Inspection on 07/02/06 for Nicholas House

This inspection was carried out on 7th February 2006.

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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Nicholas House 06/02/09

Nicholas House 27/02/07

Nicholas House 12/09/05

Nicholas House 09/12/04

Nicholas House 09/07/04

Nicholas House 01/03/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Nicholas House Cairns Close St Albans Hertfordshire AL4 OEY Lead Inspector Yoke-Lan Jackson Unannounced Inspection 7th February 2006 10:00 Nicholas House DS0000019482.V282585.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 Nicholas House DS0000019482.V282585.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. Nicholas House DS0000019482.V282585.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Nicholas House Address Cairns Close St Albans Hertfordshire AL4 OEY 01727 839909 01727 858742 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) www.pentahact.org.uk PentaHact Eamonn Cummings Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Nicholas House DS0000019482.V282585.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered manager must complete the NVQ level 4 in Management and Care by July 2008. 12th September 2005 Date of last inspection Brief Description of the Service: Nicholas House, provided by PentaHact, is a residential care home for seven younger adults with autism, severe learning disabilities and challenging behaviour. It is situated in a residential area, about two miles away from the town of St Albans. There are ample parking facilities nearby. The three storey building is part of the former Hill End Hospital complex. The external appearance of this Edwardian building blends in well with surrounding properties. It has been completely renovated internally to accommodate the assessed needs of the service users. There are six bedrooms, mainly on the first and second floors. The first floor has two bedrooms, a lounge with adjoining dining room, a domestic-scale kitchen, a Jacuzzi bathroom and toilet and a separate toilet. The office/sleep-in room is also on this floor. The second floor consists of four bedrooms, a bathroom and a separate toilet. The ground floor has a one-bedroom flat for a service user, a sensory room, a recreation room and the utility room. There is a large garden to the back of the building. It has a summerhouse, garden swings and garden furniture. The garden overlooks Highfield Park. Nicholas House DS0000019482.V282585.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection. The assistant manager was present. There are 7 service users residing in the home. The registered manager has been seconded to another home belonging to PentaHact for six months. One of the assistant managers is currently acting as home manager. The inspection began with a tour of the premises including the flat on the ground floor. The care plans and other documents were examined. Only one service user was present during the inspection. He needs to be constantly supervised and monitored by a member of staff. The other service users were at the Day Care Centre. (Please see below for details of the inspection findings). What the service does well: What has improved since the last inspection? The garden and communal rooms are kept tidy and safe from hazards. The provider has agreed to submit the monthly report on time. Hitherto there had been a delay due to an administration error. A health and safety officer (arranged by the provider, PentaHact) had assessed the damaged doors in the flat and repairs are being carried out to conform to fire safety requirements. Nicholas House DS0000019482.V282585.R01.S.doc Version 5.1 Page 6 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. Nicholas House DS0000019482.V282585.R01.S.doc Version 5.1 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 Nicholas House DS0000019482.V282585.R01.S.doc Version 5.1 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): 3, 4, 5, A comprehensive assessment is carried out prior to the admission of a service user. A trial period is arranged. EVIDENCE: Each service user has a Service User Guide and a copy of the written contract of agreement. The home is currently full with seven service users. Nicholas House DS0000019482.V282585.R01.S.doc Version 5.1 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, 7, 10. Service users are supported and encouraged to participate in all aspects of life in the home. All information about the service users is handled in accordance with the Data Protection Act 1998. EVIDENCE: The assessed and changing needs of the service users were reflected in the care plans examined. The care plans are reviewed monthly. All the service users require daily one-to-one supervision and guidance. A key worker is assigned to each of them to ensure that all their needs can be met. Service users’ individual records are kept updated and are stored securely and are handled appropriately in accordance with legislation. Nicholas House DS0000019482.V282585.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, 13, 14, 17. The daily routine promotes independence and individual choice. The activity programme is planned to suit individual needs and interests. Service users are encouraged to maintain contact with their family and friends. A healthy diet is promoted. EVIDENCE: All the service users attend the PentaHact Day Care Centre in Brickets Wood daily. Members of staff from the centre assist each day. Transportation is provided. Outdoor activities are arranged to suit the individual needs and preferences of the service users. One of them requires one to one supervision all the time and staff arranged activities to suit his needs. The home has a recreation room equipped with indoor games, including a pool table and a computer system with Internet access and some computer games. A member of staff prepares the meals daily. The manager ensures that the meals provided are healthy and nutritious. A dietician visits each service user at regular intervals. Nicholas House DS0000019482.V282585.R01.S.doc Version 5.1 Page 11 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, 19, 20. Service users are treated with respect and they receive personal care and support in the way they require and prefer. Medication is administered in accordance with legislation. EVIDENCE: Health and behavioural concerns are referred to the appropriate health care professional. One service user was recently referred for assessment and staff are monitoring him closely. Trained staff administer the medication. One medication error was investigated. The member of staff was withdrawn from administering medication and is currently being retrained and supervised. Nicholas House DS0000019482.V282585.R01.S.doc Version 5.1 Page 12 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, 23. The home has a robust Complaints’ Policy and Procedure which are available to service users and others. EVIDENCE: The home has received one complaint that was investigated and partially upheld. Staff have training on issues regarding abuse and self-harm. The manager ensures that all staff are aware of the Adult Protection Procedure of Hertfordshire Social Services. Nicholas House DS0000019482.V282585.R01.S.doc Version 5.1 Page 13 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, 30. The home is generally clean and comfortable. The facilities provided are adequate. However, there are hazards to safety. EVIDENCE: The doors and floor covering in the flat (on the ground floor) have been damaged by a service user. The damage is a hazard to fire safety. On the day of the inspection, the health and safety officer (arranged by the provider), was called in to assess the damage. Repair work is currently being carried out. The manager has assured the inspector that the kitchen on the first floor will be refitted on 27th February 2006. Nicholas House DS0000019482.V282585.R01.S.doc Version 5.1 Page 14 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): 31, 32, 33, 35. Service users are protected and benefit from an effective staff team. The staffing number is adequate. Staff have clearly defined roles and responsibilities. There are policies and procedures to guide them. EVIDENCE: The home has a rolling training programme for all staff. This ensures that they have the skills and experience necessary to care for the service users. One recent recruit said that she had induction training and shadowing until she was confident to take on the role and responsibilities assigned to her. She has recently been assigned as the key worker to one service user. Nicholas House DS0000019482.V282585.R01.S.doc Version 5.1 Page 15 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, 40, 41, 42. The home is currently without a registered manager. The safety of service users and staff is not always promoted. EVIDENCE: The registered manager has been seconded to another home (belonging to Pentahact) for six months. One of the assistant managers is currently acting as home manager. The management has not always ensured safe working practices. On the day of the inspection, it was noted that an aerosol spray was left in the kitchen on the ground floor flat. This exposed the service users and staff to danger and was a fire hazard. The management must ensure compliance with legislation regarding the storage of cleaning products and hazardous substances. (Please see Statutory Requirements). Nicholas House DS0000019482.V282585.R01.S.doc Version 5.1 Page 16 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 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X X 3 3 2 x Nicholas House DS0000019482.V282585.R01.S.doc Version 5.1 Page 17 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. Standard YA42 Regulation 13( 4 ) (a) Requirement The home manager must ensure compliance with the Control of Substances Hazardous to Health Regulations (COSSH) 1999. Timescale for action 07/02/06 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 Nicholas House DS0000019482.V282585.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Nicholas House DS0000019482.V282585.R01.S.doc Version 5.1 Page 19 - 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!