Inspection on 14/12/06 for Portishead House, 5

This inspection was carried out on 14th December 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Portishead House, 5 05/12/08

Portishead House, 5 09/11/05

Portishead House, 5 15/04/05

Portishead House, 5 23/09/04

Portishead House, 5 06/05/04

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

CARE HOME ADULTS 18-65 Portishead House, 5 Westbourne Park Estate London W2 5UP Lead Inspector Ann Gavin Unannounced Inspection 14th December 2006 10:45 Portishead House, 5 DS0000010864.V319427.R01.S.doc Version 5.2 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 Portishead House, 5 DS0000010864.V319427.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. Portishead House, 5 DS0000010864.V319427.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Portishead House, 5 Address Westbourne Park Estate London W2 5UP 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) 020 7243 0697 020 7221 3959 chichi@mungos.org St Mungo Association Mrs Chinwe Ukamaka Nzekwe Care Home 14 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (14) of places Portishead House, 5 DS0000010864.V319427.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th November 2005 Brief Description of the Service: Portishead House is a registered care home for 14 men with mental health problems. One place in the home is used to provide respite care for short periods. All 14 places in the home are funded by Westminster City Councils Social Services Department. The property is owned by Paddington Churches Housing Association. The home is staffed and the care is provided by St Mungos Association, a voluntary organisation. The home is located on a housing estate close to the transport links and community facilities of Westbourne Park and Bayswater. The home is run as a rehabilitation project. Residents live in the home for up to three years and are supported to learn and develop the skills they need to move on to more independent accommodation. At the time of this inspection there were fourteen residents living at the home. Portishead House, 5 DS0000010864.V319427.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 on 14th December from 10 45am till 5 pm. It was unannounced. This report is made up of information gained from speaking with service users, staff, managers as well as looking at records, tracking the care of three service users and a tour of the communal areas of the project. There were 9 services users and 3 professional questionnaires returned. Portishead House is well run and encourages services users to be fully involved in the project. The service users and staff were welcoming to the inspector. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Portishead House, 5 DS0000010864.V319427.R01.S.doc Version 5.2 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Portishead House, 5 DS0000010864.V319427.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2,4,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Every service users needs are assessed and they visit the home prior to admission. Service users are given clear information about the project. EVIDENCE: ‘ I got all the information about the project and I visited’ (service user) St Mungo’s has a clear assessment process. They have their own referral form which care managers and prospective service users complete. It asks for detailed information in order that the staff can discuss people’s suitability for the project. Staff were observed discussing prospective clients. They were clear about their role and the need to meet both the prospective service users needs and those of the service users in the project. Prospective service users usually make the initial visit with their care managers. Service users then stay for a three night mutual assessment where the expectations of the project are explained and levels of care and support discussed. There is a respite bed that is often used for emergency short term placements. The care plans seen all had evidence of an assessment. Portishead House, 5 DS0000010864.V319427.R01.S.doc Version 5.2 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All service users have a care plan which is created with their key worker. Risk assessments are completed for all service users. Service users are involved in and consulted on the running of the project. EVIDENCE: The support workers spoke about the creating a joint care plan with service users. This is based on the reports and assessment and continues when the service user and their assigned key worker meet. They work through a joint care and action plan covering all aspects of daily living drawing out agreed goals for each area. These are reviewed regularly and amended as necessary. The service user spoken with confirmed that they met regularly with their worker and that they worked together on plans. Portishead House, 5 DS0000010864.V319427.R01.S.doc Version 5.2 Page 9 The care plans seen all contained joint care plans signed by both parties. All had good clear risk assessments that were regularly reviewed with the service users. Part of the projects general risk assessment is that service users have keys to their own rooms but not the front door. There are staff on 24 hours and let people in. The service users understand the rationale behind the ‘no front door’ key policy and accept it. There is a ‘cycle of change’ programme in place to help service users, who use substances, to start again. Service users participate in the running of the home through the weekly house meetings where forthcoming activities, complaints and grievances are discussed. Observation of the interaction between service users and staff confirmed that they work on a model of mutual respect. Portishead House, 5 DS0000010864.V319427.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are encouraged to engage in activities within the project and in the community. The practise of monitoring service users nutrition must be reinstated EVIDENCE: ‘ They have taught me how to cook’ (service user) A service user spoke proudly of how they have been taught to cook by the life skills support worker. They were having a one to one session that morning and decided to bake a cake, which turned out very well. The life skills worker is on a part-time short-term contract dependent on funding. They also work in another local project. They spoke of how they are building up a rapport with the service users and have developed a loose structure to help people become more motivated and it seems to be working Portishead House, 5 DS0000010864.V319427.R01.S.doc Version 5.2 Page 11 well. The service user and staff spoke about the positive impact of their post. The service users related easily to them and staff said it really gave more flexibility in the support they are able to offer the service users. There are a variety of activities available for service users within the home and many also attend local projects. During the inspection service users received visits from friends and also family. One service user wanted to spend tine on their own and each of the service users choices were respected or challenged if it contradicted the agreed care plans. All service users pay £4.50 a week for all meals. Service users can keep some food in their room as there is a small fridge provided in each room. Previously the menu was decided at the weekly service users meetings but now the service user who is buying and preparing the food decides on a daily basis. Everyone felt this has worked better. The staff keep an overall eye to try and encourage a balanced healthy diet. The menus are recorded and kept. During the week the main meal is in the evening and prepared by the service users .At the weekend the staff prepare the main meal which is at lunchtime. It was observed that staff were uncertain if one of the service users had had any lunch. The project did have a system to monitor service users nutrition but it is no longer being used. The manager must reinstate the monitoring of service users nutrition Portishead House, 5 DS0000010864.V319427.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The medication records are clear and well recorded. The manager must develop a more comprehensive system to monitor service users health. ‘ The home appears to be well managed with close liaison with us. Medication appears to be managed well’ (local G. P.) EVIDENCE: All service users are registered with local GP’s. There is no personal care service users are prompted to maintain their own personal care. They are also encouraged to be self-medicating. Those who do administer their own medication keep it in their room, which can and is always locked when they are not in. The project puts in place action plans for those service users who are non compliant with medication. The medical records of three service users were looked at. They were clear and well recorded with no gaps. There were two comment cards received from local GP’s one spoke of the project being well managed the other of the project Portishead House, 5 DS0000010864.V319427.R01.S.doc Version 5.2 Page 13 ordering medication too early. The manager said that this was to allow time for the chemist to prepare blister packs. The staff said that the mental health needs of the service users are well monitored through a close liaison with local mental health teams and CPN’s (Community psychiatric nurse). The care plans had evidence of joint working. St Mungo’s have launched a champion programme which one of the project workers is developing and will cascade through to other staff and service users. The care plan does focus on the issues around service users mental health but there is not much about people’s physical health needs which should be developed further. The manager must develop a more comprehensive system for monitoring service users health Portishead House, 5 DS0000010864.V319427.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22.23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Portishead House have a clear complaint procedure for service users. Service users feel their views are listened to and acted upon. Staff showed they were familiar with adult protection procedures. EVIDENCE: Service users are familiar with the complaints process and are encouraged to complain. The form they complete includes the action decided upon and is signed by the service user and a member of staff. These complaints are monitored by the project and by the organisation. Many service users will take up issues or complaints through the weekly service users meetings. The complaints seen had all been dealt with and the action agreed by service users and staff. All staff at the project have been on adult protection training and were familiar with the issues speaking confidently and sensitively about how they might handle issues. Portishead House, 5 DS0000010864.V319427.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The project is homely bright well maintained and clean. EVIDENCE: A Tour of the communal areas showed the project to be welcoming, homely well decorated with bright colours and comfortable. The new furniture was in place and looked good. The staff were putting up Christmas decorations asking service users to join in. Service users each have their own room and share bathroom facilities. They can bring their own furniture or decide when they come what they would like in their room and if they wish to decorate. The entrance hall was full of information of the project, activities in the community and within other projects. The rota for the week for cooking and the shift rota for the staff was also displayed. Portishead House, 5 DS0000010864.V319427.R01.S.doc Version 5.2 Page 16 Service users are responsible for cleaning of their own rooms and the night staff carry out the general domestic chores. They also carry out health and safety checks do the fridge and water temperatures. Every Saturday staff carry out a check of every room in the project. Each room is then scored on different aspects taken including cleanliness, odour, lighting repairs. This highlights those service users that are in need of support and staff plan a time to work together with the service users. The project looked clean and fresh Portishead House, 5 DS0000010864.V319427.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Portishead House has a stable trained staff team who work together with service users towards planned goals. EVIDENCE: The staff spoke of good working relationships with colleagues and service users. They said they received excellent support from the manager and had clear directions about their role and the organisation. Indirect and direct observation of staff relating with service users showed a relaxed clear communication and good rapport. The feedback from service users and the two service user spoken with confirmed this. Staff work in differing shift patterns of 8am to 4 or8.30 to 4.30. 3pm – 11 pm and sleep over. There is a waking night care worker/ cleaner who works 10.30 to 8.30. Any gaps in shifts are initially filled with St Mungo’s locums and then agency staff. There are clear shift plans written daily. Portishead House, 5 DS0000010864.V319427.R01.S.doc Version 5.2 Page 18 Recruitment of staff is done centrally then project managers form part of the interview panel and interviews are held at the project sometimes service users are also involved. The records of three staff were looked at. All personnel files are held centrally in head office. There were notes of supervision and training records. There is a need to complete annual appraisal for all staff. The manager was away from the project for a planned period. An agency manager covered their post though carried out some supervision it was not thought appropriate to complete appraisals. All project workers have either obtained NVQ level 2 or are undertaking it. Portishead House, 5 DS0000010864.V319427.R01.S.doc Version 5.2 Page 19 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): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Portishead House is led by a competent manager and staff team. Service users know their views are valued ‘It’s a good place’ (service user) ‘The manager is good’ (staff) EVIDENCE: The manager was at a meeting during the day but returned at the end of the inspection. There was the deputy manager two care staff and the life skills worker on duty and many of the service users were out. The deputy manager transferred form a night management team and has some years experience in care. They are currently completing their NVQ level4. Portishead House, 5 DS0000010864.V319427.R01.S.doc Version 5.2 Page 20 The manager has many years experience in the health care field, holds the NVQ level 4 accreditation and is a qualified NVQ Assessor. Portishead House has up to date, clear record keeping. There are good fire logs kept with regular fire drills and point checks. The fire equipment is regularly maintained. Any accidents or incidents are recoded and the appropriate people informed. St Mungo’s uses an external company to compile and collate their service users questionnaires. They have a yearly internal audit of how the home is run looking at policies and procedures and how they can be improved or commended. Portishead House, 5 DS0000010864.V319427.R01.S.doc Version 5.2 Page 21 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 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 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 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 3 X 3 X X 3 X Portishead House, 5 DS0000010864.V319427.R01.S.doc Version 5.2 Page 22 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. 2 3 Standard YA17 YA19 YA35 Regulation 12 12 18 Requirement The manager must reinstate the monitoring of service users nutrition The manager must develop the system for monitoring service users health All staff must have an annual staff appraisal Timescale for action 31/01/07 28/02/07 31/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Portishead House, 5 DS0000010864.V319427.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hammersmith Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 Portishead House, 5 DS0000010864.V319427.R01.S.doc Version 5.2 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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