Care Home: Weka House

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What the care home does well The home provides a good level of support to residents who have complex needs and encourages them to be as independent as possible. Their mental health is monitored closely. Residents have access to health services and their risk assessments and care plans are reviewed regularly. Potential residents to the home have detailed assessments carried out before they move in so that staff are aware of their needs. The home is cleaned and maintained to a good standard and has a relaxed and supportive atmosphere. Staff receive the training they need to carry out their work effectively. What has improved since the last inspection? Seven requirements were issued at the last key inspection. The manager has now complied with all of these. The registered provider of the organisation has taken over the management of this home and has applied to be registered with the Commission. The manager will also shortly be applying for a relevant management qualification. The staff of the home are not moved around to work at other services so their supervision relates much more to the people they support. Staff keep records of food provided to residents as well as checking that residents are spending money on adequate supplies of nutritious and appropriate food. The garden has been tidied up and some old and worn cooking utensils have been replaced. The manager has addressed the pest control issue. What the care home could do better: One new requirement has been issued as a result of this inspection. A record of the servicing of the fire alarm must be maintained at the home for inspection and a copy sent to the Commission to provide further evidence that the fire alarm is being serviced on a regular basis. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Weka House 4 Elsden Road 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, 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: David Hastings     Date: 1 9 1 2 2 0 0 8 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 25 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 25 Information about the care home Name of care home: Address: Weka House 4 Elsden Road London N17 6RY 02088088428 02088083748 akwahouseltd@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Alexio Kadira care home 4 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home 4 Weka House is a care home located in a residential area of Tottenham, near Bruce Grove and near a park. It is registered to provide a service for up to four people with a mental disorder. Mr Alexio Kadira is the proprietor and has been the registered manager of the home. Mr Kadira has a similar care home close to this home. He has recently opened another home for which he is registered to be the manager. There is a manager employed for Weka House. The home is an ordinary terraced house, on a domestic scale and fits in well with the surrounding area. Each resident has a single bedroom and one of these has en suite facilities. The communal facilities in the home include a bathroom with a shower, two toilets, a lounge, a dining area, a kitchen and a rear garden. Information about the home including service users guide and the CSCI inspection reports are available from the home by contacting the providers. The weekly fees of the home range between seven hundred and fifty pounds to one thousand four hundred and fifty pounds per week. Currently there are three men living at Weka House. Care Homes for Adults (18-65 years) Page 4 of 25 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: We carried out this unannounced key inspection of this residential home on Friday 19th December 2008. We were assisted by the registered manager and the deputy manager of the home who were open and helpful throughout the inspection. We spoke with one person who uses the service and two staff members who were on duty. We looked around the home and examined various care records, staff files and health and safety documentation. The home also prepared a self assessment (AQAA) and this was submitted to the Commission for Social Care Inspection in May 2008. This information was used as part of the inspection. Care Homes for Adults (18-65 years) Page 5 of 25 Care Homes for Adults (18-65 years) Page 6 of 25 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 25 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 25 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. People can be assured that their needs will be assessed before they move into this home. Evidence: We examined two pre assessments for people who have been admitted to the home. These assessments were detailed and clearly identified the individual needs of each person. The manager told us that, after receiving information from the social worker, he would visit the potential resident and carry out his own assessment. After preparing an initial plan of care, the person would be invited to visit for a day and for an overnight stay to see if they like the home. The manager also told us that after four to six weeks a review of the residents placement would take place to see if they wanted to stay at the home on a more permanent basis. Care Homes for Adults (18-65 years) Page 9 of 25 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 at this home are supported to take risks as part of an independent lifestyle, but at the same time are supervised and monitored if they pose a risk to other people. Their needs are recorded in their individual care plan, which is reviewed on a regular basis and updated if their needs change. Evidence: We examined two residents care files. Both these residents had an assessment of their needs and a risk assessment, which detailed their individual risks, for example illicit drug use and violence. There was a written plan of care for both residents and these plans had been reviewed on a regular basis, every three to four months. Care plans also detailed relapse indicators for staff so they were aware of the signs to look out for if a resident was becoming more unwell. Daily records are being kept on residents progress and well being and these include comments on their daily activities and current mental health. Care Homes for Adults (18-65 years) Page 10 of 25 Evidence: Records showed that residents are encouraged to take responsible risks and to be as independent as possible, for example making their own meals with a minimum support. At the same time, staff take action to minimise known risks. One resident is not allowed out of the home without one-to-one supervision by staff as there is an assessed risk to members of the public if he were to go out unaccompanied. Care Homes for Adults (18-65 years) Page 11 of 25 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. Although residents are not using local services and leisure activities available to them, the home is trying hard to encourage people to take up these opportunities. Residents enjoy relationships with their families. Evidence: None of the three residents are using local day services, social clubs, sheltered employment opportunities or education facilities on any regular basis. The manager said that one person is not able to attend local day centres and clubs because of assessed risk. The manager explained that this person had been supported to visit centres but that the centres had not accepted him. Another resident was said to avoid engaging with staff at the home and outside professionals. Two of the three residents are able to go out independently and do so on a regular basis. One resident has oneto-one staffing in the home and goes out regularly with a member of staff to his local Care Homes for Adults (18-65 years) Page 12 of 25 Evidence: pub for lunch and for walks in the local park. An annual trip to the coast for a day along with other local homes is organised. The manager said that other local mental health homes also get together for a meal in a restaurant at Christmas, which the Weka House residents can go to if they wish. The manager said that relatives are encouraged to visit and that the manager and staff offer them support as well. This was confirmed by the resident we spoke with and by the records kept of visitors to the home. The home employs an activity worker and it was clear from discussion with the deputy manager that the staff at the home try hard to encourage residents to take part in activities. One person needs support to cook and the other two residents are able to cook independently. Records were being maintained of food items the residents were buying so staff can check they are eating properly. Records were also being maintained of the food provided to the resident who requires help with cooking. There was fresh fruit and vegetables in the kitchen. The resident we spoke to said he liked the food at the home. The kitchen was clean and cooking utensils, including pots and pans had been replaced. Care Homes for Adults (18-65 years) Page 13 of 25 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. People living at this home receive support with personal care when needed and are protected by the homes procedures for dealing with medication. Their mental health is monitored and they are given appropriate support by staff and other specialist services. Evidence: The deputy manager told us that one resident requires support from staff with washing and bathing and the other two residents are independent with their personal care. The resident we spoke with told us that staff were respectful and thoughtful about his privacy. We observed staff knocking on peoples doors before entering. We examined the health care records of all three residents. The health records showed that residents health needs were known and addressed. All residents see their GP when needed and are encouraged by the home to visit their GP every three months for a health check. At present, only one is willing to do this but the deputy manager said all residents will visit their GP if they feel unwell. Records showed that one person sees a dentist on a regular basis. The manager said that the others are encouraged to but Care Homes for Adults (18-65 years) Page 14 of 25 Evidence: the decision as to whether or not to access dental care is their own. We examined satisfactory records in relation to the receipt, administration, storage and disposal of medication at the home. The use of illicit drugs is an area of concern at this home for two residents and this is clearly documented on individuals risk assessments. Staff monitor the mental health of the residents on a daily basis and record this monitoring. We saw records that indicated that reviews are taking place with residents social workers and or mental health professionals. Care Homes for Adults (18-65 years) Page 15 of 25 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. The home has a clear complaints procedure and appropriate procedures to protect residents from abuse, neglect and self harm. Evidence: The home operates a satisfactory complaints procedure and there have been no complaints made about the home since the last inspection. There have been no adult protection investigations about residents either. The home has an adult protection procedure to guide staff on what to do should they have suspicions of or receive a disclosure of abuse. Staff have received training in adult abuse and further training has been planned for the coming year. Staff we spoke with were clear about their responsibilities to report any suspicions of abuse to the appropriate person. Some staff have also received training in managing challenging behaviour and mental health awareness. The financial arrangements also protect residents, as the manager does not act as an appointee for handling the financial affairs of any residents. Two residents manage their own finances and one residents money is managed by their relative. Records are kept of the management of personal allowances. Care Homes for Adults (18-65 years) Page 16 of 25 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 benefit from a homely environment with satisfactory facilities. Evidence: Weka house is located in a residential street in North Tottenham. The home is located with easy access to a local park, shops, pubs and other amenities. We looked at all the communal rooms in the house, the garden and one of the bedrooms. There are four single bedrooms, one of which has en suite facilities. There is a television and music system provided in the communal lounge, which some residents use. On the day of the inspection the home was clean and satisfactory measures were in place to minimise the risk of cross infection. For example anti bacterial soap and paper towels were available in all toilettes. The home is decorated and maintained to a good standard. Building materials had been removed from the garden area and the manager has called in pest control to advise about a prior insect infestation. These were two requirements from the last inspection that have now both been complied with. The resident we spoke with said he liked his room and confirmed that the home was regularly cleaned by staff. Care Homes for Adults (18-65 years) Page 17 of 25 Care Homes for Adults (18-65 years) Page 18 of 25 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. People are supported by staff who have been properly recruited and who are receiving training relevant to their job. Evidence: We looked at staff rota records, discussed staffing issues with the manager and deputy manager, looked at the staff training schedule for 2008/9, talked to one staff member and examined the files of four other staff members. At night there is one person awake on duty and this person is able to call a manager if support is needed. During the day the rota shows that there are always two staff on duty and when the manager is on duty there are three. One resident has one to one staffing throughout the day and is not allowed to leave the home without a staff escort. Staff we spoke to were positive about the training offered by the organisation and there were relevant training certificates in staff files. Training for staff includes mental health, managing violence, substance misuse and adult protection. The deputy manager told us that staff no longer move around so much between homes in the organisation. This means that supervision given to staff is now more relevant to the people they support. Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: Staff files we examined contained the required information needed to protect residents from unsuitable staff being employed. This included proof of identity, written references and enhanced criminal record checks. Care Homes for Adults (18-65 years) Page 20 of 25 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. The manager understands the needs of the people who are supported at the home. Residents at the home can be assured that the home is making good progress with quality assurance and health and safety matters. Evidence: Since the last key inspection in 2007 the registered provider of the organisation has taken over the management of the home. He told us that he has applied to the Commission to be the registered manager as well. The manager has looked into applying for the relevant NVQ 4 management training but was advised by the training organisation to wait as there is a new course coming out soon. This will be monitored at future inspections. The home has satisfactory quality assurance systems and we saw records that staff have regular one to one meetings to assess how people feel about the service. We also saw that quality satisfaction surveys have been sent out to residents and other stakeholders. Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: Satisfactory records were examined in relation to fire safety. There were records of regular fire drills at the home. The fire alarm and emergency lighting are checked every week. Emergency lighting had been serviced on 16/07/08. The gas safety certificate was dated 10/12/08. The electrical installation checks were last carried out in 2004. The deputy manager was reminded that this will need to be updated in 2009. Information we received from the home prior to the inspection indicated that the fire alarm was last service in 2007. The deputy manager told us that this had been recently serviced however the certificate was not found. A requirement has been issued that a copy of the current fire alarm certificate is sent to the Commission and the original certificate is kept at the home and available for inspection at all times. Cleaning chemicals were being stored appropriately in a locked cupboard. Care Homes for Adults (18-65 years) Page 22 of 25 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 23 of 25 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 42 23 The registered person must 13/03/2009 ensure that a copy of the current fire alarm certificate is sent to the Commission and the original certificate is kept at the home and available for inspection at all times. This is to ensure that evidence is available for inspection that the fire alarm is being regularly serviced 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 24 of 25 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 25 of 25 - 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. You have been warned!