Inspection on 23/11/06 for Carleton House

This inspection was carried out on 23rd November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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.

Other inspections for this house

Carleton House 03/02/06

Carleton House 16/08/05

Carleton House 01/03/05

Carleton House 01/05/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Carleton House 29/31 Carleton Street Morecambe Lancashire LA4 4NX Lead Inspector Mrs Jennifer Dunkeld 23 rd Unannounced Inspection November 2006 14:00 Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Carleton House Address 29/31 Carleton Street Morecambe Lancashire LA4 4NX 01524 831496 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Barbara Davidson Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd February 2006 Brief Description of the Service: Carleton house has been developed combining two semi-detached houses together to function as one care home. The three residents have a single bedroom each. The shared facilities are a lounge/dining room, a smoke room and a kitchen/diner where they prepare drinks for themselves and each other. This accommodation also offers bed & breakfast to two other people. The people who reside at Carleton house are prompted to do as much for themselves as possible and thereby enhance their independence. There is a beautiful garden to the rear with garden furniture, where service users enjoy relaxing and when weather permits and having a Bar-be-que The current fees are as set by the Local Authority as £286. Per person per week. Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This home has been inspected against the National Minimum Standards for Adults introduced in April 2002. This visit took place on 23/11/06 and was unannounced; this means that neither the service provider nor the residents were aware the inspection was to take place. In making the judgements contained in this report, the inspector has also considered: other visits that were made to then home; information supplied by the service provider and comments received from the residents/their relatives and from visiting professionals. In the report there are references to the “tracking process”, this is a method whereby the inspector focuses on a small group of residents. All records relating to these individuals are examined, along with the rooms they occupy in the home. Residents are invited to discuss their experiences of the home with the inspector. This inspection included discussion with the 2 of the 3 residents and the service provider, in addition to viewing the home. Two of the residents written plans of care were also viewed. The Care Plan is a document outlining the needs of the individual resident and how these are to be met. They cover all aspects of the individual’s life including health, personal care and social activities. Thereby ensuring people are content in the care they receive. The residents the inspector spoke with were happy with life at Carleton House. The service provider is a caring person who is committed to ensuring that the residents have a quality of life of their choosing. Comment cards were received from the 3 residents revealing that they are happy with the care they receive. Comments included; ‘I am very happy where I am and Barbara and Steve look after us very well. I love the holidays we have’ and ‘from the beginning I have always made my own decisions, sometimes Barbara gives me advice’. Comment cards were also received from 2 relatives who were full of praise for the quality of care that their son/daughter receive at Carleton House. Comments included; ‘My daughter loves living at Carleton House, I can see this when I visit her and she tells me all the nice things they do for her.’ And ‘our son and ourselves are very happy that he has found such a good and nice place to be and the care and attention he gets.’ A professional visitor commented ‘I have visited the home regularly over a number of years and consider the standard of care to have always been good in all areas.’ Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 7 As stated last year, the service provider is aware of her need to keep up to date with the ‘paper work’ such as up dating the written care plans. However the residents are very happy in their home and appear contented. They have a fulfilling lifestyle. The paper work while necessary rightly comes second to the needs of the residents. People confirmed that their needs are met. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ benefit from living in a home that can meet their assessed needs EVIDENCE: Each person admitted to the home in future would have a pre admission assessment this is when the prospective resident and their relative/representative will be asked a number of questions about the needs of the individual to ensure their choices, needs, preferences and aspirations can be met at the home. However two of the current residents have lived there for a number of years and there was no requirement at that time for an assessment prior to admission, however according to them their needs are fully met. The comment cards received from them reflect that they like living at the Carleton House and that they feel well cared for. Comments included; ‘‘from the beginning I have always made my own decisions, sometimes Barbara gives me advice’ and ‘I am very happy where I am and Barbara and Steve look after us very well. I love the holidays we have’ The other residents comment card states, ‘‘Barbara and Steve always help me with my Dentist and Doctor appointments and Barbara goes with me this is Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 10 very helpful’. The comment card from his family reflects; ‘Our Son and ourselves are very happy that he has found such a good and nice place to be and the good care and attention he gets’ He is able to go out and enjoy a social life of his choosing which he was unable to do prior to living at Carleton House. Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live at Carleton are cared for in a manner of their choosing and know that their needs will be met. EVIDENCE: The residents were aware of their rights and said that they are upheld. Their freedom of movement is not restricted; residents have a key to the front door. They stated that they can come and go as they choose and merely need to explain what time they will be back. The resident comment cards included the following comments “ We are always involved in the decision making’ ‘I am fully involved in the decision making” and ‘‘from the beginning I have always made my own decisions, sometimes Barbara gives me advice’ Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 12 Risk assessments have been developed covering such topics as are relevant to the individual resident for example administration of medication. It is evident that the service provider does enable residents to take calculated risks from the discussion with the residents who outlined how they are enabled to increase their independence. The three residents have been assessed as being capable of being on their own in the home for short periods of time. Each resident knows how to contact the Emergency Services and the service provider should the need arise. The people who live at Carleton House stated that they are very happy at Carleton House and that their every need is met. One comment card received stated ‘I am well cared for beyond my dreams’. The service provider ensures that all their needs are identified and goals set to meet the needs. One resident spoke of her medical needs and how they are being met. The inspector viewed her care plan as part of the ‘Tracking process’. This confirmed that she is consulted about her needs and has written part of her care plan herself. The residents daytime activities are chosen by themselves and include attending college classes, swimming etc. Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are enabled to have fulfilling lifestyles of their choosing and benefit from being part of the local community. Arrangements and planning to provide nutritional food are good. The residents enjoy a healthy diet. EVIDENCE: One resident goes to visit her family on a regular basis and her friend often goes with her. The comments received from relatives were indicative of their visits to Carleton House and how they are always made welcome. They were full of praise for the service provider, Barbara and for her honesty and openness. They said that Barbara actively encourages family contact. Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 14 One man has no family but he said he sees Barbara and Steve and his fellow residents as his family. Each resident has tasks/household chores to complete to ensure the home runs smoothly. The residents said that Barbara does not only make sure we get one holiday a year but we get two holidays abroad each year and go for 2 weeks. They spoke enthusiastically about their recent 2 weeks in Turkey. The inspector spoke with 2 of the 3 residents who stated that they have a fulfilling lifestyle and enjoy various activities are enabled to continue their training. At the time of this visit one resident was embroidering Christmas cards and these were very neatly created. Another resident was watching a film on the homes wide screen TV. The residents spoke of their enjoyment in their lifestyle. They access local college, sports centre, clubs etc and as such are very much part of the community. They spoke enthusiastically about the meals they have at Carleton House. They help choose and prepare meals. One resident explained that ‘We had stew and dumplings last night for our meal and oh they were good’ The residents generally choose to dine in the dining room this is a congenial setting. Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personal support offered is in a way that suits the resident’s needs and preferences meaning that, residents remain satisfied and contented in their care. EVIDENCE: The resident’s care files viewed as part of the ‘tracking process’ reflected a list of health care professionals involved with the individuals, for example; Doctor, Community Mental health Team, Dentist. The advice previously offered by the Pharmacist inspector 25/9/05 in relation to the storage and administration of medication has been acted upon ensuring the safe procedures are followed. Medication is securely stored. The homes policies and procedures are robust and explicit. Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 16 Medication is administered to people in a way that suits the resident’s needs and prescribed requirements. One resident partly self medicates following a risk assessment and has a secure place to store her medication. The residents confirmed that Doctors appointments are made as and when required, with staff support. The comment card received from one resident states; ‘‘Barbara and Steve always help me with my Dentist and Doctor appointments and Barbara goes with me this is very helpful’ The people who live at Carleton House stated that they are well cared for and that all their needs are met. The people who currently live at Carleton House are able to attend to their own personal care needs such as bathing and toileting. The residents choose when to go to bed/rise and what clothes etc to wear. Prompting is given when necessary. The residents spoke of their enjoyment in life as they are enabled to be as independent as possible. Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 an 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live at Carleton House are protected from abuse by the policies and practices within the home. EVIDENCE: The homes policies and procedures are in line with the Department of Health guidance ‘No Secrets’ and as such the manager and family are aware of what actions to take should abuse of any type be suspected. The residents said they feel safe living at Carleton House and were aware of what abuse is. The outer doors have appropriate locks on them to prevent intruders. Each of the residents has a key to the front door to let themselves in whenever they go out unescorted. The residents explained that if they had any concerns they would tell Barbara the service provider, and that she would resolve it.. The residents are aware of how to complain but state they are very happy in the care they receive. The comment cards received reflected that the relatives of the residents were also aware of how to complain but had never had a need to do so. Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 18 Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Carleton House is a clean and safe environment, which is maintained to a good standard. The residents feel safe and their accommodation meets their needs. EVIDENCE: The home was seen to be clean, hygienic and free from any offensive odours. The home is maintained to a very high standard and the residents take pride in their home assisting to keep it clean although they sometimes need prompting to do so. The premises are safe and accessible to all the residents. The furnishings are of good quality and add to the homely atmosphere. The residents spoke highly about their lovely home. They all enjoy the new 42 inch TV. Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 20 Each resident has a bedroom, which reflect his or her hobbies and interests. For instance on resident likes cars and has several model cars displayed in his room and picture of a Ferrari on his wall. Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents benefit from living in a home where their needs are fully met by people who are competent to do so. EVIDENCE: The service provider, partner and family provide all the care to people living at Carleton House. The service provider has a wealth of experience and has in the past attended a number of courses in order to meet the needs of vulnerable people. The residents stated they are happy living at Carleton House and that their needs are well met. Comments such as “We are well looked after, we really are” “Barbara is lovely, she and Steve are good to us they are always treating us when we go out” The atmosphere is one of caring for and about each other which is nurtured by Barbara (home owner) There was a relaxed, open atmosphere during this visit where the residents were encouraged to speak freely. Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 22 Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ benefit from living in a home that is well managed. EVIDENCE: Mrs Davidson (Barbara) consults the residents on a daily basis about the quality of the care they receive. A more formal form of quality monitoring has been developed, that is a Residents questionnaire. These were seen to reflect the residents are content in the care they receive. The comment cards received from the relatives as part of this inspection process reflected the following; My daughter loves living at Carleton House, I can see this when I visit her and she tells me all the nice things they do for her.’ Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 24 The service provider is aware of the need to protect vulnerable residents from hazardous situations and has had thermostatically controlled valves installed to all hot water outlets to protect the residents from accidentally scalding themselves. The home is well maintained. Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 x Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 26 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Carleton House DS0000009919.V300922.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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