Care Home: Pelham House

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What the care home does well We found a relaxed atmosphere with good interactions between staff and people who use the service. A person said "everything is good, I feel looked after". Relatives reported "staff are attentive and helpful" "staff are always visible and chatting with other residents". The staff group are well trained, a relative commented they "work with each resident to ensure their individual needs are met in a respectable way". The home meets people`s social and cultural needs. It provides flexible care to meet needs. The environment is well maintained. What has improved since the last inspection? Requirements set on the last inspection have now been achieved. The Statement of Purpose has been improved to reflect the limitations of the lift. The quality of recording has improved. This was particularly reflected in person centred planning (p.c.p) and the daily records. A record is now maintained of the food served. Plants and vases, and other decorative items now enhance bathrooms. What the care home could do better: The service must continue to progress with care plans that reflect the whole individual (p.c.p.), and avoid a task based approach to the giving of care. CARE HOMES FOR OLDER PEOPLE Pelham House 32-34 Pelham Road Wimbledon London SW19 1SX Lead Inspector Jean Stuart Unannounced Inspection 13:40 18th June 2008 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Pelham House DS0000027227.V365886.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Pelham House DS0000027227.V365886.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Pelham House Address 32-34 Pelham Road Wimbledon London SW19 1SX Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8543 8434 pelhamhouseSW19@AOL.com www.pelhamhouse.org.uk Abbeyfield Peabody (sth London) soc. Limited Patrick Timothy Edwards Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Pelham House DS0000027227.V365886.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 25 12th December 2007 Date of last inspection Brief Description of the Service: Pelham House is a registered care home for up to twenty-five older people. The home is owned and managed by a voluntary committee of the Abbeyfield Peabody South London Society Limited. Pelham House is a purpose built three storey building in a residential area of Wimbledon. Accommodation comprises of twenty-five single bedrooms, a large lounge, dining room, four bathrooms and eleven toilets. There is a small garden to the rear of the home and a lift to all floors. The home is situated close to the main shopping centre of Wimbledon and the good public transport links served by the area. On the date of inspection the fees charged by the home per week were: £464.10 to £569.10 for enhanced care or respite. Pelham House DS0000027227.V365886.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two stars. This means people who use this service experience good quality outcomes. We spent ten hours at the home from 1.40 pm to 6pm, on the first day and 9.30am to 3pm on the second day. We spoke with nine people about their experiences at the home. Time was also spent with three members of staff, and relatives. Records and documents including care plans, risk assessments, medication, food records and the complaint log were examined. Two directors joined us to hear about the outcomes from the inspection A tour of the premises and two meals were observed. The home completed an Annual Quality Assessment (AQAA), information from this has been included in this report. What the service does well: What has improved since the last inspection? Requirements set on the last inspection have now been achieved. The Statement of Purpose has been improved to reflect the limitations of the lift. Pelham House DS0000027227.V365886.R01.S.doc Version 5.2 Page 6 The quality of recording has improved. This was particularly reflected in person centred planning (p.c.p) and the daily records. A record is now maintained of the food served. Plants and vases, and other decorative items now enhance bathrooms. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Pelham House DS0000027227.V365886.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Pelham House DS0000027227.V365886.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,6. People who use the service experience good quality in these outcome areas. This judgement has been made using available evidence including a visit to this service. People can be confident that they will have sufficient information before they stay at Pelham House. A written contract is drawn up for each individual. People’s needs are assessed prior to admission and a plan of care drawn up to meet these needs. EVIDENCE: People spoken with confirmed that they had information before moving in. The service user guide has been amended to give a description of the limitations of the lift. No one is admitted unless an assessment has been carried out, this includes questions about gender, disability, race, age, and religion, ensuring that Pelham House DS0000027227.V365886.R01.S.doc Version 5.2 Page 9 the service can provide the required level of support. Staff have information on the needs and wishes of individuals before they arrive at the home. Preadmission assessments are used to set up a care plan detailing assistance people require. We saw written contracts drawn up with each individual. The person or their representative, the manager and a director sign this. This sets out the fees and gives a clear understanding of the services they can expect from the home. The home can offer an intermediate care service if a vacancy arises. Pelham House DS0000027227.V365886.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. People who use the service experience good quality in these outcome areas. This judgement has been made using available evidence including a visit to this service. People are involved in the care planning process. Action is taken to make sure that care plans address individual needs. The plan could be improved by noting people’s strengths as well as their needs. Risk assessments are completed and focus on keeping people safe. Arrangements for the administration of medication are satisfactory. EVIDENCE: Four peoples care plans were examined. Peoples’ plans lead from their assessments and contained good details of how to deliver care. The plan of care involves the person or someone close to them. Individualised care is reflected in ensuring people spend time as they wish. This was noted on care plans. People were sitting in the lounge, their own bedroom, and using community resources. The routines of the home are flexible. People spoke of Pelham House DS0000027227.V365886.R01.S.doc Version 5.2 Page 11 getting up at the same time they did at home. People make their own informed decisions and have the right to take risks in their daily lives. Care plans are agreed and signed by the person, the care manager and the key worker. Plans are regularly reviewed and amended to reflect current need. We discussed how person centred planning (P.C.P.) should look at the positive aspects of a person’s lives and what they can do. Some entries are person centred, yet many entries particularly on the daily record are task based and reflect bodily functions rather than the whole person. In line with good practice any care record should look at the whole person. To promote independence and mobility, some people use walking aids. Risk assessments are maintained to ensure that areas are kept clear of furniture and a record is maintained of falls and how to prevent these. Other risk such as going out into the community are recorded and show how the risk is managed enabling the individual to retain their independence. All people are registered with local GP practices, however the majority of people see one GP. An individual said someone from the local doctor’s surgery visits once a week. The manager confirmed that this was a practice nurse. As seen on the day the chiropodist visits and the records show that the optician also visit regularly. We found medication sheets, were up to date and accurate. Medication profiles are in place. People reported that they self medicate, and “walk to the doctors to collect prescriptions”. Pelham House DS0000027227.V365886.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. People who use the service experience good quality in these outcome areas. This judgement has been made using available evidence including a visit to this service. People are able to pursue interests of their choosing. Spiritual needs are acknowledge and supported. Family and friends visit the home. Meals are well balanced, and special diets are catered for. A record of all food served is maintained. EVIDENCE: People are able to enjoy activities both in the home and in the community. The home has considered their varied interests when planning the routines of daily living and arranging activities. Activities reflect the diverse needs of the group, considering age, disability, and religion. People spoke of their enjoyment of music and singing, of films that they discuss after watching, an exercise class to music. Clergy from both the Catholic and Church of England faiths visit. A relative spoke very highly of the care given. Pelham House DS0000027227.V365886.R01.S.doc Version 5.2 Page 13 An activity organiser is developing a life history for each individual, focusing on the individual’s strengths and personal preferences. Such issues are important to personal centred planning and the whole staff group should document what they know about an individual so that knowledge is shared. People spoken with enjoyed the food offered. Typical comments were the “food is good” “we have choices, I had egg and bacon for breakfast” “I enjoy the food”. Carers sit with people who need help, exchanging conversation with them. People with dietary needs based on their preferences are catered for. We saw that a range of different food was served on the day, and that request that were not on the menu were provided. Meal times are flexible and the right of the individual to autonomy with regard to when they eat is respected. Individuals spoke of having a late “breakfast, and later after every one else has finished staff serving them with lunch”. A record of food served is maintained. Pelham House DS0000027227.V365886.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. People who use the service experience good quality in these outcome areas. This judgement has been made using available evidence including a visit to this service. People feel safe and secure in the service provided and are aware of how to use the complaint procedure. If people have concerns this will be looked into and action taken. People are protected from harm by appropriate training for staff. EVIDENCE: Comments from people were that they have “no complaints” we have “ never need to make a complaint”. Individuals felt able to speak with the staff or “talk with the manager”. On the surveys people knew how to make a complaint and who to talk to if they are not happy. The manager reported that he has not received any complaints since he had started at the home. The complaint log reflected two complaints made in the last twelve months, both of which were unfounded. Staff reported that they had received training in Safeguarding Adults, there are policies and procedures to access if necessary. This was confirmed in the AQAA. Pelham House DS0000027227.V365886.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26. People who use the service experience good quality in these outcome areas This judgement has been made using available evidence including a visit to this service. The environment is clean, safe and comfortable. The accommodation is well maintained. EVIDENCE: People were positive about the environment provided. The home is “comfortable”. The home was well lit, on the surveys all people agreed that it was clean and tidy and smelt fresh. The garden is accessible to people with poor mobility. Pelham House DS0000027227.V365886.R01.S.doc Version 5.2 Page 16 Bedrooms viewed were tidy. People had their own photos, personal items, and pictures on the wall. Bathrooms have specialist equipment for people with a physical disability. The addition of plants and vases make the environment in the bathroom more homely. As reported in the AQAA most bedrooms have been redecorated and recarpeted, ten adjustable beds have been purchased to meet people’s needs. The lounge has a new plasma television, which a person reported was “fantastic” and new armchairs have been purchased. Pelham House DS0000027227.V365886.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. People who use the service experience good quality in these outcome areas. This judgement has been made using available evidence including a visit to this service. People are supported by sufficient numbers of staff that respond appropriately to their needs. There is a comprehensive recruitment procedure, which is followed to protect people from harm. Staff have NVQ level two training. Staff are appropriately trained to support people. EVIDENCE: Feedback about the way staff carry out their duties was positive. Comments included “staff are very helpful” “will do anything for us”, “I like some of them very much”. Sufficient staff were on duty to meet the needs of people. On the survey forms people said staff are always available when needed. We found staff to have a good understanding of the needs and preferences, they interacted with people and showed good communication skills. New teams with designated key workers are being developed to promote consistent care for people. Pelham House DS0000027227.V365886.R01.S.doc Version 5.2 Page 18 When required the home will take disciplinary action against staff. This is adequately recorded. To ensure fairness any stated action should be followed through. The AQAA demonstrates that staff receive training. When speaking to people they said NVQ level two and three training and courses in the Protection of Vulnerable Adults (POVA), moving and handling, have been completed. The individual staff files supported these statements. The manager has set up a new training programme of refresher course to make sure all staff have a correct level of knowledge. The manager demonstrated that the service has an understanding of equality and diversity throughout their recruitment process employing staff of different genders and from different cultures. Staff reported that their references were collected and CRB check carried out before they were employed. The staff files supported this. Such checks promoted peoples safety. Pelham House DS0000027227.V365886.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38. People who use the service experience good quality in these outcome areas. This judgement has been made using available evidence including a visit to this service. The manager is very conscientious in fulfilling all aspects of the role. The information in the AQAA is fully supported by appropriate evidence. People’s finances are managed appropriately and securely The view of people, families and other stakeholders are sought on a regular basis. Pelham house follows safe working practices. EVIDENCE: The home has completed an AQAA that contains information of how the home is run. The information given in the AQAA, is clear and relevant. The AQAA Pelham House DS0000027227.V365886.R01.S.doc Version 5.2 Page 20 lets us know about changes a service has made and where they intend to make improvements. The data section of the AQAA was accurately and fully completed. The manager has appropriate qualifications and experience for the role. The manager is seeking to continually improve the home, as seen by the environment and plans for staff training, all of which will benefit people living there. Relatives commented, “the manager is a very helpful person who does everything he can to improve lives for residents, at Pelham House”. The home is safe for people and staff because health and safety procedures are carried out. Many records are maintained concerning safety issues around the environment. The record of fire checks was seen. Policies and procedures are up to date. The view of families and stakeholders are sought. A family member confirmed that their views are sought in a “family meeting” when they will look at the running of the home and how it meets the persons needs. People’s who are able hold their own money. For others all outgoings are covered by the home. Peoples representative are invoiced as required. The record of supervision showed that people have designated times, staff confirmed that supervision happened. Pelham House DS0000027227.V365886.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Pelham House DS0000027227.V365886.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? yes No. Standard Regulation Requirement 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 OP7 Good Practice Recommendations The quality of recording of care (p.c.p.)should continue to illustrate how people’s needs are being met. Commission for Social Care Inspection London Regional Office Pelham House DS0000027227.V365886.R01.S.doc Version 5.2 Page 23 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Pelham House DS0000027227.V365886.R01.S.doc Version 5.2 Page 24 - 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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