The Care Quality Commission
  • Care Home
  • Care home

Archived: Edinburgh House

36 Forty Avenue, Wembley, Middlesex, HA9 8JP (020) 8908 4151

Provided and run by:
Spanish and Portuguese Jews Home for the Aged

Important: The provider of this service changed. See new profile

All Inspections

12 August 2014

During a routine inspection

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, is the service effective, is the service caring, is the service responsive, is the service well led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed, and the records we looked at. If you want to see the evidence which supports our summary please read the full report.

We spoke with five people who used the service, five relatives, the registered and deputy manager, the resource officer and four staff members. We reviewed the care plans of four people.

This is a summary of what we found:

Is the service safe?

People's care plans were personalised and identified the required level of care and support required, including how any risks were to be managed.

During our inspection we assessed how the Mental Capacity Act (MCA) 2005 was being implemented. This is a law which provides a system of assessment and decision making to protect people who do not have capacity to give consent. We also looked at Deprivation of Liberty Safeguards (DoLS). DoLS aim to make sure people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom. We saw some people were unable to leave the home without the assistance of staff. This may mean deprivation of liberty authorisations were required.

Procedures were in place for dealing with emergencies and staff were suitably trained in regard to keeping people safe. We saw systems were in place to protect people against the risks associated with medicines.

Is the service effective?

Staff had an understanding of people's care and support needs and knew them well. Staff were friendly in their attitude towards people and had a good rapport with them. We saw staff co-operating with each other and working as a team to support the needs of people. Staff assessed people's health and care needs with the person and their family members. Staff told us care plans assisted them to meet people's needs.

Staff were able to attend relevant training and told us they were supported in their roles. However, staff did not receive appraisals feedback on their performance or have an opportunity to identify any learning needs in a formal appraisal. We have asked the provider to tell us how they will make improvements and meet the legal requirements relating to supporting staff.

Is the service caring?

All the people we spoke with told us they felt safe in the care of staff. People's relatives told us they felt their family was safe in the care of staff.

Care staff showed patience and gave encouragement when supporting people. People and relatives were all positive about staff. People told us they were, 'Good,' 'Very Good' and 'Quite Caring." One relative said, 'Staff are absolutely lovely. All the staff are efficient and delightful.' Another relative said staff were, 'Kind, helpful, responsive and nothing is too much trouble.' A third family member said staff were, 'Very highly regarded.'

Is the service responsive?

People took part in activities within the home and the wider community. The home had an activities co-ordinator. People's preferences, interests and dietary choices were recorded, and care and support was provided in accordance with the wishes of people who used the service and their families.

People and family members told us they knew how to make a complaint. We saw there was a process in place to respond to any issues of concern.

Is the service well-led?

People and family members told us the registered manager held an open door policy. We saw the registered manager responded to incidents and complaints appropriately.

All members of staff we spoke with were clear about their roles and responsibilities.

14, 15 October 2013

During a routine inspection

During the inspection we spoke with most of the people who used the service, eight visitors, three care staff, a cleaner, a cook, a senior care worker, and the registered manager. People who used the service told us that they were happy living in the home. They said the staff were kind and treated them well. We saw people who used the service approach staff without hesitation and they accessed their bedrooms and the communal areas freely.

We saw staff supported people to make choices. People told us that they made decisions about their care. Best interest decisions were made when people were unable to consent about matters to do with their care and treatment.

Numbers and skill mix of staff were flexible to ensure people's needs were met. Staff knew about their roles and responsibilities in meeting the needs of the people whom they supported. Staff interacted with people who used the service in a respectful and sensitive manner. Comments from people who used the service included 'I am looked after very well, I can't fault the place,' 'they are very good here,' and 'I am happy here.'

People who used the service had a plan of care that included up to date information about the individual support and care they needed. People's health, safety and welfare were protected as they received the advice and treatment that they needed from a range of health and social care professionals.

Records were up to date and kept securely.

29 May 2013

During an inspection looking at part of the service

We carried out this unannounced inspection to check if the provider had complied with a compliance action from a previous inspection of the service. We spoke with a relative, four people who used the service and four staff. We inspected the premises and checked maintenance records to make a judgement as to whether the provider was meeting Outcome10 : Safety and suitability of premises and was compliant with Regulation 15 HSCA 2008 (Regulated Activities) Regulations 2010.

At this inspection we found that the provider had taken action to ensure that people who used the service were cared for in safe and accessible surroundings that supported their health and welfare.

17 January 2013

During a routine inspection

We spoke with eight people who use the service and three relatives. They indicated that people had been treated with respect and dignity. Their views can be summarised by the following comment, 'I am well looked after, the care is excellent and they treat me with respect.'

People and their relatives informed us that the care needs of people had been attended to and they had access to medical services. Assessments, including risk assessments had been carried out. Care plans had been prepared and these were reviewed regularly. The home had a varied programme of social and therapeutic activities. There were suitable arrangements for the administration of medication.

The premises were clean and there were suitable arrangements in place to prevent infections. We however, noted that some window restrictors were not in place and there was no evidence of a fire risk assessment.

There were effective quality assurance systems in place. Complaints made had been responded to.

2 September 2011

During an inspection looking at part of the service

We did not speak to anyone using the service on this occasion, as this was a review of the safe handling of medication following a Warning Notice issued on 4 August 2011 in respect of medication.

However the inspection showed us that the service enabled people to self-medicate or assisted them in self medication. For those being fully supported by the service with their medications, we saw that care workers remembered when medication was needed and gave it promptly.

29 July 2011

During an inspection looking at part of the service

We received a lot of positive comments about the overall services. These typically included, 'It's a very nice home' from someone who uses services, and 'I can't fault anything' from a relative. People generally told us that there were no complaints but they knew what to do if there were.

People told us that they are treated with respect. A typical comment was, 'Staff are generally attentive.' Relatives spoken with confirmed staff attentiveness, with comments such as 'Great respect is shown to people.'

People confirmed that they are supported to make choices around their care and support, and the majority of people told us that the service meets their needs. A few people felt that there had been times when staff were too busy to effectively support them, however the majority of people told us that there are enough staff. Comments included, 'The staff come quickly.'

Relatives' comments included, 'The atmosphere is rather good. Residents seem happy.' Relatives provided examples of how the care had helped to improve people's quality of life. They also confirmed that the service keeps them informed, and that they found there to be enough staff to meet people's needs.

People raised no concerns about medication management at the service. We have however found there to be major concerns in this area.

14 December 2010

During an inspection in response to concerns

We received comments from residents, relatives and stakeholders as part of this review. The majority of comments were received during the site visit.

In terms of care and welfare, there was a mixture of comments. A relative told us that the service provides 'exemplary care'. A resident told us, 'Staff are generally able to help those that need it'. Another talked about getting good nail and skin care support, and said, 'The staff are alright.' All residents confirmed that they could see a doctor when needed. Most said that they have no concerns with how the service handles health matters. One added that the service does what the GP advises them to do. A relative explained how the service has supported his wife to access specific health professionals.

Some people commented less positively about care and welfare. A relative was concerned that their mother had been injured three times whilst at the home, in each case whilst being supported to move by staff. Another relative explained in detail their unhappiness with the service's response to their mother having falls. A visiting professional also had concerns.

In terms of safety and responsiveness of the service, one resident said that she has a call-bell in her room. When she operates it, staff come quickly enough. Another gave an example of how staff provided her with the support she needed one night. A third told us that if they need staff at night, they use the call-bell and someone comes. However it can sometimes take '15-20 minutes' with staff explaining that they were busy.

One resident told us that, 'everything's in a hurry' and at times there is no-one in the lounge to help when they need to use the toilet. A relative commented that they have seen times when only one staff member is present in the lounge and so residents sometimes have to wait to have requests addressed. Another relative said, 'I have often been in there when people are shouting for carers or require the bathroom and there is no carer around.'

In terms of cleanliness and infection control, the many comments received ranged from 'It's clean enough' to 'The home is kept very clean'. One resident praised the cleanliness of the toilets especially. One relative was however unsure whether stools used for residents to rest their legs on are disinfected to avoid cross-contamination.

Residents said that medication is always given when it is supposed to be. One resident commented, 'They chase you for it' if it is not taken, and that 'they watch that you take it.' When we asked one resident about getting pain-relief when they wanted, they said, 'Painkillers are like sweets here.' We later saw them being offered Paracetamol as per their medication chart, which they refused.

We were told about people's experiences of the management of the service. Some people were very positive in their feedback. Comments included, 'It is a very well run home', 'it's very good here', 'it's a marvellous home' and that the manager is a very strong person. Other people were unhappy with aspects of the home's management. Comments included that management were not responsive, that 'the manager gives orders to everyone', and that the manager is unapproachable.

Residents and relatives told us of their experiences of complaints processes in the home. People told us that they have, or know where to find, a written complaints procedure. No-one raised problems with accessing it. One resident told us that they know how to complain, but added, 'I've never needed to.'

Some people were however unhappy with complaints processes. The common theme was insufficient action by the service to address matters. As one person told us, 'We get given excuses and nothing changes'. Another stated that they had spoken with the manager about a certain matter on a number of occasions but that no improvements appeared to have been made.