities suited to their needs many of which are pursued in and around the local community. Contact with family and friends is seen as an important part of peoples’ lives. People living at the home are treated with respect and dignity and responsibilities are encouraged where they are able. People benefit from a good food provision. EVIDENCE: People living at the home are able to follow a range of activities. These include: shopping, visits to places of interest in London such as museums, walks, attendance at a Wednesday night club, going to the synagogue on Fridays and Saturdays, sports and music therapy sessions. A planned holiday Hanna Schwalbe Home DS0000010431.V336699.R01.S.doc Version 5.2 Page 12 to Cornwall is due to take place in August. The majority of people also attend a day service where activities and skills training take place. All of the current people living at the home have contact with family and/ or friends. A mother of one person advised me that she and her husband could visit when they wished and also took their son home for weekends. She was very complimentary about the care and attention her son received. People living at the home are encouraged to make decisions about their lives and undertake responsibilities where they are able. Meetings where people can express their views are held every fortnight and people have input into menu planning and what activities they wish to pursue. The one person at home during the inspection was seen to be treated with respect and a relative spoken with said they were happy with the way their son is treated. Food provision at the home is fully in keeping with the religious and cultural needs of the people living there. Menus were seen which reflected a varied range of meals. Kitchen and dining areas were seen to be suitable in terms of provision of appropriate facilities and choice. Hanna Schwalbe Home DS0000010431.V336699.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living at the home receive good support from staff in line with their religious needs. People have their health needs monitored and met. Only one person is currently receiving regular medication and the home needs to ensure there is a suitable coding system in place for instances of nonadministration. EVIDENCE: In line with the religious and cultural needs of people living at the home personal care is provided by male members of staff. Care plans identify the care needs of people and how these are to be met. It was clear from healthcare records and care plans that people living at the home have their emotional and physical health needs at the forefront of staffs thinking. Records showed that regular appointments with health professionals such as dentists, opticians, g.p’s, chiropodists and others as necessary take place. Hanna Schwalbe Home DS0000010431.V336699.R01.S.doc Version 5.2 Page 14 At the time of inspection only one person was receiving medication. There was seen to be a safe and secure place for medication to be held. Staff involved in administration of medication had received appropriate training. The home had not adopted a coding system to denote reasons for any non- administration of medication and this needs to be rectified. A requirement to this effect is given in the report. Hanna Schwalbe Home DS0000010431.V336699.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use this service experience adequate outcomes in this area. . This judgement has been made using available evidence including a visit to this service. A suitable policy and procedure is in place to respond to any concerns and complaints of people living at the home or from their family/friends. Although a policy/ procedure is available for the protection of vulnerable adults, this needs to be updated and separated from the policy in relation to children. EVIDENCE: The home was found to have a suitable complaints policy and procedure. There is a pictorial aide for making a complaint to help people living at the home. There had been no recorded complaints made since the previous inspection. A complaints record was available. At the time of the inspection there were no protection of vulnerable adults issues ongoing. The home had a policy on the protection of vulnerable children and adults. The manager was advised that this needed to be changed, as the home itself does not cater for children. Also the substance of the policy was not robust enough and for example made no reference to the policies and procedures of the London borough of Barnet in respect of how abuse allegations would be dealt with. A requirement to address these issues is given in the report. Hanna Schwalbe Home DS0000010431.V336699.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a homely environment, which is comfortable and clean. EVIDENCE: Since the previous inspection in September 2006, the home had improved its environment for people living there. A new floor covering had been laid in the lounge/dining area and new furniture had been purchased for people’s bedrooms. Bedrooms of people living there were seen to be personalised with items of interest such as photographs, pictures, drawings etc. The home was well maintained in appearance and no safety hazards were apparent during the inspection. The home was found to be free of any offensive odours and was clean and tidy during the inspection. Hanna Schwalbe Home DS0000010431.V336699.R01.S.doc Version 5.2 Page 17 Staff did comment that the top floor of the home gets very hot and uncomfortable for people during hot summer weather. It is recommended that the registered provider examine a solution to this problem. Hanna Schwalbe Home DS0000010431.V336699.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34, and 35 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home benefit from a good, well qualified and trained staff team. People are protected by the homes’ recruitment processes. EVIDENCE: The home employs twelve full and part time care staff. Of these, eight have achieved national vocational qualifications in care at level two or above meaning that the home well exceeds the requirement to have fifty percent of staff with these qualifications. Each staff member has an individual training file with details of individual training courses completed and when these were taken in order that the provider can arrange refresher courses when needed. A staff member spoken with confirmed that he received training in relevant care topics such as food hygiene, manual handling, first aid and fire training. It was clear that regular staff meetings and supervision sessions were held to support the staff in their roles. Hanna Schwalbe Home DS0000010431.V336699.R01.S.doc Version 5.2 Page 19 The files of a number of staff were reviewed and these indicated that appropriate recruitment processes were in operation. Applications are filled in by potential employees and those deemed suitable are invited for interview. If successful, reference checks are made, criminal records bureau checks progressed and photo identity is required. A staff member spoken with confirmed he underwent these processes. Hanna Schwalbe Home DS0000010431.V336699.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 People who use this service experience adequate outcomes in this area. . This judgement has been made using available evidence including a visit to this service. The home is well run by a dedicated manager and staff team. A system of quality assurance needs to be fully implemented. The health, safety and welfare of people living at the home is given a good level of priority. EVIDENCE: The registered manager, Mrs Judy Meshulam has held that position for over seven years. She has the registered managers award and has great experience of the client group experienced in this and other settings. Staff praised her supportive management style, saying that no matter how busy she is she finds Hanna Schwalbe Home DS0000010431.V336699.R01.S.doc Version 5.2 Page 21 time to help and guide them. A relative spoken with said “I have nothing but praise for the manager” Since the previous inspection the manager had sent out survey forms to relatives and others asking for comments on the quality of service. Some had been returned and had generally positive comments on the way that Hanna Schwalbe operates as a care home. The manager was advised that as part of a quality assurance process, an action plan should be written based on the findings of surveys. Various safety certificates were seen and found to be up to date in respect of the home. These included, certificates relating to fire safety equipment, electrical and gas safety. As indicated earlier in the report the home was free of safety hazards during the inspection. Risk assessments for the premises had been completed and staff had received various training courses relating to health and safety matters. Hanna Schwalbe Home DS0000010431.V336699.R01.S.doc Version 5.2 Page 22 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 3 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 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 X X 3 X Hanna Schwalbe Home DS0000010431.V336699.R01.S.doc Version 5.2 Page 23 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 YA6 Regulation Requirement Timescale for action 30/09/07 15(1)(2)(a)(b)(c) The registered person must ensure that service users’ care plans, when reviewed, indicate the outcome of the review in greater detail than “no change”. Plans should be shared with people and/or their representatives, who if able could sign to indicate their involvement in the care plan objectives. This requirement is amended and restated from the previous inspection where the requirement was not fully met. 13 (2) The registered person must ensure that a coding system is adopted to indicate the reasons for any non-administration of medication for people living at the home. The registered person must ensure that the homes policy on the protection of vulnerable adults is rewritten in line with advice DS0000010431.V336699.R01.S.doc 2. YA20 31/07/07 3. YA23 13 (6) 31/08/07 Hanna Schwalbe Home Version 5.2 Page 24 4. YA39 24(1) given in standard twenty three of this report The registered person must ensure that people who live at the home, their carers and visitors are consulted annually about the quality of the services and facilities provided at the home. The outcome of the consultation must be collated and an action plan written to meet any identified shortfalls in the service. This requirement is amended and restated from the previous inspection where the requirement was not fully met. 31/08/07 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 YA24 Good Practice Recommendations It is recommended that to enhance the comfort of people living on the top floor of the home, measures are taken to reduce the effects of hot weather. Hanna Schwalbe Home DS0000010431.V336699.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Harrow Area Office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!