Inspection on 05/08/09 for Carlton and Pelham House

This is the latest available inspection report for this service, carried out on 5th August 2009.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Key inspection report Care homes for adults (18-65 years) Name: Address: Carlton and Pelham House 2 Pelham Road Bradford W Yorkshire BD2 3DB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Mary Bentley     Date: 0 5 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Carlton and Pelham House 2 Pelham Road Bradford W Yorkshire BD2 3DB 01274634913 01274634913 carltoncaregroup@homecall.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Carlton Nursing Homes Ltd Name of registered manager (if applicable) Mr John Wright Type of registration: Number of places registered: care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: 1. The registered person may provide the following category of service user only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categorie: Learning Disability, (Code LD) 2. The maximum number of service users who can be accommodated is 8. Date of last inspection Brief description of the care home Carlton & Pelham House is a new home and was built to be a care home. Up to 8 people can live at the home. There are 2 houses that are joined together. Each house has 4 bedrooms. Everyone who lives at the home can have his or her own bedroom. No one has to share a room. Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 8 Brief description of the care home In each house there is a kitchen, a dining room and a lounge for people to share. There are lots of bus services that pass the home. The home also has a car, and staff support people that live there to go out in the car. The home is near shops and a park. The home has a book that tells people who the service is for. The manager will give people a copy of this. The manager will give a copy of the inspection report to people who want to see it. The fees start at 1197.00 pounds per week. The fees are different for everyone because some people need more support than others. The fees include a holiday once a year. The manager will give people more information about what is included in the fees. Care Homes for Adults (18-65 years) Page 5 of 26 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 is what the inspector did when they were at the care home. The inspector did not tell the home they were going to visit. It was a surprise. The inspector talked to the people who live and work at the home. The inspector looked at some of the paperwork that the home has to keep. We looked at care plans, medicine records and some staff files. The inspector looked around the home. This was to make sure it is clean, safe and comfortable. Care Homes for Adults (18-65 years) Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 26 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 26 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. Peoples needs are assessed before they move in. People are involved in the assessment process and are given information to help them decide if the home is the right one for them. Evidence: The home told us they carry out a detailed assessment of peoples needs before they move in to make sure they will be able to meet the persons needs. People are invited to visit the service before a final decision is made. This usually involves a number of visits during the day and an overnight stay. This means that the person thinking about moving in and the people already living in the home have the opportunity to get to know each other. This was confirmed by people we spoke to during the visit and information in the care records. Everyone living in the home is given a copy of the Service User Guide. This includes detailed information about the service, for example how to raise any concerns. The information is presented clearly in large print with pictures. The Service User Guide is also available in a talking book format if required. Care Homes for Adults (18-65 years) Page 9 of 26 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 are involved in making decisions about the care and support they receive. Evidence: People have detailed plans of care setting out what support they need and how this support will be provided. We saw that people and/or those close to them are involved in drawing up and reviewing the care plans. There are risk assessments in place for areas of potential risk, for example smoking. Any restrictions in place are clearly documented and are kept under review. The care plans show that people are given appropriate support to manage their own finances. Records are kept of any money which the home holds for people and receipts are obtained for all transactions. The care plans show that people have access to a range of health and social care professionals and independent advocates where necessary. Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: People told us get the support they need to live independent lives. One relative who completed a comment card for us said my ------ needs are always of paramount concern and every effort is made to meet those needs. I am consulted and kept informed on a regular basis. Care Homes for Adults (18-65 years) Page 11 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to make decisions about their lifestyle, they are given appropriate support to follow their personal interests and develop new skills. Evidence: People told us that they can make decisions about what they want to do. The home told us that daily routines are flexible and arranged around how people choose to spend their time and this was confirmed by our observations during the visit. One person went out with a support worker in the morning to do their weekly grocery shopping, another person preferred to spend most of the morning in their room and went out in the afternoon. People are supported in keeping in contact with family and in developing relationships with their peers. Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: The care records have information about peoples interests and goals and the support they need or want from staff to follow these interests. One person told us they are interested in enrolling for a beauty course at the local college. Another person said they like to spend time on their computer researching information about model planes and boats. A number of people commented on the fact that the homes car it out of action and waiting to be repaired. They said they felt there should be transport available when people want to go out. This was discussed during the visit and the management team are aware that people are missing the convenience of having a car available. However, they said people are still able to go out and are being supported to use taxis or public transport. There is a minibus at the companys home is Huddersfield should it be required. Peoples privacy in respected and staff only go into peoples rooms with their permission. People are encouraged to take responsibility for keeping their bedrooms clean. People are supported to do their own cooking and can have their meals whenever they choose. The home keeps a record of what people eat so that they can check that people are having a healthy and balanced diet and provide additional support if necessary. Nutritional risk assessments are done and peoples weight is recorded. Care Homes for Adults (18-65 years) Page 13 of 26 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. Peoples personal and health care needs are met in a way that takes account of their preferences and abilities. Evidence: The care plans have information about peoples personal and health care needs. They are person centred and have information on the level of support people need and how they prefer this support to be given. People have an OK Health Check assessment every six months or more often if needed. This is an assessment of peoples overall health and is used to identify any areas where people need additional support. For example, if people need to have a dental check up. People are registered with local GPs and have access through their GP to a range of NHS services. People are supported in improving their health, for example one person is being supported to reduce their alcohol intake. Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: Medicines are stored safely in each persons room. Staff are only allowed to help people with their medicines when they have undergone training. The medicine records were up to date and showed that people are supported in receiving their medicines as prescribed. Care Homes for Adults (18-65 years) Page 15 of 26 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. People using the service are listened to and any concerns they have are taken seriously and acted on. People are protected from harm. Evidence: The home has a complaints procedure. People using the service are given information about the complaints procedures in a format which is appropriate to their needs. Surveys from people living in the home, relatives and health care professionals confirmed that they are given information about how to raise concerns. One health care professional told us that the home has responded appropriately to any concerns they have raised and they said the home had arranged an independent advocate for their client. There is a complaints log which shows that the home has not had any complaints since they opened in February of this year. They have received one compliment about the service. No complaints have been referred to us. There are policies and procedures in place to make sure people are protected. Staff have attended training on safeguarding adults and children as one of the houses is intended to provide services to 16 to 18 year olds. Staff spoken to had a good understanding of their responsibility to protect people and were aware of how to report any concerns they might have. Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: The company has an advocacy manager and a part of his role is to provide support and information to relatives of people living in the home. Care Homes for Adults (18-65 years) Page 17 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a clean, comfortable and suitably equipped place for people to live. Evidence: The is home is new and purpose built. It consists of 2 four bedroom houses. Each house has bedrooms on the first floor and a kitchen, dining room and lounge on the ground floor. The houses are decorated and furnished in a modern style and are appropriate to the needs of the people living there. Each bedroom has an en-suite with shower and people have keys to their rooms. People are encouraged to personalise their rooms and take responsibility for keeping them clean. One person showed us their room, it was clean and had lots of their personal belongings. There is a locked medicine cabinet in every bedroom so that peoples medicines can be stored safely. The kitchen is large and well equipped. People are supported to cook their own meals and everyone has a designated cupboard and a shelf in the fridge to store their food. Both houses have a domestic style washing machine and tumble dryer and people are encouraged and supported to do their own laundry. Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: There is a small garden at the front of the home which people can use. Care Homes for Adults (18-65 years) Page 19 of 26 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 given appropriate support by a trained and competent team of staff. People are protected because all the required checks are carried out before new staff start work. Evidence: People living in the home told us staff listen to them and act on what they say. They said staff treat them well. Relatives told us that staff are welcoming and supportive and always willing to be flexible. The staff files we looked at showed that all the required checks are completed before new staff start work. All new staff have a 12 week induction training programme. At the end of that they are enrolled for NVQ (National Vocational Qualification) training at Level 2. The NVQ training includes a module on caring for people with autism. Eleven of the 26 staff currently employed have obtained an NVQ at Level 2 in care. The home has on ongoing training programme which includes training on safeguarding adults and children, person centred care planning, challenging behaviour as well as mandatory training such as moving and handling, fire safety and infection control. Staff who completed surveys for us said they are given the training they need to meet peoples Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: needs. The deputy manager told us that because it is a new service staff supervision is done every month at present. Care Homes for Adults (18-65 years) Page 21 of 26 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. There are appropriate arrangements in place to make sure the home is managed safely and in the best interests of the people using the service. Evidence: The home is owned and run by Carlton Nursing Homes Ltd. The company operates a similar service in Huddersfield and therefore has experience and expertise in providing services to adults with a learning disability. The registered manager left a few days before we visited. The company is in the process of recruiting a new manager. In the meantime the home is being run by the deputy manager with support from the Operations manager and Advocacy manager. The deputy manager has completed the Registered Managers Award. The company are aware of the importance of appointing a new manager as soon as possible so that people can be confident the home is being managed by a suitably trained and competent person. The home completed the annual quality assurance assessment (AQAA) and sent it to Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: us in good time. It was clear and provided us with good information about the service. Two of the senior managers are designated to take the lead on issues relating to the Mental Capacity Act and Deprivation of Liberty. The majority of staff have attended training on these subjects and the remaining staff are booked to attend training over the coming months. The company has established systems for consulting with people using the service. Not all of these systems are in place at Carlton & Pelham House yet because it is a new service. However, people living in the home and their representatives told us that they are able to express their views and are listened to. There are suitable systems in place to make sure that the home provides a safe place for people to live and work. Care Homes for Adults (18-65 years) Page 23 of 26 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 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 37 The company should appoint a suitably experienced person to manage the home and the manager should apply for registration with the Commission. So that people can be confident the home is managed by a suitably experienced and competent person. Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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