Inspection on 15/08/05 for Whittington House

This inspection was carried out on 15th August 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 but made no statutory requirements on the home.

Other inspections for this house

Whittington House 24/10/08

Whittington House 01/05/08

Whittington House 11/09/07

Whittington House 05/04/07

Whittington House 12/10/06

Whittington House 06/04/06

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 Unannounced 15 August 2005 @ 11.15 am 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. Whittington House G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Whittington House Address 46 Dongola Road, London, N17 6EE 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) 020 8376 9219 Mr Francis Cleland Mr Francis George Cleland PC - Care Home only 3 beds Category(ies) of MD - Mental Disorder registration, with number of places Whittington House G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 29 April 2005 Brief Description of the Service: Whittington House is owned and managed by a private individual, Mr Francis Cleland who owns a number of other 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. 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 home’s 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 small garden. The home’s aims and objectives state that it provides support for service users to be part of the local community and to develop leisure and social activities. Special meals are available for those who have specific medical or cultural and religious preferences. Whittington House G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection lasted approximately four hours and was carried out as a routine unannounced visit to the home and in order to check compliance with the seventeen requirements made at the previous inspection. There were two residents living in the home and it was possible for the inspector to speak to both of them during the course of the inspection. The third resident was in hospital at the time of the inspection and the inspector was told that they would be moving into supported living accommodation on discharge, so would not be returning to live at the home. The inspector was assisted, in the main, by a staff member who also plays a lead role in arranging activities in the home, and had the opportunity to speak to a second staff member in the afternoon. The registered provider (and manager) was not working at the home on the day of the inspection. A tour of the premises took place and care records were inspected, however financial records could not be inspected on this occasion. Written feedback forms were received from two residents and one social worker, and information was supplied to the inspector, as requested, within the pre-inspection questionnaire. It is of concern to the inspector that eight of the seventeen requirements from the previous inspection have been restated in this report. The provider is aware that continued failure to comply with requirements made may result in enforcement action being taken against the home. What the service does well: Feedback from residents indicates that they are happy with the way they are supported at the home. The home’s main strength is at supporting residents who are relatively independent, to maintain and improve their living skills, whilst respecting their privacy. All residents have care plans that are reviewed regularly and are consulted about these as far as possible. Whittington House G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 Page 6 Staff members are knowledgeable about their role and responsibilities within the home. What has improved since the last inspection? What they could do better: The home still does not have a fully functioning quality assurance system, and it remains required that an audit be completed to ensure that residents receive a service of a high measurable standard. The residents guide to the home must be updated with residents’ views of the home, and their statements of terms and conditions with the home must be updated to cover all the areas specified in the national minimum standards. Whittington House G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 Page 7 It remains required that training be provided to the remainder of staff members in the protection of residents from abuse. It was not possible to determine whether the provider has continued to advocate on behalf of a resident who does not have identity documents, and a report regarding the situation is therefore required from the provider. It is required that a risk assessment be undertaken for the resident who is taking non-prescribed painkillers and that all risk assessments be reviewed on a regular basis appropriate to the particular service user and risk factors. The possibility of arranging a holiday for residents must be investigated, and the identified resident’s room must be painted/repapered. The rear garden wall must be made safe to protect residents and staff. There is also a need for an increase in the frequency of staff supervision sessions and staff meetings at the home. Any serious incidents affecting residents at the home must be reported to the CSCI without delay. The registered provider and manager must maintain a record of his hours worked at the home. A current portable appliance testing certificate must be obtained for the home, and the provider must consult with the local fire prevention authority regarding fire precautions within the home and a fire risk assessment must be undertaken for the home. It is recommended that residents be encouraged to tend to the garden, that an induction procedure specific to Whittington House be developed and that staff be updated in fire safety training each year. 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. Whittington House G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Whittington House G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 and 5. Insufficient information remains available for prospective service users to make an informed choice about the home. However an adequate system is in place to assess service users’ needs and goals effectively and ensure that these can be met. Service users’ rights are not sufficiently protected by contractual arrangements with the home and their local authorities, making them vulnerable to abuse/ exploitation. EVIDENCE: No new service users had been admitted since the previous inspection, however one service user has left the home (having been admitted to hospital and is now due to move out into supported living accommodation). At the previous inspection it was required (for the fourth time) that the service users guide be updated to include service users’ views of the home and access to the most recent CSCI inspection report. Although the service user’s guide for the home had been updated to include photographs of the home and greater detail about services provided, it still did not contain the information required. This requirement is therefore restated for the fifth time. At the previous inspection, the provider advised that he had hired a consultant to conduct a survey of service users’ views as part of a quality assurance audit for the home. However a report of the audit was not yet available although it Whittington House G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 Page 10 was agreed that this must be completed by the end of May to avoid enforcement action being taken against the home. As noted at the previous inspection, service user plans included assessments with regard to the needs of each individual service user, and service users spoken to confirmed that they were consulted with regard to their needs. At the previous inspection it was also required that the content of service users’ statements of terms and conditions with the home be revised to ensure that all information as specified under Standard 5 of the National Minimum Standards is included, such as the room to be occupied, rights and responsibilities, arrangements for reviewing the service user plans, and any limitations to the freedom of each service user and that a copy of each service user’s contract with the local authority be available on their file. Inspection of service user’s files indicated that this had not yet been carried out, and this requirement is restated for the third time. Whittington House G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 Page 11 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 and 9. Service users’ needs and goals are assessed and responded to adequately, to ensure that these are met. There is however, room for improvement in the recording of risks, and actions taken to protect service users rights, so that service users receive consistent and effective support. EVIDENCE: Whittington House G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 Page 12 Service users plans were available for all service users, and contained relevant information regarding particular areas of support identified as appropriate. The signatures of service users were also included indicating their involvement in the care planning process. At the previous inspection it was required that all risk assessments be reviewed at least six-monthly and that a risk assessment regarding noncompliance with medication be recorded for one service user. As required records indicated that risk assessments for all service users were being reviewed at least six-monthly. A risk assessment was required for the service user who refused to take their medication on a regular basis. However, following a social worker’s review, this service user was encouraged to selfmedicate in order to improve independence skills so that they might move on to a more independent living environment. Although a risk assessment was undertaken by the home prior to this service user starting to self-medicate, the inspector was not satisfied at the level of monitoring and review of this service user’s medication, taking account of the service user’s history of refusing medication. In the event, the service user had been unsuccessful in self-medicating and had required hospitalization. It is required that the review and monitoring of all risk assessments must be arranged at timescales that take account of the level of risk, changes in the level of responsibility expected by service users and history of problems relating to particular activities. A requirement is made under Standard 20 regarding the need for risk assessments regarding non-prescribed medications. At the previous inspection it was noted that a client account had been set up for a service user who did not have sufficient identity documents to open their own bank account. The manager also advised that he was also still chasing up back payments of Disability Living Allowance for the service user. Although the use of a client account for the service user has partially resolved the situation, it remains required that the service user’s rights be protected by continuing to pursue his identity documents, and that all actions taken on their behalf must be recorded. As the manager was not available during this inspection, it was not possible to verify compliance with this requirement. It is required that the provider write to the inspector detailing the current situation with regard to service users’ finances looked after by the home. Whittington House G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 Page 13 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) 12, 13, 14, 15, 16 and 17. There has been an improvement in meeting the needs of service users with higher dependency, and general provision of leisure activities for all service users in the home, although there remains room for improvement in this area. Freedom is provided for service users to engage in personal relationships and maintain contact with family and friends. Dietary needs of service users are catered for with a balanced and varied selection of food available that meets their nutritional needs. EVIDENCE: Whittington House G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 Page 14 The inspector spoke to two service users and examined each service user plan, as well as discussing service users’ lifestyle choices with the staff member on duty. Minutes of house meetings and discussion with staff and service users indicated that service users were encouraged to be involved in house work within the home. It is recommended that service users be encouraged to be involved in tending to the garden. One service user attends day services sporadically according to their wishes, and the other continues to require further support in finding meaningful daytime activities and therapeutic treatment. The registered provider had requested an occupational therapy assessment for this service user, and this had been undertaken by the time of this inspection. The staff member on duty advised that an occupational therapist was visiting this service user on a weekly basis, to support them with activities within and outside of the home. As required, minutes of the most recent review for the identified service user were available, and there was also evidence that staff from the home now maintain their own minutes of meetings regarding service users welfare, so that action may be taken promptly. One service user is very able to maintain social contacts. The other service user needs far more support in this area, and does not appear to have opportunities of meeting people of their own age or with shared interests. It is anticipated that this area will be addressed in conjunction with the occupational therapist working with this service user. Records indicated, and service users and the staff member confirmed that a daytrip had been arranged to Brighton, and a further daytrip was planned over the summer. Other activities included shopping trips, walks in the local park, board and card games. A new format for recording service users’ activities was in use, and this indicated that there had been a marked improvement in the provision of activities for service users at the home. It remains required that the possibility of a short holiday away from the home for all service users be investigated. Records of food served to service users indicated that a varied menu was served and service users spoken to were satisfied with the food available to them including some Caribbean food for the service user who requests this. Whittington House G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20. Service users receive appropriate physical and emotional support and are supported to take their prescribed medicines appropriately to ensure medication needs are met. However service users could be further protected by the monitoring of non-prescribed medicines within the home. EVIDENCE: Service user plans, and feedback from service users indicated that they are treated with respect and that their privacy and dignity are maintained. There was also evidence that service users attended regular health care appointments as appropriate. The storage and recording of the administration of medication appeared to be satisfactory. The storage temperature of medicines was recorded daily and was within the specified range, and records of medicines received, administered and disposed of were up to date as appropriate. On visiting a service user in their room, the inspector noted that they had purchased a homely remedy for toothache, containing paracetamol. It is required that a risk assessment be undertaken for this service user regarding their ability to self-medicate with regard to non-prescribed medicines, and that action be taken and this be monitored at regular intervals as appropriate to the needs of this individual. Whittington House G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 Page 16 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 and 23. The home has a complaints procedure in place to ensure that the concerns of service users are acted upon effectively. Procedures and training are in place to ensure that service users are protected from abuse. EVIDENCE: The home has a complaints procedure, an adult protection procedure and guidance for staff regarding whistle blowing. A copy of the Haringey Adult Protection Policy and Procedure is also available within the home. Evidence was available that the majority of staff at the home had undertaken training in the protection of vulnerable adults in May 2005. At the previous inspection a requirement was made regarding the recording of all complaints within the home’s record, with particular regard to a previous complaint raised and addressed concerning the home’s stock of food. This had been addressed as required. No further complaints had been recorded since the previous inspection. Whittington House G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 Page 17 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, 26 and 30. Service users live in an environment that is generally homely and comfortable, with adequate private and communal space. However although improvements have been made to the rear garden, an unsafe wall in the rear garden poses a potential health and safety risk to service users. One service user’s room requires redecoration in line with the service user’s wishes. EVIDENCE: The location and layout of the home are suitable for the service user group, there is sufficient communal space for three service users and the cleanliness in the home was of an acceptable standard. A requirement made regarding the replacement of the curtains in one service user’s room, in line with their wishes, had been met. At the previous inspection new carpet had been fitted in the lounge and on the staircase, and a new sofabed was provided in the office for staff sleeping-in. It was noted that new cast iron and wood, garden furniture of a high quality had been provided within the garden, and one service user advised that they enjoyed using this area. However the rear garden wall was found to be in a hazardous state, due to pressure applied by the roots of a tree. This must be Whittington House G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 Page 18 addressed as a matter of urgency in order to protect the safety of staff and service users using the rear garden. One service user advised that they wished for the walls in their bedroom to be repainted/papered. In addition the inspector noted that the wardrobe walls in this bedroom required cleaning/repainting. A requirement is made accordingly. Whittington House G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 Page 19 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) 34, 35 and 36. Staff have undertaken a range of relevant training to meet the needs of service users safely and effectively. A recruitment procedure is in place for staff, which adequately protects service users. Inadequate staff supervision and consultation may place service users at an increased risk. EVIDENCE: Satisfactory enhanced CRB disclosures were available for all staff as required, and staff files had been updated to include the required information. There was evidence that staff training had been undertaken in health and safety, moving and handling, first aid, administration of medication, drug and alcohol awareness and dealing with potentially violent situations. At the previous inspection it was required that all staff undertake adult protection training. Evidence in staff files indicated that the majority of staff had now undertaken this training. However it remains required that the remainder of staff members are trained in this area. It is recommended that an abbreviated induction format specific to Whittington Whittington House G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 Page 20 House, be available for agency/bank staff members working in the home for the first time. This should be separate from inductions for other homes, and include important information about the service users accommodated. At the previous inspection a requirement was made regarding the frequency of staff supervision. Inspection of staff files and discussion with staff confirmed that whilst individual staff supervision sessions are occurring, these are not occurring at sufficient frequency to meet the National Minimum Standard of at least six times annually. This requirement is restated. It was also noted that separate staff meetings (other than house meetings including service users) have not been occurring. This is required. Whittington House G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 Page 21 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, 39, 41 and 42. In the absence of a record of the acting manager’s hours and access to service users’ financial records, it is unclear as to whether the home is adequately managed with the needs of service users in mind. The absence of adequate quality assurance procedures, staff supervision and some safety checks also places service users at an increased risk. EVIDENCE: Concerns remain regarding the ability of the registered provider to balance the demands of the other homes and services that he owns and still manage this home on a full time basis. At the previous inspection the registered person was required to record the hours that he works within the home on a daily basis. This requirement is restated for the second time. Whittington House G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 Page 22 At the previous inspection it was required that a quality assurance audit be conducted for the home. The provider advised that he was working with an independent consultant to complete this task and had already circulated questionnaires to service users. He was reminded that he also needed to request feedback from health care professionals and other visitors to the home in addition to an internal audit of how the home is functioning. It was agreed that a report of the findings of this audit would be sent to the local CSCI area office by the end of May. However no report had been received and this requirement is restated with a decreased timescale. Failure to comply with this requirement may result in enforcement action being taken against the home. The inspector was concerned to note that an incident during which the police had been called to the home had not been notified to the CSCI and a requirement is made accordingly. It is also required that the provider write to the inspector detailing the current situation with regard to service users’ finances looked after by the home. COSHH materials were stored in locked facilities as appropriate, and as required hazard analysis sheets were available for all COSHH materials used within the home. Current gas and electricity installation certificates were available for the home and records indicated that appropriate fire safety checks were generally being undertaken. As required, fire alarm checks were being undertaken weekly, however the inspector did not see evidence of recent portable appliances testing for the home. A copy of this certificate must be sent to the local CSCI area office. A fire safety audit was undertaken, and it is required that the provider must contact the local fire prevention officer regarding non-self-closing fire doors on service users bedrooms and the kitchen door, and complete a fire risk assessment for the home. It is recommended that staff are updated in fire safety training annually. Whittington House G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 Page 23 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 2 3 x x 2 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 2 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 2 x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x 3 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Whittington House Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 2 x 1 x 2 2 x G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 Page 24 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 1 Regulation 5(1) and 5(2) Requirement The registered person must ensure that the service users guide is updated to include service users’ views of the home and access to the most recent CSCI inspection report. A copy of the completed document must be sent to the local CSCI area office. (Previous timescale of 10/06/05 not met.) The registered person must ensure that service user’s statements of terms and conditions with the home are updated to include all the information as specified under this Standard, including the room to be occupied, rights and responsibilities, arrangements for reviewing the service user plan and any limitations to the freedom of each service user. Timescale for action 23rd September 2005 2. 5 5(1)(c) 21st October 2005 3. 7, 41 20 Copies of local authority contracts with each service user must also be available. (Previous timescales of 05/11/04 and 24/06/05 not met). The registered person must write 16th to the inspector detailing the September current situation with regard to 2005 G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 Page 25 Whittington House 4. 9, 20 12, 13(2)(4) (b) service users’ finances looked after by the home. The registered person must ensure that a risk assessment is undertaken for the identified service user regarding their ability to self-medicate with regard to non-prescribed medicines, and that identified action is taken. This must be monitored at regular intervals as appropriate to the needs of this individual. The review and monitoring of all risk assessments must be arranged at timescales that take account of the level of risk, changes to the level of responsibility expected of service users, and any history of problems relating to particular activities. The registered person must ensure that the possibility of a short holiday away from the home for all service users is investigated. (Previous timescales of 22/10/04 and 01/07/05 partially met). The registered person must ensure that the rear garden wall is made safe. The identified service users bedroom walls and cupboard must be repainted/papered or cleaned effectively. The registered person must ensure that all staff who have not yet received training in adult protection, receive this training. (Previous timescales of 22/10/04 and 3/06/05 partially met). The registered person must ensure that staff receive individual supervision sessions at least six times each year and 2nd September 2005 5. 14 16(2)(m) (n) 23rd September 2005 6. 24, 26, 42 13(4)(a) 23(2)(b) (d) 9th September 2005 21st October 2005 21st October 2005 7. 35 13(6) 18(1)(c) (i) 8. 36 18(2) 23rd September 2005 Page 26 Whittington House G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 9. 36 18(2) 10. 37 10 11. 39 24 that these are recorded. (Previous timescale of 15/07/05 not met). The registered person must ensure that staff meetings are held at least six times annually and that these are minuted. (Previous timescale of 15/07/05 not met). The registered person must record the hours that he works within the home on a daily basis. (Previous timescales of 01/10/04 and 20/05/05 not met). The registered person must undertake a quality assurance audit of the home, and this must be repeated at least annually, obtaining feedback from each service user (with assistance from an advocate where appropriate), care managers, health care professionals and regular visitors to the home. 23rd September 2005 23rd September 2005 23rd September 2005 12. 41 13. 42 14. 42 A copy of the findings of this audit must be sent to the local CSCI area office. (Previous timescales of 05/11/04 and 10/06/05 not met). 37 The registered person must inform the CSCI of any serious event affecting the wellbeing of service users without delay. 13(4)(a) The registered person must ensure that portable appliances testing is undertaken for the home. A copy of the current portable appliances testing certificate must be sent to the local CSCI area office. (Previous timescale of 10/06/05 not met). 13(4)(a) The registered person must 23(4)(a)c) contact the local fire prevention (v) office regarding non-self-closing doors on service users bedrooms and the kitchen door. G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc 15th August 2005 23rd September 2005 23rd September 2005 Whittington House Version 1.40 Page 27 A fire safety risk assessment must be produced for the home with a copy sent to the local CSCI area office. 21st October 2005 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. 2. Refer to Standard 12 34 Good Practice Recommendations It is recommended that service users be encouraged to be involved in tending to the garden. It is recommended that an abbreviated induction format specific to Whittington House, be available for agency/bank staff members working in the home for the first time. This should be separate from inductions for other homes, and include important information about the service users accommodated. It is recommended that staff are updated in fire safety training annually. 3. 42 Whittington House G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 Page 28 Commission for Social Care Inspection Solar House 1st Floor, 282 Chase Road Southgate, London, N14 6HA 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 Whittington House G59 S10799 Whittingham House V240841 15.08.05 Stage 4.doc Version 1.40 Page 29 - 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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