Care Home: Elsden House

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What the care home does well Feedback from the residents is positive about support provided to them. People appear well cared for and supported, particularly in gaining and maintaining independance. Staff are trained in counselling techniques and are able to offer support sessions to the residents. The home is supported by a team of care directors from the provider organisation, so that all the homes in the Wimbourne House group can share information and experiences for the benefit of the residents in each home. Two activities coodinators who work across the homes provide links between people with similar interests to others in Wimborne House homes. What has improved since the last inspection? This is the home`s first inspection under new registration. There are no outstanding requirements. What the care home could do better: No new requirements were made at this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: Elsden House 49-51 Elsden Road Tottenham London N17 6RY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Margaret Flaws     Date: 2 4 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 21 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 21 Information about the care home Name of care home: Address: Elsden House 49-51 Elsden Road Tottenham London N17 6RY 0 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Wimborne House Limited Name of registered manager (if applicable) Mr Kamany Onokoko Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home 6 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 21 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unnannounced key inspection took place on one afternoon. This limited key inspection was done to follow up the new registration of the service, following the need for this service to be correctly registered under a company, and in response to the Care Quality Commissions prepartation for a new risk based methodology. The service is now registered under Wimborne House Ltd, with the same provider. There are no other changes to category of registration or to the number of places in the home. The last detailed key inspection of the previously registered service took place in June 2009. During this inspection, we toured the home, spoke to two residents and the Registered Manager. The Registered Manager confirmed that, other than the new registration, there were no other changes since the previous key inspection. Care Homes for Adults (18-65 years) Page 5 of 21 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 6 of 21 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 7 of 21 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents needs are properly assessed and they are able to spend time in the home to test its suitability for them. Evidence: The home has satisfactory admission procedures, including opportunities to visit prior to coming to live in the home. The home obtains and produces detailed assessment information for each resident.Residents confirmed that these procdedures were followed. One new resident has recently moved into the home and the Registered Manager confirmed that this resident, who came from another Wimborne House home, is settling in well. Staff are trained to meet peoples mental health needs. Care Homes for Adults (18-65 years) Page 8 of 21 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have their care planned and risks evaluated and they are involved in the process. Evidence: Residents are supported to make their own decisions and pursue their preferred lifestyles. There are good care plans and risk assessments in place. These include coverage of peoples mental health needs and have good detail about how they will be supported by the staff. Residents are involved in planning for their own care. Risk assessments cover the range of activities that people are involved in and set out how risks can be minimised. Care plans and risk assessments are regularly reviewed. Records are also kept of how support is provided and actions taken. Care plans also cover equality and diversity needs and issues. The Registered Manager told us that the placing authorities have completed annual Care Homes for Adults (18-65 years) Page 9 of 21 Evidence: reviews. He described how the home is working towards supporting people to develop sufficient independance to move into supported living accomodation. Care Homes for Adults (18-65 years) Page 10 of 21 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to pursue the lifestyle they wish and keep community and family contact. There is good quality food available in the home and residents are able to prepare the meals they wish. Evidence: The home benefits from the support of the groups activities coordinator and their local activities centre. Most residents however prefer to pursue individual activities of their own choosing. Residents are involved in the day to day running of the home and one resident we spoke to showed us the meal that he was preparing for dinner. He said that this was part of his preparation for more independant living. Care Homes for Adults (18-65 years) Page 11 of 21 Evidence: Residents felt that their rights were respected and that they are able to maintain regular family and social contact. There was good quality food available in the home and people are able to cook for themselves and to prepare culturally appropriate food if they wish. At the time of the inpsection, the home received a food delivery from a local supermaket. The resident who was cooking showed us the stew that he was freshly preparing. Care Homes for Adults (18-65 years) Page 12 of 21 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents personal and healthcare needs are properly assessed and met by the home. They are also protected by the homes medication arrangements. a Evidence: Residents have good access to physical and mental health professionals. This includes routine appointments with GPs, hospital, dentists and opticians. These visits or refusals of visits are documented. Residents mental health needs are kept under close review and the Registered Manager described to us how they were working with each residents needs at the time of the inspection. Medication is supplied in dossett boxes by a local pharmacist. Receipt, disposal and storage arrangements are satisfactory. There is also information for residents and staff about the medications prescribed. Residents are supportd by staff to take their medication as necessary. Care Homes for Adults (18-65 years) Page 13 of 21 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are protected by the homes complaints and safeguarding policies and procedures. Evidence: The Registered Manager told us that there had not been any complaints since the last key inspection in June 2009. The home has appropriate complaints and safeguarding policies and procedures in place. Staff are trained in safeguarding adults and understand how to follow up safeguarding concerns and residents are aware of how to express their concerns. Care Homes for Adults (18-65 years) Page 14 of 21 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is a pleasant environment for people to live in. Evidence: The physical environment is of a reasonable standard. The home undertakes regular improvement and maintenance to keep the home and living environment in good order. One resident showed us his bedroom which was in very homely and personalised by him. The home was clean and hygienic on the day of the inspection. Care Homes for Adults (18-65 years) Page 15 of 21 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported by an appropriately recruited, trained and supported staff team. Evidence: The home is staffed by at two staff members at all times. Residents said that they were happy with the support the staff provided to them. We met one staff member and the Registered Manager on the day of the inspection. The Registered Manager told us that there had been no changes to the staff team since the last key inspection in June 2009. The home has a sound recruitment policy and procedure and undertakes required preemployment checks prior to staff starting work. New staff are fully inducted and the home has comprehensive training programme to meet statutory requirements and residents needs. Staff also have regular supervision and the home holds regular staff meetings. Half the staff team have NVQ qualifications. Staff have recently been trained in Deprivation of Liberty Standards. Care Homes for Adults (18-65 years) Page 16 of 21 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported and protected by the homes management, quality assurance and health and safety policies and procedures. Evidence: The Registered Manager has completed a Diploma in Mental Health and the Registered Managers Award. He works in the home on a fulltime basis. The Provider undertakes regular unannounced visits to the home and keeps copies of the records of these visits. These quality assurance visits includes actions and follow up. The home also has an annual quality assurance survey. Residents meetings are part of the daily life of the home. Residents are supported with budgeting their own finances in preparation for independant living. Health and safety and maintenance certificates are kept up to date and in order.Fire Care Homes for Adults (18-65 years) Page 17 of 21 Evidence: safety policies, procedures and training are in place. Care Homes for Adults (18-65 years) Page 18 of 21 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 19 of 21 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 20 of 21 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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