Inspection on 03/02/06 for Carleton House

This inspection was carried out on 3rd February 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 23/11/06

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 Unannounced Inspection 3rd February 2006 &1st March 2006 10:00 Carleton House DS0000009919.V270532.R01.S.doc Version 5.1 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.V270532.R01.S.doc Version 5.1 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.V270532.R01.S.doc Version 5.1 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.V270532.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th August 2005 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 Carleton House DS0000009919.V270532.R01.S.doc Version 5.1 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 year, all registered Care Homes are to be inspected at least twice and both visits can be unannounced. The first day of this inspection was unannounced and as such neither the service provider nor the residents were aware the inspection was to take place. People were about to go out so the visit was brief with arrangements made to complete the visit on another date 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 3 residents and the homeowner, in addition to viewing the home’s required written information such as policies and procedures. 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 homeowner 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. 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 ‘I think Barbara is a wonderful person and all the residents think a lot about her and Steve’ What the service does well: Carleton House DS0000009919.V270532.R01.S.doc Version 5.1 Page 6 The homeowner has developed a very homely environment where people care about each other. Indeed the comment cards received from the residents stated ‘I like living at Carleton House and I like the nights out we have’ I like going on the holidays, before I came to live at Carleton House I had never had a holiday’ I like Barbara very much ‘(home owner) Other comments included ‘I like living at Carleton House because we are well looked after beyond my dreams’ ‘We are taken on holiday abroad to a five star hotel’ The residents state that Barbara (the home owner) is a kind person who looks after them well. The home is maintained to a high standard The home is run around the needs of the people who live in the home and their activities. The homeowner ensures that people have a healthy, balanced diet. What has improved since the last inspection? What they could do better: The homeowner 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 Carleton House DS0000009919.V270532.R01.S.doc Version 5.1 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Carleton House DS0000009919.V270532.R01.S.doc Version 5.1 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.V270532.R01.S.doc Version 5.1 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): None of these Standards were assessed during this visit as the key standards were fully met during the previous inspection EVIDENCE: Carleton House DS0000009919.V270532.R01.S.doc Version 5.1 Page 10 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 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 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.V270532.R01.S.doc Version 5.1 Page 11 Carleton House DS0000009919.V270532.R01.S.doc Version 5.1 Page 12 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): 15 & 16 The residents have a fulfilling lifestyle with opportunity to maintain family contact and friendships. They live in an environment where their rights will be respected. EVIDENCE: One resident spoke of visits to his parent’s home and also of his mum visiting him at Carleton House. Another resident goes to visit her family 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 homeowner, Barbara and for her honesty and openness. They said that Barbara This home has been inspected against the National Minimum Standards for Adults introduced in April 2002. This year, all registered Care Homes are to be inspected at least twice and both visits can be unannounced. The first day of this inspection was unannounced on 25th August 2005 and was followed up by an arranged visit on 9th September 2005 in order that the inspector could talk with the homeowners. The 2 visits lasted for 4hrs in total and covered various aspects of care. Carleton House DS0000009919.V270532.R01.S.doc Version 5.1 Page 13 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 is not to the exclusion of the other residents who contributed in many ways. This inspection included discussion with residents, staff and the homeowners who manage the home on a day-to-day basis. The inspector also viewed the home’s required written information such as the resident’s plans of care. Each resident has a written plan of care, which 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 Tylecote. The staff enjoyed their work at Tylecote and spoke to the inspector in a professional manner about the residents. The inspector spoke with all the residents during this inspection revealing that the residents are happy with the care they receive. actively encourages family contact. One man has no family but he said he sees Barbara and his fellow residents as his family. The residents said they have their rights respected at Carleton House and that Barbara ensures that other people outside of the home are aware of their rights. 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 to holidays abroad each year and go for 2 weeks. They spoke enthusiastically about their forthcoming 2 weeks in Turkey. Carleton House DS0000009919.V270532.R01.S.doc Version 5.1 Page 14 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): 19 & 20 The people who live at Carleton House are supported to ensure their physical and emotional health needs are met. Medication is administered to people in a way that suits the resident’s needs and prescribed requirements meaning that, residents remain satisfied and contented in their care. EVIDENCE: The 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 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. One resident partly self medicates following a risk assessment and has a secure place to store her medication. On the day of the 2nd visit one resident had a GP appointment to ascertain the cause of her current health condition. Carleton House DS0000009919.V270532.R01.S.doc Version 5.1 Page 15 The residents confirmed that Doctors appointments are made as and when required, with staff support. The people who live at Carleton House stated that they are well cared for and that all their needs are met. Carleton House DS0000009919.V270532.R01.S.doc Version 5.1 Page 16 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): 23 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 staff 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 and stated that they would tell Barbara if anyone tried to abuse them. 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. Carleton House DS0000009919.V270532.R01.S.doc Version 5.1 Page 17 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): 30 The residents live in a safe and hygienic home which gives them contentment within their environment. 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. The inspector viewed policies and procedures relating to infection control and found them to provide good guidance to staff in reducing the risk of cross infection. Policies and procedures also appeared to be in line with relevant guidance and legislation. Carleton House DS0000009919.V270532.R01.S.doc Version 5.1 Page 18 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 EVIDENCE: The homeowner, partner and family provide all the care to people living at Carleton House. The homeowner 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” and “I am well cared for beyond my dreams”. The atmosphere is one of caring for and about each other which is nurtured by Barbara (home owner) Carleton House DS0000009919.V270532.R01.S.doc Version 5.1 Page 19 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): None of these Standards were assessed as the Key standards were met during the previous visit EVIDENCE: Carleton House DS0000009919.V270532.R01.S.doc Version 5.1 Page 20 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 x 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 x 23 3 ENVIRONMENT Standard No Score 24 x 25 x 26 x 27 x 28 x 29 x 30 4 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 x 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 3 16 3 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 3 x x x x x x x x Carleton House DS0000009919.V270532.R01.S.doc Version 5.1 Page 21 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.V270532.R01.S.doc Version 5.1 Page 22 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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