Inspection on 04/05/05 for Prema House

This inspection was carried out on 4th May 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Prema House 20/04/06

Prema House 12/10/05

Prema House 28/10/04

Prema House 27/05/04

Prema House 03/12/03

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

CARE HOME ADULTS 18-65 Prema House 45-47 Gleneagle Road Streatham London SW16 6AY Lead Inspector Lynne Field Unannounced 4th May 2005 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 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 Stationary 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. Prema House G52-G02 S22749 Prema House V225766 040505 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Prema House Address 45-47 Gleneagle Road, Streatham, London, SW16 6AY Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208 677 2302 Mr Sam Vindalon and Mrs C Vindolon Patrick Chibagu CRE Care Home 24 Category(ies) of PC Care home only registration, with number of places Prema House G52-G02 S22749 Prema House V225766 040505 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 up to five persons only 65 years and above Date of last inspection 28th October 2004 Brief Description of the Service: Prema House is a 24-bedded private home for adults with mental health problems, one of two homes in the Streatham area owned by the same proprietors. Prema House mainly accommodates people over the age of 45 with enduring mental health problems and provides long-stay accommodation and support for them. It is situated within easy walking distance of all the amenities in Streatham High Road. The home is made up of two large interconnecting Victorian house with a large paved rear garden. There are two main sitting rooms, a tea and coffee making room, two small smoking rooms, 16 single bedrooms and four double bedrooms, two of which are almost completely divided by a wall providing a high level of privacy. Although no plans have been submitted as yet, the registered providers plan to phase out the double rooms as service users vacate them and convert them into en-suite facilities. Some of the service users attend various day centres and other outside activities. Prema House G52-G02 S22749 Prema House V225766 040505 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and lasted six hours. It was the managers last day in post and the registered provider told the inspector that he would be managing the home until he appointed a new manager for the home. The Inspection methods included discussion with approximately ten service users; interviews of a team leader, the registered provider; three staff; examination of records and a tour of the building. The registered provider told the inspector he was considering ways to develop the home to include en-suite bedrooms and group living to meet the standards in 2007. 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. Prema House G52-G02 S22749 Prema House V225766 040505 stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Prema House G52-G02 S22749 Prema House V225766 040505 stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1-5 The statement of purpose provides all the information needed about the home. The home works well with the placing authority to make sure the home can meet the needs of the service user before the service user comes to live at the home. EVIDENCE: The home has a statement of purpose, which has been developed to include all the information that service users would need to know about the home. The manager said all service users are given a handbook that gives information about the home, area, amenities, staff, visitors, meals etc when they are admitted to the home. The manager said service users receive a full care assessment undertaken by the placing authority. There were care management assessment includes a Care Programme Approach (CPA) of the individual’s holistic needs seen in the service users files inspected as well as assessments provided by the placing social worker. These are used to develop the service users care plan. Risk assessments are completed along with what action needs to be taken to minimise the risk once the service user is admitted to the home. Service users said they had the opportunity to visit the home and meet other service users prior to making a decision to move there on a permanent basis. Prema House G52-G02 S22749 Prema House V225766 040505 stage 4.doc Version 1.30 Page 8 On service users file there were contracts or licences which the service user, the home manager and /or the care manager signs when they are admitted to the home. Prema House G52-G02 S22749 Prema House V225766 040505 stage 4.doc Version 1.30 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 standard(s) 6, 7, 8 & 9 Service users are encouraged to and make their own choices with staff support when necessary. The home involves families and other professionals when reviews are held. Information is given to the service users by the home management at house meeting and service users are encouraged to participate in making decisions about how the home is run. EVIDENCE: Prema House G52-G02 S22749 Prema House V225766 040505 stage 4.doc Version 1.30 Page 10 On the day of the inspection three service users files were seen by the inspector. Service users care plans were developed using the home’s care planning system. These include areas in the service users life that have been identified as anticipated requirements and rehabilitation to meet the service users individual needs. Service users have a key worker who supports the service user at reviews, which are held annually, six-monthly or more frequent if required. There was also evidence there is input from other professionals involved with the service user as well as the service users families. Care plans are reviewed every four weeks and are kept in individual folders. The manager said the good practise of service users being given the opportunity to make as many decisions over their life as possible has been maintained, with staff support where necessary. The Inspector saw this first hand when a service user came to the office to ask the manager to go with them to the appointment that had been made with the local bank to open an account for the service user. From the minutes of the house meeting, the Inspector could see service users attend regular house meetings and participate in issues of relevance regarding the organisation of the home. The proprietor keeps the service users informed of any forthcoming changes to the home by coming to speak to service users at the house meetings. Service users views were sought on the suitability of prospective staff and management decisions were made on the basis of service user observations. The Inspector observed that service users had front door keys and came and went as they pleased, but told staff when they were going out. The manager told the Inspector the service users are encouraged to make decisions concerning their daily activities. Risk assessments are in place, reviewed and records kept on service users files. Prema House G52-G02 S22749 Prema House V225766 040505 stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14 & 17 Service users are supported in maintaining independence and in achieving a fulfilling lifestyle in and outside the home, so that they would have opportunity for personal development and inclusion in the community, consistent with their aspirations, cultural and spiritual needs. Family and friends are encouraged to keep in touch. The menu must be more varied and reviewed to include service users individual preferences. EVIDENCE: Service users said they were encouraged to take part in various activities that are run by the home. They said all service users had allocated chores and this was done at key worker meeting and in house meetings. Service users individual preferences and skills were taken into consideration when the rota was drawn up. Some service users said they went to college and day centres where they were encouraged to join courses offering occupational training and personal development skills which would help prepare the service users for independent living. Some of the service users said they enjoyed cooking and this was encouraged by the home. Prema House G52-G02 S22749 Prema House V225766 040505 stage 4.doc Version 1.30 Page 12 One service user said they regularly attended the local church and joined in some of the activities the church arranged. Another said they attended a local creative writing group. The inspector saw service users coming and going from the home using their front door key. When the manager showed the inspector around the home, he always knocked on bedroom doors and waited for the service user to answer before entering the room. Most of the bedrooms were locked and the inspector was told all service users had their own bedroom key. Service users said felt there could be more choice on the menu. Service users said menus were discussed in service user meetings and they were able to express their preferences in the type of food that was served at the home. One service user felt there were too many meals that included eggs dishes; another said there was no choice of a cooked breakfast. The cook and team leader were going to look at the comments made about the food. Prema House G52-G02 S22749 Prema House V225766 040505 stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 & 20 Service users received personal and emotional support in a way that they considered reliable and responsive to their needs. Their health care needs were assessed and recognised. Staff are aware of the service users mental health needs and respond to them immediately when the need arises by contacting the appropriate professional involved in the service users care. EVIDENCE: Service users were satisfied with the way staff respected their privacy and supported them with personal care tasks and during the inspection it was noted that staff provided support to service users in a respectful and sensitive manner. From the three service users files seen at the inspection it was evident that service users have regular access to healthcare. There were records on the service users’ files that demonstrated that service users had seen various health professionals. All service users were registered with a local general practitioner (GP) and were encouraged to go for dental, eye and other health checks as necessary. Most service users visited the local surgery and made their own appointments. Staff said the GP was very supportive. Medication was regularly reviewed and the staff said they have a good pharmacist who works well with the home. Prema House G52-G02 S22749 Prema House V225766 040505 stage 4.doc Version 1.30 Page 14 Risk assessments have been carried out for service users who might be able to self medicate, but the risk as it was deemed as being to great and none of the service users are self medicating. Staff at the home worked with the multi-disciplinary team involved in each service users care and worked closely with the CPNs, contacting them as the need arises. The staff record the amount of medication received into the home and measures are in place to record the running daily total of service users medication in order that administration of the medication can be properly checked. Prema House G52-G02 S22749 Prema House V225766 040505 stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Service users are able to express their views, are listened to and this is acted on in an appropriate way. Menus must be reviewed to include service users choice of food. See standard 17. The home acts immediately if there is any concern about the service users welfare in an appropriate way. EVIDENCE: There has been one complaint since the last inspection about the food on the menu. This was discussed at the house meeting and is being dealt with by the cook and team leader. The manager told the inspector all the service users have their own bank account which they administer themselves or if they need help the staff will assist them to do this. This was witnessed by the inspector on the day of the inspection when the manager went with a service user to the bank to help deal with a problem that had arisen with the service users bank account. The home had an adult protection procedure, including whistle blowing. The manager confirmed that staff had been attending training in Residents Rights, Abuse and Adult Protection as well as in the homes policies and procedures. Prema House G52-G02 S22749 Prema House V225766 040505 stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 - 30 Service users live in a home that they found comfortable and where they could personalise their space. Work has been done to make the premises more suitable to service users needs and there is an ongoing plan to develop the home so more bedrooms are single occupancy and will have en suite facilities. EVIDENCE: The home is clean and comfortable. The home had a range of communal space available for the service users. These included a large garden, a separate nonsmoking lounge and two separate smoking lounges, which were recently re carpeted. There is a main kitchen where the main meals are prepared and two small kitchens where service users are able to make snacks and drinks though out the day. The manager told the Inspector that the double rooms were continuing to be phased out and redecorated as they become empty. The registered provider told the inspector they were still considering how they will introduce group living into the home by the deadline of 01/04/07. Prema House G52-G02 S22749 Prema House V225766 040505 stage 4.doc Version 1.30 Page 17 The service users who showed the inspector their bedrooms said they were happy with them and were able bring furniture and put up pictures to make them homely. Several service users had brought their own televisions and radios. All the bedrooms had a wash hand basin. Toilet and bathroom facilities were inspected and were clean and well decorated. The laundry is still located in the basement. The manager told the Inspector the discussions with the registered provider about the suitability of the present location of the laundry room and the possibility of building a large shed in the garden to house the laundry were ongoing. On the day of the inspection the home was free from offensive odours and there is a pest control contract in place. Prema House G52-G02 S22749 Prema House V225766 040505 stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 34, 35 & 36 Staff are made aware of the homes policies during the induction program they under take when they are employed by the home. Service users are protected by the home’s recruitment policy and practices. The training program devised by the home meets the needs of the present staff team and this reflects on the team’s ability to meet the needs of the service users. EVIDENCE: Three staff files were examined and these contained evidence of appropriate checks being conducted before staff can start work in the home. All files examined included evidence of identity, two written references, criminal records bureau checks and checks against the list of people considered unsafe to work with vulnerable adults. Service users spoken to stated that staff have the appropriate skills and attitudes and that they are flexible to meet needs. Service users said they were involved in the selection of staff who work at the home. There are seven full time staff and three part time staff. Three staff have completed NVQ level 3 and three staff have completed NVQ level 2. Prema House G52-G02 S22749 Prema House V225766 040505 stage 4.doc Version 1.30 Page 19 The inspector was shown a rolling program of training dates and was told staff had recently completed training in Food Hygiene and Health and Safety. First Aid training had taken place in October 2004. Staff must have attained NVQ level 3 before they can become a team leader. There is a team leader or the manager on with two support workers on the early and late shift with an extra member of staff working a middle shift to support service users who are going out to help them access the community activities. Team meetings take place every two months and staff told the inspector they had regular supervision with their allocated team leader. They said they felt they could approach the manager or the team leader at any time if they needed help or advice. Prema House G52-G02 S22749 Prema House V225766 040505 stage 4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 41 & 42 The home is being well managed by a manager of good character and experience working with service users with mental health problems. Working practices and associated records ensure that the health and safety of service users is promoted. EVIDENCE: Staff files evidenced that supervision takes place at least six times per year as required by a previous inspection and this helps to ensure that service users are supported by a competent staff team. Records indicated that fire drills are carried out and fire alarms are tested at appropriate intervals. Certificates evidenced that equipment is serviced Prema House G52-G02 S22749 Prema House V225766 040505 stage 4.doc Version 1.30 Page 21 regularly. Certificates for electrical safety of the homes portable appliances were out standing and should be sent to the inspector following the inspection. Prema House G52-G02 S22749 Prema House V225766 040505 stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 x x 2 Standard No 31 32 33 34 35 36 Score 3 3 x 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Prema House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 2 2 x 3 2 x G52-G02 S22749 Prema House V225766 040505 stage 4.doc Version 1.30 Page 23 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA17 Regulation 12 (1)(a) Requirement The registered person ensure the menu is more varied and reviewed to include service users individual preferences The registered person must make reports of visits made under Regulation 26 of the Care Homes Regulations 2001 and they must be forwarded to the Commission for Social Care Inspection (Southwark). Timescale for action 30th September 2005 30th September 2005 2. YA39 6 (5)(a) 3. 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 Good Practice Recommendations Prema House G52-G02 S22749 Prema House V225766 040505 stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 46 Loman St Southwark Se1 0EH 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 Prema House G52-G02 S22749 Prema House V225766 040505 stage 4.doc Version 1.30 Page 25 - 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!