Inspection on 11/09/07 for Whittington House

This inspection was carried out on 11th September 2007.

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

Other inspections for this house

Whittington House 24/10/08

Whittington House 01/05/08

Whittington House 05/04/07

Whittington House 12/10/06

Whittington House 06/04/06

Whittington House 15/08/05

Whittington House 29/04/05

Whittington House 15/09/04

Whittington House 24/05/04

Similar services:

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

Clovelly House Residential Home Ltd

Abbey Road [53]

Cherry Tree House

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

CARE HOME ADULTS 18-65 Whittington House 46 Dongola Road London N17 6EE Lead Inspector Susan Shamash Key Unannounced Inspection 11th September 2007 12:00 Whittington House DS0000010799.V346525.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 Whittington House DS0000010799.V346525.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. Whittington House DS0000010799.V346525.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Whittington House Address 46 Dongola Road London N17 6EE 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 8376 9219 F/P 020 8376 9219 Mr Francis Cleland Mr Francis George Cleland Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Whittington House DS0000010799.V346525.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th April 2007 Brief Description of the Service: Whittington House is owned and managed by a private individual, Mr Francis Cleland who owns a number of similar small homes in the North London area. The home is registered to provide a service to up to three people with mental health problems. Current weekly fees as of September 2007 are £670 - £950. The home is located in a densely populated area off Philip Lane, close to shops, pubs, the post office and other amenities. The home was opened in August 1999 and consists of a two-storey Victorian house with a newer, ground floor extension that is used as the kitchen. All the homes three bedrooms are single although none have en suite facilities. It is on an ordinary domestic scale and fits in well with the surrounding area, with a conservatory and small garden to the rear. The homes aims and objectives state that it provides support for residents to be part of the local community and to develop leisure and social activities. Inspection reports are made available to residents by them being informed when new reports have been received, and that they may ask to see the office copy whenever they wish to. Whittington House DS0000010799.V346525.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection lasted approximately five hours and was carried out as a routine unannounced visit to the home and in order to check compliance with the requirements made at the previous inspection. There were three residents living in the home and I was able to speak to all of them. No new residents had been admitted since the previous inspection. I also observed residents’ relationships with staff and each other, and records maintained at the home in gaining an understanding of their experience at the home. I was assisted throughout by two staff members, as the manager was not available at the time of the inspection. I spoke to both staff members during the inspection, conducted a tour of the premises and inspected care and support, and health and safety records. What the service does well: What has improved since the last inspection? More evidence was being recorded regarding progress made on goals through key-working sessions with residents. Adequate stocks of fresh fruit are provided in the home and the home was relying a little less on convenience foods. Whittington House DS0000010799.V346525.R01.S.doc Version 5.2 Page 6 All medicines received at the home or returned to the pharmacist from the home were being recorded, and there were guidelines available for the administration of PRN (as and when) medicines. The front garden path had been repaved, matching taps had been fitted on the sink in the bathroom, and bathroom windowsill and radiator, and the banisters on the staircase had been repainted. New furniture was provided in one resident’s room, weeds had been removed from the rear garden, the paved area had been levelled and the external window frames of the home were redecorated. The carpet in the hallway at the top of stairs had been cleaned and paper towels were being provided in the bathroom. Two staff members had commenced training to NVQ level 2 in care, annual appraisals were being carried out with staff members. A current portable appliances testing certificate was available and the smoke alarm in an iesident’s room had been repaired. An evening fire drill had also been carried out as required. As recommended the medication cabinet in the downstairs office had been replaced. What they could do better: Improvement is needed in the level of detail recorded in care plans and updates, particularly in addressing areas of concerns agreed at review meetings. It remains required that regular supervised trips be arranged outside of the home to places of interest to residents, such as trips to the cinema, pub and local cafes/restaurants, and day trips to more distant destinations. Staff need to encourage identified people living at the home to be me more involved in cooking their own meals in order to develop their independence skills. There is a need for increased consultation with people living at the home regarding food purchased and served, to ensure that their preferences are respected. Labelling and storage of food in the freezers needs improvement to ensure the safety of food served at the home. Some minor improvements are needed in the recording of medication administration and storage. Whittington House DS0000010799.V346525.R01.S.doc Version 5.2 Page 7 It remains required that sufficient staff members be provided to ensure adequate flexibility in arranging activities for residents at the home. Staff need to undertake current training in fire safety to ensure that people living and working at the home are safeguarded appropriately. The homes policies need to be reviewed and updated regularly to ensure that these remain relevant and the quality assurance procedure needs to be improved. More frequent fire drills are needed for the home in order to protect the safety of staff and residents in the home. Finally it is recommended that further evidence be recorded regarding progress made on goals through key-working sessions with residents, to ensure that they are supported appropriately. 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. Whittington House DS0000010799.V346525.R01.S.doc Version 5.2 Page 8 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 Whittington House DS0000010799.V346525.R01.S.doc Version 5.2 Page 9 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. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. An appropriate system is in place to assess residents’ needs and goals effectively and ensure that these can be met. EVIDENCE: No new residents have been admitted since the previous inspection. Each resident’s care plan included assessments of their individual needs including lifestyle choices, religious and emotional needs. These assessments were seen to inform the care plans available for each person living at the home as appropriate. People living at the home confirmed that they were consulted about their needs and preferences. There was an improvement in records maintained regarding the support provided to residents, and progress made on working towards their individual goals, although there remains room for improvement in this area as described under Standard 6. Residents spoken to indicated that they received support in meeting their needs and goals. Whittington House DS0000010799.V346525.R01.S.doc Version 5.2 Page 10 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 and 9. People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s needs and goals are assessed appropriately however there remains insufficient evidence that they are responded to adequately, to ensure that they are met. They have the opportunity to make decisions about their lives although they would benefit from more opportunities to learn independent living skills. They are supported to take some informed risks, with support to ensure that apparent dangers are minimised to safeguard them from harm. EVIDENCE: Care plans were available for all people living at the service, and contained relevant information regarding appropriate areas of support. The signatures of residents were also included indicating their involvement in the care planning process. Residents that I spoke to also confirmed that they were encouraged to be involved in this process. Records indicated that care plans and risk assessments for all residents were being reviewed at least six-monthly as appropriate. Resident meeting minutes Whittington House DS0000010799.V346525.R01.S.doc Version 5.2 Page 11 indicated some consultation about how the home is run, and this was confirmed by staff and residents spoken to. Daily notes recorded for people living at the home indicated that each was encouraged to make their own decisions about their lifestyle and routines. Those spoken to confirmed that they were able to make their own choices about relationships and that their cultural and religious needs were respected by staff at the home. At the previous inspection it was required that care plan reviews and daily notes provide evidence of staff support for people living at the home in meeting their identified goals. Inspection of key working notes, care plan evaluations and review meeting records included more entries about how staff support individuals with budgeting, hygiene issues and depressive moments as required, although it is recommended that more detailed records be maintained. Residents that I spoke to indicated that they were generally getting the support that they needed from staff other than in the area of learning cooking skills as described under Standard 16. Further inspection of review meeting minutes indicated that some areas of concern raised for an individual person living at the home, were not carried forward into that person’s care plan. For example the areas of sleeping problems, nicotine intake and cooking skills identified in one person’s review meeting, were not carried forward into their care plan, daily notes or evaluations in any detail. A requirement is made accordingly. Whittington House DS0000010799.V346525.R01.S.doc Version 5.2 Page 12 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, 14, 15, 16 and 17. People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living at the home have limited opportunities to undertake supported leisure opportunities within the local community. Freedom is provided for residents to engage in personal relationships and maintain contact with family members and friends. Their rights are respected, but more support is needed to encourage independent living skills. People’s dietary needs are catered for with a varied selection of food, but there is currently some dissatisfaction with the quality of food served at the home. EVIDENCE: Whittington House DS0000010799.V346525.R01.S.doc Version 5.2 Page 13 I spoke to all people living at the home and examined each person’s care plan, as well as discussing residents’ lifestyle choices with staff members on duty and observing routines within the home. Staff spoken to were aware of the need to respect people’s choices with regard to sexuality, religion and cultural preferences. Minutes of house meetings and discussion with staff and residents indicated that residents are encouraged to be involved in housework, and that they have an opportunity to discuss their preferences about the home. One person attends day services sporadically according to their wishes. Two residents go out independently using public transport during the day and the other attends a day centre approximately weekly, accompanied by staff from the home, which represents significant progress for them. Residents indicated that they receive staff support in participating in meaningful and therapeutic daytime activities. Two residents are very able to maintain social contacts independently and both indicated that they did so on a regular basis. The other resident needs far more support in this area and has less opportunities of meeting people of their own age or with shared interests, other than at the day centre they attend weekly. Last year staff and residents confirmed, that a short break away from the home had been arranged to Brighton over the summer, including an overnight stay. However no day trips of break away from the home has yet been arranged for this year. Staff advised that a break was being planned to take place shortly. Other activities included shopping trips, walks in the local park and board and card games within the home; however records still indicated that there were few organised leisure activities for residents outside of the home within the last few months as required at the previous inspection. Residents spoken to indicated that they would be interested in participating in more activities outside of the home. Whilst it is appreciated that staff may find it difficult to motivate some residents, it remains required for the seventh time, that there be an increase in the number of activities available to residents including occasional meals out, trips to the cinema and daytrips to places of interest. Examination of the staffing rota for the home indicated that there are currently insufficient staff working at the home to provide a varied leisure activity program outside of the home, a requirement is restated accordingly under Standard 31. Whittington House DS0000010799.V346525.R01.S.doc Version 5.2 Page 14 Records of food served to residents indicated that a varied menu was served including some Caribbean food for residents who request this. However two residents that I spoke to were generally dissatisfied with the meals provided to them. The home was stocked with a range of foods including some fresh fruit and vegetables, meat and fish. Residents also advised that they felt ‘in the way’ if they wanted to cook for themselves in the kitchen and therefore predominantly relied on staff to cook the meals, and ate out frequently. It is required that staff encourage identified people living at the home to be me more involved in cooking their own meals in order to develop their independence skills within the home. There must also be increased consultation with people living at the home regarding food purchased and served, to ensure that their preferences are respected. Food storage was generally appropriate, however there were some items in the freezer which were not wrapped and unlabelled. All meat and fish stored in the refrigerators are wrapped and labelled appropriately, to ensure the safety of food served at the home. Whittington House DS0000010799.V346525.R01.S.doc Version 5.2 Page 15 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 and 20. People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living at the home receive appropriate physical and emotional support and are supported to take their prescribed medicines. EVIDENCE: Resident plans, and feedback from those spoken to indicated that they are treated with respect and that their privacy and dignity are maintained. Records also indicated that people living at the home attend regular healthcare appointments as appropriate, and those spoken to confirmed this. The medication administration records appeared to be completed appropriately. No residents are self-medicating. A pharmacist now dispenses all possible medicines into weekly dossett boxes, and these were being administered appropriately. As required at the previous inspection records were being maintained of medicines received at the home and those returned to the pharmacist. However stock carried over from one month to the next is currently not Whittington House DS0000010799.V346525.R01.S.doc Version 5.2 Page 16 recorded, so that the record of current stocks of medicines within the home is not accurate. Some photocopied medication administration records being used at the home did not include the complete name of each prescribed medication that was being administered (due to inaccurate photocopying). This must be rectified to ensure that the names of all medicines to be administered are clearly legible, to avoid mistakes being made that might place residents at risk of harm. Evidence was available in the form of review meeting minutes, that the social worker of an identified resident who has diabetes, had been notified that they are refusing to have regular blood sugar monitoring tests. As recommended the medication cabinet in the office had been replaced, for easier access to medicines by staff. Whittington House DS0000010799.V346525.R01.S.doc Version 5.2 Page 17 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 and 23. People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has procedures in place to ensure that the concerns of residents are acted upon effectively and procedures and training in place to ensure that they are protected from abuse. EVIDENCE: The home’s complaints procedure and adult protection procedure and guidance for staff regarding whistle blowing were inspected. The complaints procedure was posted in the corridor of the first floor of the home. However the local CSCI area office contact details recorded on these procedures were not current. This must be addressed to ensure that staff and residents are provided with the correct information. A copy of the Haringey Adult Protection Policy and Procedure is also available within the home. Evidence was available that all staff at the home had undertaken training in the protection of vulnerable adults as appropriate. No complaints had been recorded since the previous inspection, however residents spoken to advised that they would feel able to express any concerns or complaints to staff, or the manager, if necessary. Whittington House DS0000010799.V346525.R01.S.doc Version 5.2 Page 18 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 and 30. People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Significant improvements have been made to the environment in which residents live, so that it is comfortable and adequately decorated. People’s bedrooms are personalised as appropriate and there is a reasonable level of hygiene within the home for the safety of residents. EVIDENCE: Residents spoken to advised that the location and layout of the home meet their needs. There is sufficient communal space for three residents and the cleanliness in the home was of an acceptable standard. Individual bedrooms were decorated according to people’s choices and were personalized. The person living at the home who has orientation needs, had a blackboard with the day of the week and date recorded, in their bedroom. Whittington House DS0000010799.V346525.R01.S.doc Version 5.2 Page 19 Some new garden furniture had been provided within the garden, and residents told me that they enjoyed using this area when it is warm. The rear garden wall continues to be a hazard, due to pressure applied by the roots of a tree from an adjacent garden. The manager has previously provided evidence of communication with the neighbour regarding this issue. In the meantime preventative action remains in place, with the affected area of the garden fenced off, to protect the safety of staff and residents using the garden. It remains recommended that the issue of this wall be followed up so that a longterm solution can be found. As required the front garden path had been repaved where it was uneven and action had been taken to clear weeds and ensure a level surface in the rear garden. Matching taps had been fitted on the sink in the bathroom, and the bathroom, banisters on the staircase and external windowsills had been repainted. The furniture in an identified resident’s room had also been replaced as appropriate. The carpet outside an identified resident’s room had been cleaned and paper towels were provided in the bathroom for hygiene reasons. The ant problem in the kitchen near to the boiler had also been addressed safely. The home included a number of bare bulbs hanging from light fittings in residents’ rooms and corridors. All people living at the home should be consulted regarding whether they wish to have light shades in their bedrooms and the home’s corridors for their comfort. Whittington House DS0000010799.V346525.R01.S.doc Version 5.2 Page 20 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): 31, 32, 34, 35 and 36. People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Insufficient staff are available to provide residents with flexible support outside of the home. Adequate recruitment procedures are in place to protect residents from harm and staff generally undertake a range of relevant training to meet the needs of people living at the home safely and effectively with the exception of current fire safety training. Staff are adequately supported and supervised to ensure that they support residents in line with best practice. EVIDENCE: Whittington House DS0000010799.V346525.R01.S.doc Version 5.2 Page 21 Examination of the staffing rota showed that only two staff members are currently working regularly at the home, with the manager also working on a support shift occasionally during the week. Two staff files were inspected and were found to include satisfactory enhanced CRB disclosures as appropriate. They also included two references, identity documents, application forms, inductions records, training and supervision records. No new staff had commenced work at the home since the previous inspection. Discussion with residents and review of activities records indicated that insufficient staff are available to support residents with a flexible selection of activities outside of the home. A requirement is restated accordingly. Staff training records indicated adequate training in health and safety, moving and handling, first aid, adult protection, administration of medication, drug and alcohol awareness and dealing with potentially violent situations. However fire safety training was not current, and this is required to ensure the safety of staff and residents at the home. Discussion with staff members indicated that they were experienced at working with residents with mental health problems and alcohol or drug dependency and had undertaken some specific training in this area as required at the previous inspection. They were also knowledgeable about the cultural needs of individual residents. Both regular staff members had registered and commenced training to complete NVQ level 2 in care as required at the previous inspection. Inspection of staff files and discussion with staff indicated that regular individual staff supervision sessions had been occurring. As required, separate staff meetings (other than house meetings including residents) had also been occurring although these could be undertaken on a more regular basis. As required at the previous inspection, annual appraisals had been undertaken with each staff member, and records of these were available on each staff file and confirmed be the relevant staff members. It remains required that sufficient staff members are provided to ensure adequate flexibility in arranging activities for residents at the home. Staff advised that the manager was in the process of recruiting more staff for the home. Whittington House DS0000010799.V346525.R01.S.doc Version 5.2 Page 22 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, 40 and 42. People who use this service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Appropriate arrangements are in place to manage the home with the needs of residents in mind. Basic quality assurance procedures are in place to monitor the standards of care but there remains insufficient evidence that resident’s views are taken into account. Residents would benefit from a review of policies and procedures within the home and an improvement in some health and safety procedures. EVIDENCE: Due to ill health in the last few months, the manager had not been available at the home as frequently at previously, but staff advised that he still provided adequate support and he was on the rota to work at the home regularly. Whittington House DS0000010799.V346525.R01.S.doc Version 5.2 Page 23 A rudimentary quality assurance audit had been conducted for the home covering the care planning process, service user welfare and health and safety. Previously the provider had advised that he was working with an independent consultant to complete a quality assurance audit, however no evidence of this was available during the inspection. There remains inadequate evidence of consultation with people living at the home, visitors and health and social care professionals, and that the views of people living at the home are taken into account. Regular residents meeting were being undertaken and these covered activities including a barbeque held at the home, shopping for provisions and a trip to London zoo, as well as a number of activities that had not yet materialised such as cinema and leisure centre trips. The home has a selection of policies and procedures for the home, however these have not been updated for several years. The home’s policies regarding the Protection of Vulnerable Adults, and Complaints did not include the current CSCI local office contact details and these must be updated. All policies must be reviewed and updated at least annually to ensure that these remain relevant. COSHH materials (harmful chemicals) were stored in locked facilities as appropriate, and hazard analysis sheets were available for COSHH materials used within the home. As required at a previous inspection the manager had obtained and followed advice from the local fire prevention officer with regard to their requirement to ensure that emergency exits can be easily opened. A current satisfactory electrical installation certificate for the home, gas safety certificate, and water tank maintenance certificates were available as required. As required at the previous inspection a portable appliances testing (PAT) certificate was available and the identified smoke alarm in one resident’s room had been repaired. Records indicated that regular fire alarm testing is carried out for the home, and fire drills are also held periodically. As required at the previous inspection, an evening fire drill had been carried out during the year. However the general frequency of fire drills in the home had decreased, and was not sufficient to ensure that the safety of staff and residents are adequately protected. Some meat and fish stored within the freezers, were unwrapped and unlabelled, and this must be addressed to ensure the safety of food served at the home for residents. Whittington House DS0000010799.V346525.R01.S.doc Version 5.2 Page 24 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 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 2 32 3 33 X 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 2 15 3 16 2 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 2 X 2 X Whittington House DS0000010799.V346525.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15(2) Requirement The registered person must ensure that more detailed information is recorded in care plans and updates, particularly in addressing areas of concerns agreed at review meetings e.g. sleeping patterns, nicotine intake and cooking skills for one identified individual. The registered person must ensure that regular supervised trips are arranged outside of the home to places of interest to residents, such as trips to the cinema, pub and local cafes/restaurants, and day trips to more distant destinations. People living at the home should also have the option of going on holiday with support. Activities should be recorded in resident files, to ensure that they are given adequate leisure opportunities. (Previous timescales of 22/10/04, 01/07/05, DS0000010799.V346525.R01.S.doc Timescale for action 09/11/07 2. YA14 16(2mn) 19/10/07 Whittington House Version 5.2 Page 26 3. YA16 16(2h) 18(1ci) 4. YA17 16(2ij) 23/09/05, 19/05/06, 22/12/06 and 18/05/07not met). The registered person must ensure that staff encourage identified people living at the home to be me more involved in cooking their own meals in order to develop their independence skills within the home. The registered person must ensure that there is increased consultation with people living at the home regarding food purchased and served, to ensure that their preferences are respected. 25/10/07 05/10/07 5. YA20 13(2) All meat and fish stored in the refrigerators are wrapped and labelled appropriately, to ensure the safety of food served at the home. The registered person must 05/10/07 ensure that medication administration records are copied accurately so that the names of all medicines are clearly legible, and that stock carried over from one month to the next is recorded so that there is an accurate record of current stocks of medicines within the home at all times to ensure that medication needs of people living at the home are met. The registered person must 26/10/07 ensure that all people living at the home are consulted regarding whether they wish to have light shades in their bedrooms and the DS0000010799.V346525.R01.S.doc Version 5.2 Page 27 6. YA24 23(2d) Whittington House 7. YA31 18(1a) 8. YA35 18(1ci) 23(4d) 9. YA39 24 10. YA40 13(6) 22 11. YA42 23(4e) home’s corridors for their comfort. The registered person must ensure that sufficient staff members are provided to ensure adequate flexibility in arranging activities for residents at the home. (Previous timescale of 25/05/07 not met). The registered person must ensure that all staff (and any interested residents) undertake current training in fire safety to ensure that people living and working at the home are safeguarded appropriately. The registered person must ensure that the quality assurance system is further developed to incorporate the view of people living at the home, visitors and health and social care professionals, and that evidence is available that the views of people living at the home are taken into account. The registered person must ensure that the home’s policies regarding the Protection of Vulnerable Adults, and Complaints, are updated to include the current CSCI local office contact details. All policies must be reviewed and updated at least annually to ensure that these remain relevant. The registered person must ensure that more frequent fire drills are carried out for the home in order to protect the safety of staff and residents in the home. DS0000010799.V346525.R01.S.doc 12/10/07 23/11/07 23/11/07 09/11/07 05/10/07 Whittington House Version 5.2 Page 28 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 YA6 Good Practice Recommendations It is recommended that further evidence be recorded regarding progress made on goals through key-working sessions with residents, to ensure that they are supported appropriately. It is recommended that the damage to the rear garden wall continue to be pursued with the owner of the adjoining property, so that residents can have access to this area of the garden once more. It is recommended that the orientation board in the identified person’s bedroom be fixed to the wall, and the ironing board be removed. 2. YA24 3. YA24 Whittington House DS0000010799.V346525.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 Whittington House DS0000010799.V346525.R01.S.doc Version 5.2 Page 30 - 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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