Inspection on 05/12/08 for Portishead House, 5

This inspection was carried out on 5th December 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Portishead House, 5 14/12/06

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 13/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Portishead House, 5 Westbourne Park Estate London W2 5UP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Wynne Price-Rees     Date: 1 0 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Portishead House, 5 Westbourne Park Estate London W2 5UP 02072430697 02072213959 chichi@mungos.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) William Patrick O`Sullivan Type of registration: Number of places registered: St Mungo Association care home 14 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 14 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Male whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia -- Code MD Date of last inspection Brief description of the care home 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. People who use the service live in the home for up to three years and are Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 14 Brief description of the care home 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. Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means people who use this service experience good quality outcomes. The inspection was unannounced and took eight hours to complete over two days, starting on 05/12/08 and ending on 10/12/08. During the inspection we spoke to six people who use the service to get their views of the service they receive. We also spoke with staff, care practices was observed, records and procedures checked and a tour of the premises took place. We inspected all the key standards and the information seen was triangulated with that Care Homes for Adults (18-65 years) Page 6 of 26 gathered since the last key inspection including Regulation 37 notifications forwarded. Regulation 37 notifications tell us about any accidents or incidents that affect people who use the service. This was compared with the AQAA information that the home returned to us before the inspection. An AQAA is an annual quality assurance self assessment carried out by the home. The files of three people who use the service were case tracked. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs of the people who use the service are fully assessed prior to moving in and they choose if they want to move in. Evidence: The home has a written assessment policy and procedure that a sample of three files of people who use the service showed is followed. All referrals come from the coordinator the Community Mental Health Team at Westminster. The information forwarded includes risk management plans, risk screening tools, risk event history, discharge summary and last care programme from hospital. I visited the service before moving in. Once received the home initially identifies if needs can be met and the person who uses the service is invited to visit during which the home carries out an assessment with them. This enables the home to identify if they can meet needs and gives the person who uses the service an opportunity to decide if they want to move to the home. A handbook is available for people who use the service to help them understand what they can expect from it. Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: All referrals are discussed by staff as a group and their opinions are recorded on a comment sheet to better inform the decision-making process. Care Homes for Adults (18-65 years) Page 11 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are comprehensive acton plans that show how staff support people who use the service to develop their independent living skills. People who use the service are encouraged to make decisions within a risk assessed environment and recognise the consequence of their actions. Evidence: I have an action plan. The sample of three files of people who use the service that were case tracked and conversations with them identified that there are agreed action plans in place. The initial action plans are devised from the assessments forwarded, those carried out by the home and information volunteered by the person who uses the service. The volume of this information increases as the person who uses the service becomes used to and more comfortable with living at the home. The care system used is the St Mungos star system that includes areas such as managing tenancy and accomodation, offending, motivation, taking responsibility, self care living skills, social network relationships, physical health, emotional and mental Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: health and making meaningful use of time. The action plan identifies areas of need, need description, client goal, staff goal and agreed goal with client and staff action plans th achieve them. Daily records are kept that feed monthly reviews. These are underpinned by individualised risk assessments that are regularly reviewed and updated when needs change. On one file there was a letter of promise regarding meeting the requirements for living at the home that referred to paying the balance of money owed for meals and possible consequence of not paying. This corresponded to the money management and taking responsibility areas of the star system. Placement reviews also take place quarterly with the Community Mental Health Team Co-ordinator and six monthly with the consultant. People who use the service are involved in the decision-making process through house meetings and discussion groups that take place alternate weeks. There are also organisational wide people who use the service involvement meetings and twelve people who use the service from the home attended one the Wednesday prior to the inspection visit. One person who uses the service also sits on recruitment interview panels. Care Homes for Adults (18-65 years) Page 13 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have their preferences observed and their social, cultural, religious and recreational needs and interests met, meaning they have fulfilling lifestyles. They also have a variety of balanced meals geared to their individual tastes. Evidence: The home encourages people who use the service to participate in different activities both inside and outside the home to develop life skills required for independent living. A number of college courses are being attended including english, poetry, art and music. One person who uses the service has enrolled on an english language course to enable them to later do an electrical engineering course and progress their career. The home has a nominated life skills worker who helps people who use the service develop their skills by doing activities at home. Areas addressed include cooking and personal hygiene. Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: My needs are met. There are also leisure activities available that include art group, bingo, breakfast club, film group, music group and attending the gym. I like the bingo. People who use the service also make good use of facilities based in the community going to the cinema, out for coffee, to the zoo and they have also visited to Kew Gardens. A cultural timetable has been put together to celebrate significant and religious cultural days such as Eid. One person who uses the service is a Jehovahs Witness, does not celebrate Christmas and alternate activities they have chosen have been arranged. Activities have taken place to celebratrate diversity such as Black history month. One person who uses the service attends an Irish focus group. Family and friends are encouraged to visit and people who use the service are encouraged to visit them. As the referrals are made by the Westminster CMHT many family and friends are based locally. The home is having a party on 19th December and everyone is invited. I like cooking. Meals are generally eaten communally and people who use the service have a cooking rota as there is no chef. They are supported to go food shopping and cook on Mondays, Tuesdays, Thursdays and Fridays with staff cooking on the other days. People who use the service get their own breakfast individually. The meals are planned with clients to make sure they are nutritionally balanced and varied. Care Homes for Adults (18-65 years) Page 15 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have their physical and emotional health needs met. The medication administration records were up to date and appropriately kept. Evidence: The home does not provide direct personal care. Health and personal care and hygiene are addressed as part of life skill development by the designated life skill worker and staff team within the framework of the action plans. The sample of three case files case tracked identified that these development areas are addressed. Nutrition is also promoted with a nutritionalist visiting three times per month as well as an identified health champion. This is a member of staff that feeds back organisational health related issues and development to the team. People who use the service have access to community based services such as hospitals, chiropodists, dentists and everyone is registered with a GP. They are encouraged to acces these services within the community rather than have them come to them as part of life skill development and integration into the community. Ive come to take my medication. The home operates a stepped self-medication plan whereby people who use the service gradually progress levels of self-medication as Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: they and the staff team feel confident to do so. Currently there is only one person who is self-medicating. They have been risk assessed to do so and regular spot checks take place. All staff are trained to administer medication including Locums and the home checks with the agency that any of their staff used are also trained. The medication administration records were checked for all people who use the service and were up to date and correctly recorded. The home does not keep controlled drugs. Care Homes for Adults (18-65 years) Page 17 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can feel confident they are listened to and their complaints and concerns investigated with outcomes. They are safe and well protected by the homes adult protection procedures. Evidence: I know how to complain. The home has a written complaints policy and procedure and also keeps a record of complaints made, investigation, course of action and outcome. There has been one complaint since April 2008. There is a complaints and comments box located near the entrance that people can use if they do not wish to communnicate directly. There is a comprehensive adult protection policy and procedure. All staff have undertaken mandatory adult protection training. All staff have CRB clearance and there are no current POVA issues. CRB is the Criminal Records Bureau and POVA is the protection of vulnerable adults. An accident and incident record is also kept with notifications of any adverse incidents made to us. Care Homes for Adults (18-65 years) Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A safe, homely and comfortable environment is provided for people who use the service to live in. Everyone has their own bedroom and there are suitable shared areas that can accomodate everyone comfortably. Evidence: Im happy with my room. A tour of the home showed it is fit for its stated purpose and provides a comfortable and safe environment to live in. It is well decorated, furnished and has suitable furniture. All communal areas are scheduled to be redecorated in the next two months. People who use the service have their bedrooms decorated when they move in choosing the colour scheme. They have access to a well equipped kitchen, laundry and computer and meeting room. There is also a garden area. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitably trained, competent and diverse staff employed to meet the needs and wishes of people who use the service that have been properly vetted. People can be confident they are protected by the homes robust recruitment policies and procedures. Evidence: There are currently three staff vacancies that have been advertised with short-listing currently taking place. One person who uses the service will sit on the interview panel. The staff rota showed that there are enough staff on duty at all times to meet the needs of people who use the service. New staff receive thorough induction training that includes mandatory areas such as first aid, food hygiene, health and safety and fire procedures. They also have access to a rolling training programme with training requirements identified during four to six weekly supervision sessions and annual appraisals. Further training is available from Westminster City Council. Staff also receive a training manual. All staff are qualified at NVQ level 2 or above. NVQ is a national vocational qualification. The staff are good. There is a thorough recruitment policy and procedure that a sample of three staff files showed is followed, protects people and meets the criteria required by the standard. All staff are CRB cleared, references and health checks taken up and work history and Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: qualifications verified. The team support me. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed in the best interest of people who use the service and the quality assurance system is efficient. Health and safety is well managed meaning people who use the service live in a safe environment. Evidence: The Care Manager holds an NVQ management qualification and has been in post for a number of years. Previously they were Deputy Manager at the home. The manager is good. There are up to date health and safety risk assessments in place. An annual audit takes place and there are monthly unannounced visits from senior managers within the organization all of which contribute to the quality assurance system that has identified performance indicators and trigger levels. This is also contributed to by feedback from meetings for people who use the service, their involvement in staff recruitment, focus groups, annual questionnaires and the Mental Health Team and consultants. The home has a current building plan and fire procedures with exits well signed. The Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: fire fighting equipment was checked and serviced on 01/12/08, fire points are randomly checked weekly, fire drills take place quarterly and the alarm and the alarm was tested by contractors on 24/09/08. PAT tests took place on 09/01/08 and are updated when new electrical equipment comes into the home. PAT is the testing of portable electrical goods. The fridge and freezer temperatures are checked and recorded twice daily and there is an up to date accident and incident book. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - 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!