Inspection on 28/11/05 for Nile Centre (The)

This inspection was carried out on 28th November 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Nile Centre (The) 08/01/08

Nile Centre (The) 31/08/06

Nile Centre (The) 20/06/05

Nile Centre (The) 04/11/04

Nile Centre (The) 05/07/04

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

CARE HOME ADULTS 18-65 Nile Centre (The) 105-109 Foulden Road Hackney London N16 7UH Lead Inspector Sandra Jacobs-Walls Unannounced Inspection 28th November 2005 10:00 Nile Centre (The) DS0000010278.V269138.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 Nile Centre (The) DS0000010278.V269138.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. Nile Centre (The) DS0000010278.V269138.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Nile Centre (The) Address 105-109 Foulden Road Hackney London N16 7UH 020 7241 3003 020 7241 4421 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) Kush Housing Association Limited Mr Allan Michael Eno Care Home 9 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (9) of places Nile Centre (The) DS0000010278.V269138.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th June 2005 Brief Description of the Service: The Nile Centre project aims to provide 24-hour crisis, outreach and therapeutic service for members of the African/Caribbean community living in Hackney experiencing mental health crisis. The project provides a preventative service, through the avoidance, where possible of longer-term hospital admissions. The Nile Centre works in partnership with existing mental health services to enable service users to manage their mental health needs. Short-term accommodation for up to 2 weeks is available for a maximum of nine people in single rooms. Culturally reflective counselling, complementary therapy, group work, activities and support are available. Service users can make self-referrals and referrals are additionally received from health and social care agencies. The home is situated in a residential area of Stoke Newington within the London Borough of Hackney. Local shops and amenities, including a local market, are within close proximity. Bus links are good. At the time of the inspection five service users were having respite at the unit. Nile Centre (The) DS0000010278.V269138.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection of The Nile centre was conducted on the morning of November 28 2005 over the course of 3.5 hours. The purpose of the inspection was to follow up on requirements made at last announced inspection that was conducted on June 20 2005 and a subsequent additional inspection visit that was conducted on September 6th 2005. The inspection process included an interview with a current resident, the review of three service users files and other key documents and discussion with the registered manager. The inspector also later that day, completed a site visit to KUSH head office to review staff personnel files. As a result of the inspection three requirements and one recommendation was made. The inspector would like to thank service users and staff who co-operated and contributed to the inspection. What the service does well: What has improved since the last inspection? The inspector was encouraged to note that a number of issues highlighted at the previous announced inspection had been resolved. The service user who spoke with the inspector indicated that she felt services had improved since she was last staying at the unit, some 10 months ago. The service had addressed issues pertaining to adult protection and medication records. The Nile Centre (The) DS0000010278.V269138.R01.S.doc Version 5.0 Page 6 long anticipated building works is now planned to commence in the New Year and the registered manager was enrolled on management training as required. The inspector was particularly encouraged to note that all staff personnel records are now fully compliant with the regulations; this issue had been cause for serious concern at the previous 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. Nile Centre (The) DS0000010278.V269138.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 Nile Centre (The) DS0000010278.V269138.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): No standards under this heading were assessed during the inspection. EVIDENCE: Nile Centre (The) DS0000010278.V269138.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): No standards under this heading were assessed during the inspection. EVIDENCE: Nile Centre (The) DS0000010278.V269138.R01.S.doc Version 5.0 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): No standards under this heading were assessed during the inspection. EVIDENCE: Nile Centre (The) DS0000010278.V269138.R01.S.doc Version 5.0 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): 20 Service users appropriately retain, administer and control their own medication. The home’s medication policies and procedures are sound EVIDENCE: The inspector expressed considerable concern for the home’s medication practices at the last announced inspection. Two related requirements were made that highlighted the need for Medication Action Records (MAR sheets) to be amended and for relevant information to be accurately documented. The inspector reviewed the medication information for one service user in detail. The inspector observed that the newly designed medication record had been appropriately amended to allow for fuller information and staff signatures. The registered manager also informed the inspector that a local pharmacist had provided medication training to staff following the announced inspection. Protocols to working effectively with the Home Treatment Team are being developed. The inspector suggests that any exceptional/immediate changes to the administration of service user medication authorized by the Home Treatment Team be additionally documented on service users’ main file as further safeguard. Nile Centre (The) DS0000010278.V269138.R01.S.doc Version 5.0 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): 23 Service users are protected from abuse, neglect and self-harm. EVIDENCE: Files reviewed by the inspector contained comprehensive risk assessments for all residents, these included the risk of aggression, neglect and self-harm. Effective strategies were in place to address general and specific issues around adult protection. The announced inspection had highlighted the need for staff to have access on site to local adult protection protocols and for the home’s own policies to reflect local social services policies. The registered manager informed the inspector that the home’s adult protection policy was currently under review; all staff had been issued with the adult protection policies of the relevant local authority. General issues of protection had featured in recent staff meetings. Nile Centre (The) DS0000010278.V269138.R01.S.doc Version 5.0 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 A considerable amount of building work the home’s premises remain outstanding. Service users’ toilets and bathrooms provide sufficient privacy and meet individual needs. EVIDENCE: The inspector was informed that the long anticipated building works to the home’s premises had very recently been approved by all parties involved. It is thought by the registered manager that structural and the re-decoration of the building will commence early in 2006. The previous announced inspection had highlighted the need for a leak in one of the bathrooms to be repaired; this had been completed. Nile Centre (The) DS0000010278.V269138.R01.S.doc Version 5.0 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): 34 Service users are supported and protected by the home’s recruitment policy and practices. EVIDENCE: The registered manager informed the inspector that staff recruitment for the home was due to commence in the near future. The staff recruitment practices of the home was cause for grave concern at the last inspection, many staff personnel files seen on that occasion failed to evidence full information as required by the regulations. During this inspection, the inspector reviewed again, at the service’s head office, the personnel files for all staff currently working at the home and noted that full information and documentation, in particular CRB disclosures forms were evidenced. Nile Centre (The) DS0000010278.V269138.R01.S.doc Version 5.0 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 & 41 Service users benefit from a well run home, but some aspects of the home’s record keeping is in need of improvement. The registered manager must complete required management training. EVIDENCE: The inspector interviewed a service user resident at The Nile Centre at the time of the inspection. She informed the inspector that she had stayed at the home for respite previously. She commented that she felt the running of the home had improved since her last stay, she said, “It felt more organised” She commented that she felt management and staff were sensitive to her needs and remained non judgemental about how she had presented. She indicated that the home’s general environment was relaxing and gave her the opportunity to safely review her current circumstances. Nile Centre (The) DS0000010278.V269138.R01.S.doc Version 5.0 Page 16 The inspector noted on files reviewed that staff continue to not document details of 1:1 (key work) sessions with service users. This had been highlighted as an issue at the announced inspection. It was difficult to ascertain from documentation on file whether placement objectives were being addressed and more importantly, the outcomes of action taken by staff or service users to address placement goals. Staff must document more explicitly work conducted with individual service users and the outcome of the care plan objectives. The manager had recently become the registered manager of the service. He informed the inspector that he had enrolled on required management training (NVQ4/Registered Manager’s Award). The registered manager will need to complete this training in order to comply with the Care Homes Regulations. Nile Centre (The) DS0000010278.V269138.R01.S.doc Version 5.0 Page 17 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 X X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X 3 X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X 3 X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Nile Centre (The) Score X X 3 X Standard No 37 38 39 40 41 42 43 Score 2 X X X 2 X X DS0000010278.V269138.R01.S.doc Version 5.0 Page 18 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 YA24 Regulation 23 Requirement The registered manager must ensure that outstanding building works and re-decoration of the premises are completed. The registered manager must ensure that he complete the required management training The registered manager must ensure that documentation in service user files detail the content of individual sessions held between staff and service users and detail outcomes of care plan objectives (Timescale of 01/08/05 not met) Timescale for action 31/08/06 2 3 YA37 YA41 19(5)(b) 12(1)(a) 31/12/06 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA20 Good Practice Recommendations It is recommended that exceptional/immediate changes to the administration of service users medication as authorized by the Home Treatment Team be additionally documented in service users’ main file. DS0000010278.V269138.R01.S.doc Version 5.0 Page 19 Nile Centre (The) Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford London E15 4BQ 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 Nile Centre (The) DS0000010278.V269138.R01.S.doc Version 5.0 Page 20 - 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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