Inspection on 16/05/05 for Wimbourne House

This inspection was carried out on 16th 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 but made no statutory requirements on the home.

Other inspections for this house

Wimbourne House 22/01/08

Wimbourne House 01/03/07

Wimbourne House 07/10/05

Wimbourne House 17/08/04

Wimbourne House 01/04/04

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 WIMBORNE HOUSE 16 Wimborne Road London N17 6HL Lead Inspector Teferi Degeneh Unannounced 16 May 2005 @ 9:30 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. WIMBORNE HOUSE Version 1.10 Page 3 SERVICE INFORMATION Name of service Wimborne House Address 16 Wimborne Road, London, N17 6HL 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 8493 9947 Mr Kwame Adusei Mr Kistnasamay (Chris) Thandrayen PC Care Home 3 Category(ies) of MD registration, with number of places WIMBORNE HOUSE Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 17 August 2004 Brief Description of the Service: Wimborne House is located in a residential area close to Bruce Grove where there are a range of local shops and easily accessible public transport. The home is registered to provide residential care for three (3) people with Mental disorder, excluding learning disability or dementia. Currently there are two service users living at the home. The registered provider, Mr Kwame Adusei, owns a number of similar small homes in this area. The home is an ordinary house, on a domestic scale and fits in well with the surrounding area. It has three bedrooms, a separate toilet room and one bathroom, with a shower over the bath. There is a shared lounge, kitchen and dining area and a rear garden. The home has four care staff, a cook and a manager. Staff are on duty on a twenty four hour basis.The organisation’s brochure states that it specialises in supporting service users who may have a forensic history or may be on the supervision register and that the aims are to respect the resident’s privacy and dignity, maintaining and promoting personal identity and the right to choose. WIMBORNE HOUSE Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on 16th May 2005 between 9:30 am and 5:30 pm. The manager, Mr Kistnasamay (Chris) Thandrayen, was present throughout the inspection to assist the inspector. The report is based on the evidence gathered from three service users’ and five staff files. Other documents seen as part of the inspection included the home’s diary, policies, procedures and medication record sheets. A service user and one member of care staff were also spoken to . Finally, the premises were inspected. What the service does well: What has improved since the last inspection? What they could do better: The home is in need of redecoration. In addition, there is a need for the registered provider to take health and safety issues seriously and ensure that the television aerial in the lounge is fixed against the wall and all portable electrical appliances are tested by a qualified electrician. The manager must WIMBORNE HOUSE Version 1.10 Page 6 move the fridge/freezer, microwave oven and the toaster from the office on the first floor to a more appropriate location in the home. It is essential that the manager consults service users and provides them with suitable food in sufficient quantities. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. WIMBORNE HOUSE Version 1.10 Page 7 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 WIMBORNE HOUSE Version 1.10 Page 8 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) 2 and 4 The system of requiring new service users to have day visits and overnight stays has helped service users to make informed decisions about their admission. New service users are confident that their admission is based on the ability of the home to meet their assessed needs, which the home receives from their social workers and health professionals before their admission. EVIDENCE: One new service user has been admitted since the last inspection. As the service user was away on holiday during the inspection, it was not possible to speak to them. However, records in the service user’s files and a discussion with the manager confirmed that information had been obtained and care plans developed before the new service user was admitted. It was evident from the records that the service had a day visit and overnight stays before admission. Another existing service user said they visited the home before they were admitted. WIMBORNE HOUSE Version 1.10 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 and 9 Service users have benefited from being able to have reviews of their needs and care plans in place. The home endeavours to enable service users to make decisions and achieve independence. This is commendable. There is a satisfactory system of risk assessment, which ensures that risks are minimised and appropriately managed. EVIDENCE: Care plans have been reviewed and there is evidence in the files that service users have been involved in the review of their care plans. A diary showed that social workers, health professionals and representatives have been invited to attend an annual review meeting. It was evident from a discussion with a service user that the service user attended their review meetings and discussed issues on a regular basis with a member of staff. Wimborne House, the Company which runs the home, has employed an activities co-ordinator who comes to the home to support service users with their chosen activities. Currently the activities’ officer is studying the feasibility of service users accessing a work placement with a view to build confidence and gain work experience for future employment. The home does not manage service users’ finances. However, correspondence and records seen in service WIMBORNE HOUSE Version 1.10 Page 10 users’ files showed that the staff supported service users with managing their benefits. Service users are able to travel independently to shops, cafés, post offices and recreational places. They all have bedroom keys and can decide when to go to bed and when to get up. Each service user has an up-to-date risk assessment, which includes areas of risks and strategies of minimising and managing the risks. There is written evidence that the home has received detailed information, advice and agreement regarding a service user’s overseas travel. WIMBORNE HOUSE Version 1.10 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) 12, 14, 15, 16 and 17 Service users are satisfied with the support and services provided in respect of social and leisure activities and the current arrangement for visitors to come to the home. The policies, facilities and services of the home have enabled service users to feel that they live in an environment where their privacy and dignity are respected. The food provided at this home is poor in its quantity, quality and presentation time. Service users felt that they are neither consulted nor provided with the type and amount of food they wanted. EVIDENCE: The home has an activities co-ordinator who supports service users to identify and engage in day and leisure activities. One service user said they used to have paid employment but had to give it up because of medical issues. It was clear from discussions with the registered provider and a service user that service users have been to cafés, public houses and cinemas. The home has also facilitated group trips to a seaside. One service user was away on a holiday abroad for one month during this inspection. The entries in the diary WIMBORNE HOUSE Version 1.10 Page 12 and discussions with the registered provider and a service user confirmed that friends visited service users. It was also evident that some visitors have been banned from the home to protect the well-being of all who live and work there. There are clear statements and guidance in the placement agreement and in the home’s policies regarding smoking, alcohol and drugs. All service users have bedroom keys and can choose when to be alone. A service user spoken to said staff talked to them appropriately and always knocked on the doors and waited outside to seek permission to enter bedrooms. The menu was not available for inspection. The registered provider said the home does shopping twice a week to ensure fresh supply of food is available. The shopping list and the actual shopping seen did not indicate that service users have been consulted. The food items bought were mostly ready-made and frozen food items. The quantity and quality of the food seem were not satisfactory and a service user was not happy with the food provided at the home. For example, a discussion with a service user revealed that the home provided the same food item most of the time and service users were not provided with the kind of food they requested. At the last inspection the registered provider was required to reassess the location of the fridge/freezer and the microwave oven in the office on the first floor and place them in a more appropriate position in the home so that service users have easy access and their health and safety is ensured. This is yet to be complied with. WIMBORNE HOUSE Version 1.10 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) 19 and 20 There are satisfactory systems in place to ensure that service users receive appropriate medical care. The systems for medication storage and administration have enabled service users to take their medication appropriately as prescribed by their doctors. EVIDENCE: There is evidence in the files, appointment letters and the home’s diary that service users have access to appropriate health care. All service users have their own general practitioners. It was evident from a discussion with the manager that service users regularly see psychiatrists and receive counselling from psychologists and the staff. There is a smoking policy which service users are clear about. Medicines are kept in a locked cabinet in the office. All medication is administered by staff who have attended training in the handling and administration of medication. Medicines kept at the home and the medication record sheets were checked and found to be in order. WIMBORNE HOUSE Version 1.10 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The process of complaints procedure is clear and service users feel confident by their knowledge of how and who to complain to. The registered provider has satisfactory policies, procedures and practices which ensure that service users are protected from abuse. EVIDENCE: A service user spoken to was aware of the home’s complaints procedure and of being able to talk to the manager or provider if they have concerns. It was evident in the minutes of service users’ meetings that the manager has reminded how people can complain if they are not happy. The home’s complaints procedure is clear and contains details of how complaints are dealt with. No complaints have been recorded since the last inspection. It was evident from a discussion with the manager and the staff files that the staff have attended training on abuse. Each service user has a bedroom key. A service user said staff treated them with respect and dignity and they are happy living at the home. All service users look after their own money but the home supports them with their benefits. There are satisfactory policies and procedures on the protection of vulnerable adults from abuse. A copy of the placing authority’s policy and procedures of protecting vulnerable adults from abuse has been obtained and the manager is familiar with its contents. WIMBORNE HOUSE Version 1.10 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26 and 30 Even though the home was clean and tidy, there was a need for the registered provider to redecorate the walls in all rooms and to fix the loose aerial in the lounge. The health of one service user on the first floor was put at risk due to a bed base, which was not suitable/comfortable to sleep on. EVIDENCE: The premises were clean, tidy and free from offensive odours. However, the walls in communal rooms were in need of redecoration and the registered provider said this due to be undertaken within a week. One service user’s bedroom was seen during this inspection. The service user said they are happy with their room and have been involved in the selection of the carpets and redecoration of the room. It was noted from observations and a discussion with a service user that the base of the bed was tilted to one side making it uncomfortable and unsafe to sleep on it. This was raised with the registered provider who agreed to change this to a new bed for the service user. The registered provider has repaired and repainted the hole in the wall in the lounge. However, the television aerial behind the television set was loose from the wall and needs re-fixing. WIMBORNE HOUSE Version 1.10 Page 16 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) 33 and 35 The level of staffing and the training programmes provided at this home are satisfactory to meet service users’ individual and collective needs. EVIDENCE: There are five care staff, a cook, an activities co-ordinator and the manager working at the home. The activities co-ordinator comes to the home regularly to talk to and provide service users with social and leisure activities. The cook comes everyday around 4 pm to prepare dinner. There is one member of staff on shift at all times at the home. The staff have attended a range of training programmes relevant to the purposes of the home. Three care staff have completed a care qualification equivalent to NVQ level 2. The company, which owns this home, has a training co-ordinator whose responsibility includes identifying and providing training programmes for the staff. WIMBORNE HOUSE Version 1.10 Page 17 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) 39 and 42 Service users are inconvenienced and their health and safety is put at risk due to the location in the office of the electrical equipment such as the fridge/freezer, microwave oven and the toaster. The home has compromised the health and safety of service users by failing to ensure that the portable electrical appliances are checked. There is a good system of gathering the views and acting upon the outcome of service users’ feedback regarding the quality of the services and facilities provided at the home. EVIDENCE: The minutes of service users’ meetings showed that service users are consulted on how the home should run or things they may like to take place at the home. The service users said they could talk to the staff and the manager. The registered provider has developed and administered quality assurance questionnaires to service users and visitors. The registered provider has written a summary of the outcome of the feedback and attached a copy to service users’ guide. WIMBORNE HOUSE Version 1.10 Page 18 Each service user has a risk assessment, which includes the risk of going missing and the reporting procedures. The registered provider has consulted appropriate health and social work professionals in respect of a service user who was travelling abroad. The premises were clean and tidy on the day of the inspection. Inspections of the gas boiler, fire equipment and the fire alarm system have taken place and the certificates were seen. However, there was no evidence to indicate that portable electrical appliances have been tested and are safe to use them. As mentioned elsewhere above, a fridge/freezer, toaster and a microwave oven have been kept in the office on the first floor and this has inconvenienced and potentially put service users’ health and safety at risk. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x 3 x 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No WIMBORNE HOUSE Score Standard No 24 25 26 27 Version 1.10 Score 2 x 2 x Page 19 6 7 8 9 10 LIFESTYLES 3 3 x 3 x Score 28 29 30 STAFFING x x 3 Standard No 11 12 13 14 15 16 17 x 3 x 3 3 3 2 Standard No 31 32 33 34 35 36 Score x x 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 2 x WIMBORNE HOUSE Version 1.10 Page 20 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 17 Regulation 16(2)(i) Requirement The registered person must consult service users and provide, in adequate quantities, suitable, wholesome and nutritious food which is varied and properly prepared and available at such times as may reasonably be required by service users. The registered person must consult a service user and change the bed in the bedroom next to the toilet on the first floor. The registered person must ensure that all parts of the home are redecorated and the loose arial in the lounge is securely fixed to the wall. The registered person must reassess the location of the fridge/freezer, toaster and the microwave oven in the office on the first floor and replace them in a more appropriate position so that service users have easy access and their health and safety is ensured. (Previous timescales of 20/9/04 not met). The registered person must ensure that all portable electrical Version 1.10 Timescale for action 15/6/05 2. 24 16(2) 15/6/05 3. 26 23(2)(b) (c)(d) 30/605 4. 42 13(4)(a) (b)(c) 15/6/05 5. 42 23(4) 30/6/05 WIMBORNE HOUSE Page 21 appliances in the home are checked by a qualified electrician and ensure that a copy of the certificate is forwarded to the CSCI inspector. 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 WIMBORNE HOUSE Version 1.10 Page 22 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 WIMBORNE HOUSE Version 1.10 Page 23 - 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. 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