Care Home: Stanhope Gardens 109

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What the care home does well We received postive feedback about the home from the residents we spoke to. They all said that they liked living there and received excellant care and support. Residents are well supported in going about their daily ways in ways that they wish, are encouraged to develop as people and to focus on rehabilitation and wellness. The family run ethos of the home is clearly popular with residents. What has improved since the last inspection? There were no requirements made at the last inspection. What the care home could do better: Mandatory training areas would benefit from being updated. Home must have quarterly fire drills and at least one of these drills take place after dark. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Stanhope Gardens 109 Stanhope Gardens 109 London N4 1HZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Margaret Flaws     Date: 1 3 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Stanhope Gardens 109 Stanhope Gardens 109 London N4 1HZ 02088006393 02088000429 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Eftychia Joannides,Mr Phivos Joannides Name of registered manager (if applicable) Mr Christos Joannides Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home 109 Stanhope Gardens is a care home registered to provide personal care for a maximum of four service users between the ages of 18 to 64 years who have mental disorders. Mr Phivos Joannides and Mrs Eftychia Joannides, who also run a number of other, similar homes in the immediate vicinity, own this home. The stated aim of the home is to motivate service users to live as full a life as possible with emphasis on education, training, social skills, maintaining links with families and friends and promoting cultures and traditions of those from ethnic minority backgrounds. The home is a two storey terraced family house. On the ground floor, there are two single bedrooms, one with en-suite facilities, and a separate bathroom with a toilet, a kitchen and lounge/ diner. On the first floor, there are two single bedrooms, a bathroom, a separate toilet and the staff office. There is a small back garden, with a variety of fruit trees. The home is situated in a residential area of Haringey and close to a large selection of Mediterranean restaurants, shops and community facilities located along Care Homes for Adults (18-65 years) Page 4 of 27 care home 4 Over 65 0 4 Brief description of the care home Green Lanes and in Wood Green Shopping Centre. St. Anns Hospital is about half a mile away. The fees are normally between #600 and #950 for each placement per week, and service users are expected to pay separately for items such as hairdressing and clothes. Following Inspecting for Better Lives the provider must make information available about the service, including inspection reports, to service users and other stakeholders. Care Homes for Adults (18-65 years) Page 5 of 27 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 over one day. The Registered Manager Chris Joannides and the Registered Provider Mrs. Eftychia Joannides assisted us throughout the inspection. The inspection consisted of meeting with and talking to people living in the home and with the Registered Persons. We also saw care and staff records and general home records. We also undertook a tour of the building. The home supplied with us with a good quality Annual Quality Assurance Assessment (AQAA), which we used in the inspection. Care Homes for Adults (18-65 years) Page 6 of 27 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 27 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 8 of 27 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. New residents can be confident that their needs will be fully assessed before they move in, so that they know the home can meet these needs. Evidence: At the time of the inspection, there were four people living in the home. Residents all come from North London boroughs. The home has not had any new admissions since the last inspection. We saw the files for all people living in the home. The files had a good range of assessment information completed by the home and by their referring agencies. The evidence we saw on peoples files was in line with the homes admissions policy and procedure. The Registered Manager said that each person has an initial review six weeks after their admission. There was also evidence on file that the local authorities had completed annual reviews of peoples needs and of multi-disciplinary assessments for peoples changing needs. Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: The home has a comprehensive service user guide, which we saw and each person had a signed contract in place and signed. Care Homes for Adults (18-65 years) Page 10 of 27 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. People living in the home receive good quality, well planned care to meet their needs and wishes and they are actively involved in planning their care. Residents are supported to make their own decisions and choices and work towards degrees of independance. Risks to their wellbeing are assessed and managed to protect their interests. Evidence: We saw the care files and plans for all four residents. The care plans were kept up to date and had been regularly reviewed. Peoples care plans covered a range of their needs, physical, social, emotional, spiritual and mental health needs. The home is registered for people with enduring mental health needs and there was good evidence that the home assesses and meets these needs. With all three residents we spoke to and case tracked through their files and Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: discussed with the Registered Manager, there was good evidence of how residents welllbeing had improved considerably and consistently since coming to live in the home. There was also good evidence of how peoples wishes are canvassed, planned for and met. These improvements were documented in care plans and reviews. Residents involvement in reviews was clearly documented and signed off by them. Both the Registered Manager and the Registered Provider were able to give sound overviews of the residents needs and wishes and how the home went about meeting them. We checked the daily notes for the residents. These were of reasonable quality. Residents we spoke to told us what it was like to live in the home and how much they liked being there. We observed good communication between the residents and the staff on duty. The staff we spoke to had a good understanding of the residents needs. All residents manage their own finances. Risk assessments were in place for a range of possible risks to people and these had been regularly reviewed in the files we saw. The last reviews had been done in this month. Examples of risks assessed included crossing the road, cooking, getting locked in the toilet, going missing, daily living activities, tripping over, being locked in the bathroom, managing finances, isolation, not eating, overeating, non-compliance with medication. There was also a risk assessment for one resident who goes out with one other to visit people in their homes to talk about her faith. The risks assessed were highly personalised and actions to protect the residents were well thought through. Care Homes for Adults (18-65 years) Page 12 of 27 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. Residents enjoy a good range of activities that meet their needs and preferences, including their cultural needs. They can organise their daily lives in ways that suit their needs. Contact with relatives and friends is supported in line with their wishes. Their rights and responsibilties are respected and promoted and they enjoy balanced and varied meals according to their preferences. Evidence: During the inspection, we were able to speak to three out of four of the residents. They told us about what actvities and interests they pursue. We also saw the evidence on their files about activities and spoke to staff. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: One person does cooking and some shopping for the home at the local shops, which the Registerd Persons said has been a good achievement for her, Another resident said she spends time partipating in her Christian religious community and enjoys this very much. She leads an active life in this community and said she appreciated the support the home gave her to do this. She also goes on day and overnight trips out of the home. Staff said that another resident, whom we didnt speak to and who communicates mainly non-verbally, spends time reading, writing and participates in one to one arts and crafts activities at home. One other resident goes to day centre three days per week. Residents have freedom passes and use public transport. The home also has a minbus for outings. Peoples cultural and religious beliefs are respected and supported. For example, as indicated above, one resident is very active in her Christian religious community and another resident is a Buddhist. The home is nicely decorated with a range of photos of residents at events, celebrations and on holiday. Most residents go on holidays annually, for example, to the seaside for a few days or to Greece. They are always accompanied by staff. We talked with one resident about how she is gradually building her confidence, with the support of the Registered Provider, Mrs. Johannides, to go on holiday overseas. Most people we spoke to had some family involvement and they are supported by the home to maintain these links. In the case of one resident without a family, the Registered Manager said that she has the support of an advocate, where needed. Residents meetings are held regularly and we saw the minutes. They recorded discussions about events and outings and noted the residents requests and food choices. There was a menu on the noticeboard, which appeared reasonable. It included peoples cultural food choices. Two dinner options were available, chicken or vegetable casserole. The food kept in the home appeared of very good quality and plentiful for peoples needs. Residents said they liked the food. The home records what food people eat each day. Care Homes for Adults (18-65 years) Page 14 of 27 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 receive appropriate personal care support, in line with their wishes. Their physical and mental health needs are assessed and met, with specialist support as needed. They are also protected by the medication policies and procedures. Evidence: Residents had all been asked about whether they needed support with personal care and this had been documented in their care plans. Some residents need prompting support. There was good evidence that the residents physical and mental health needs were assessed as and where necessary. Routine health care appointments were also planned for and appointments made. Residents are supported to attend hospital appointments if necessary. Residents also had six monthly medical reviews. Mental health support professionals are involved with the residents according to their needs. One resident said that living in the home had been a incredibly positive experience and created a vast improvement in her wellbeing. Living at Stanhope Gardens had saved my life. Now, I have a life, she said. Another resident said that they loved the quality Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: and ethos of rehabilitation in the home said that everyone was fantastic to them as residents. The home has reasonable medication policy and procedure and the Registered Provider, who is also a Registered Nurse, explained it to us and showed us the medication storage and administration arrangements in this home. A local Pharmacist delivers the medication monthly using a blister pack system. Staff prepare the medication for the week and two staff complete an audit. We sampled the medication records (MAR sheets) for two people and these were in good order, with no errors or omissions. Medication is stored in a locked cupboard in the kitchen. For one person who self medicates, there are safe arrangements in place and good storage in her room. The Area Manager said that he is currently writing a self-medication policy and procedure for the home. Staff who administer medication have been trained to do so. Peoples wishes in relation to death and dying had been ascertained and recorded. Care Homes for Adults (18-65 years) Page 16 of 27 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 and others supoporting them can express their views and concerns and know that these will be addressed appropriately by the home. Residents are also safeguarded from harm by the homes policies and procedures. Evidence: We saw evidence throughout the inspection that residents are encouraged to express their concerns and views. Residents told us that they were confident about how to express concerns and knew how to complain if they wanted to. We also saw the complaints policy and procedure and saw that residents have copies of this document. We saw the complaints records. No formal complaints had been recorded since the last inspection. The home has a copy of the local authoritys safeguarding policy and procedure. We discussed safeguarding with the Registered Manager. He said that the host local authority (London Borough of Haringey) had recently visited the home, checked the homes policy and procedure and left copies of posters and leaflets on how to do a safeguarding referral for the residents and staff. All staff have been trained in safeguarding and the Registered Manager said he is going to become a safegurding trainer for the staff. Care Homes for Adults (18-65 years) Page 17 of 27 Care Homes for Adults (18-65 years) Page 18 of 27 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. Residents live in a home that is well decorated, maintained and meets their needs. The home was clean and tidy throughout and residents said that they liked their physical surroundings. Evidence: The home consists of an ordinary two storey terraced house in the multicultural area of Haringey off Green Lanes. There are two bedrooms on the ground and two on the first floor. These bedrooms have have their own washbasins. The kitchen, dining porch and lounge are on the ground floor. There is a pleasant and accessible back garden. The home was in a good state of physical repair. It was a cold day and the home was kept warm and comfortable. We toured the building with the Registered Provider and saw three residents rooms. The bedrooms were highly personalised by the residents. Residents said they had recently chosen how their rooms were decorated. The commmunal spaces were comfortable and residents we saw throughout the day said they found the home a pleasant and homely space. There are photos of the residents enjoying life displayed throughout the home. Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: The home was clean and hygenic on the day of the inspection. Care Homes for Adults (18-65 years) Page 20 of 27 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 protected by the homes staffing arrangements, recruitment procedure and the way that staff are trained and supported. Evidence: On the day of the inspection, one staff member and the Registered Manager were on duty. The Registered Provider was also available during the inspection. The Registered Manager, who went out to interview for a new staff member during the inspection, told us about the staffing arrangments in the home and we saw the duty rota. There appeared to be sufficent staff on duty to meet the needs of the residents. The home is in the process of recruiting new permanent staff. The home has a satisfactory staff recruitment process. We checked two staff files, including the file of one new staff member. All staff had had pre-employment checks, including full Criminal Records Bureau checks, two written references obtained and photographic identification supplied. Staff had been trained in different mandatory training areas at different times and would benefit from having their training updated. The service has a strong committment to training staff and we are confident that they will easily make these improvements. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: Staff had had also received two monthly supervision, which was documented in their files. There are regular staff meetings which are minuted. Care Homes for Adults (18-65 years) Page 22 of 27 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 live in a well managed home that is run in their interests. They are consulted on a day to day basis and their health and safety needs are safeguarded. Evidence: The Registered Manager holds a Registered Managers Award. He demonstrated a good understanding of the residents needs and of proactive management. There was good evidence that the home consults regularly with the people who live there and with their families. We saw the minutes of regular residents meetings and saw the annual satisfaction survey results. The sampled surveys we saw had been completed by the residents and their views were positive. We checked the health and safety records and certificates. These were in good order and confirmed the information provided in the homes Annual Quality Assurance Assessment provided to CSCI. Fridge and freezer temperatures were taken daily and recorded to keep food safe.Accidents and incidents records were good, with clear Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: guidelines about what to do and actions to improve practice included. There is a good fire policy and procedures are followed. Regular fire safety checks had been carried out. However, the fire records indicated that there has not been a fire drill in the past six months. A requirement is given that the home has quarterly fire drills and that at least one of these drills take place after dark. There are health and safety risk assessments in place for the building and for key issues in the home (for example, building security, the risk of residents going missing, infection control). These risk assessments have been regularly reviewed and updated. The home regularly reports incidents and accidents to CSCI and the in-house procedures are good. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 1 35 18 The Registered Persons 30/04/2009 must ensure that staff had been trained in all mandatory training areas on a regular basis. Some staff training not up to date 2 42 12 The Registered Manager must ensure that the home has quarterly fire drills and that at least one of these drills take place after dark Fire drills must be done for resident and staff safety. 30/04/2009 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 26 of 27 Helpline: 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 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. 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