Inspection on 07/04/08 for Carlton Bridge

This inspection was carried out on 7th April 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Carlton Bridge 30/04/07

Carlton Bridge 11/12/06

Carlton Bridge 01/06/06

Carlton Bridge 19/12/05

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOME ADULTS 18-65 Carlton Bridge 42 Woodfield Road London W9 2BE Lead Inspector Ffion Simmons Key Unannounced Inspection 7th April 2008 09:50 Carlton Bridge DS0000065284.V361979.R02.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 Carlton Bridge DS0000065284.V361979.R02.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. Carlton Bridge DS0000065284.V361979.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Carlton Bridge Address 42 Woodfield Road London W9 2BE 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) 020 7286 4032 F/P 020 7286 4032 The Westminster Society Manager post vacant Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Carlton Bridge DS0000065284.V361979.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service 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 categories: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 8 30th April 2007 Date of last inspection Brief Description of the Service: Carlton Bridge is a residential care home for eight people with a learning disability. There are currently 4 men with significant care needs living in the home. Stadium Housing Trust owns the property, Westminster Society, a voluntary organisation, provides the care and staff and Paddington Churches Housing Association are responsible for the property management. The home is located near the Harrow Road, close to shops and other community facilities. Transport links are very good with both tube and buses near by. Carlton Bridge is a modern, terraced four-storey property. The service users’ rooms are arranged over the first, third and fourth floor. Lounge/dining rooms and kitchens are situated on the ground and second floors. There is a spacious lift to all floors and all parts of the home are accessible to wheelchair users. The weekly fees for the service is £2, 095.40. Carlton Bridge DS0000065284.V361979.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This key unannounced inspection took place on the 7th April 2008 and lasted a total of 7¼ hours. We met all four residents during this time and spoke to two residents and observed the care of all four residents. We spent time talking to the Manager and staff and checked records. We received five completed surveys from staff, comments from these have been included in the body of the report. All four residents were supported to compete a survey. The designated Manager took time to complete and return the Annual Quality Assurance Assessment (AQAA), and has been used as evidence to inform this report. What the service does well: What has improved since the last inspection? The extensive redecoration and refurbishment work has greatly enhanced the home’s environment and as a result the atmosphere in the house has improved. The team have worked hard to update the support profiles and care plans and as a result, residents’ current care needs and goals are well documented. This has resulted in staff being aware of residents’ individual needs and personal goals. The home has worked to improve the accessibility of certain documents, such as the complaints policy and staff have introduced a pictorial menu. Carlton Bridge DS0000065284.V361979.R02.S.doc Version 5.2 Page 6 Improvements have been noted in the level of personal care provided to residents. What they could do better: 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. The summary of this inspection report can be made available in other formats on request. Carlton Bridge DS0000065284.V361979.R02.S.doc Version 5.2 Page 7 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 Carlton Bridge DS0000065284.V361979.R02.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 4. People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The Society has clear policies and procedures for referring and admitting new residents. Admissions are not made to the home until a full needs assessment has been undertaken and prospective individuals are given the opportunity to spend time in the home. EVIDENCE: Currently there are four men living in the home with four vacancies. Information within the Annual Quality Assurance Assessment (AQAA) indicated that three of the four residents have lived at the home for a number of years. No new residents have moved into the home since 2006. There have however been two referrals to the home within the last twelve months. In each case the home’s policies and procedures were followed, which included arranging introductory visits to enable people to decide if they felt that the placement was suitable. Staff teams worked together to co-ordinate the introductory visits and to share information and to assess needs. Carlton Bridge DS0000065284.V361979.R02.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9. People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Each resident has a person-centred care plan, which has recently been reviewed and updated. This has resulted in residents’ current care needs and goals being well documented and met. EVIDENCE: During the inspection, we tracked the care of two of the four residents currently living at the home. As part of this process, we checked their personal files. The last key inspection report included a repeat requirement that a current care plan must be developed for each resident. During this inspection we noted that the team have worked hard to update the support profiles and care plans in response to these requirements. This has resulted in residents’ current care needs and goals being well documented. Information within the Annual Quality Assurance Assessment (AQAA) completed by the designated Manager, confirmed that residents have been involved in this process. The profiles seen during the inspection were written in the resident’s voice and include a range of issues, including personal care needs, social and leisure activities, communication and healthcare. Some pictures appear in the documentation in an attempt to make the content more accessible to each individual. Staff commented “Care plans are good and have been recently updated” and “There has been a lot of improvement in this area in recent Carlton Bridge DS0000065284.V361979.R02.S.doc Version 5.2 Page 10 months”. Night support profiles have also been developed in order to meet residents’ specific needs during the night. Risk Management plans for the two residents were also checked. They have been updated within the last month to reflect any changing needs. Specific guidelines were in place for responding to a resident’s needs in relation to their epilepsy. Carlton Bridge DS0000065284.V361979.R02.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17. People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living at the home have opportunities for personal development and are encouraged to be involved in meaningful daytime activities. The menu is varied and based on residents’ preferred meals. EVIDENCE: Two of the four residents attend day centres where they have opportunities to take part in activities and outings. The other two residents have decided that they no longer wish to attend day service as they consider themselves retired. Their wishes have been respected and alternative daytime activities are organised for them during the day. On the day of the inspection, a resident enjoyed a day out to Madame Tussauds and another resident went out to a local café for lunch. We observed another resident being supported to watch a programme of their choice on the television and was later offered to be supported outside the home. There is a choice of communal areas for residents, which have been equipped with comfortable seating. Picture books were available for residents to look at and a resident spent some of the morning drawing. Carlton Bridge DS0000065284.V361979.R02.S.doc Version 5.2 Page 12 Information within the Annual Quality Assurance Assessment (AQAA) completed by the designated Manager, confirmed that monthly music sessions have been implemented, where a person visits the home to play the guitar and sing. Other activities offered in the home also include playing games, reflexology, aromatherapy and pampering sessions. Musical instruments were in use during the afternoon of the inspection. All four resident were supported to complete the surveys sent by the Commission. Within these they commented that they can do what they want during the day, evening and at the week-end. A resident commented, “you can do what you like in this place.” One of the staff explained that a resident enjoys visiting the cinema and a list of current films on show in a local cinema was displayed on the main notice board. Details of other community based activities and events were also displayed on the board. Both care plans checked included details of residents’ religious needs and how best to ensure that these needs are met. It was noted within the daily logs that residents are supported to attend the religious services of their choice, or arrangements are made for them to receive Holy Communion at their home if they preferred. There are dining tables in both lounges that provide a choice of comfortable spaces for people to eat their meals. Since the last inspection, person centred menu plans have been introduced making use of images and photographs of residents. Carlton Bridge DS0000065284.V361979.R02.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. People using the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents have access to health care services for advice and input. Residents’ weights are not monitored and monitoring records are not fully completed to ensure that residents’ healthcare needs are fully monitored. Residents are protected by the home’s procedures for dealing with medication. EVIDENCE: Residents’ personal care needs are documented in their individual support plans, which have recently been updated and improved. Residents are supported to attend health appointments and each of the residents whose care was tracked had a health action plan in place. Residents’ health records showed that they have access to Speech and Language therapists, Physiotherapists, Dentists, Opticians, Psychiatrist and Podiatrists and District and Community Nurses. The AQAA confirmed that “staff have undergone First Aid and Medication training and have attended Healthlinks sessions at Croxley Road as well as attending more specialised training which is relevant to individuals who use the service such as epilepsy training.” At the home’s random inspection on the 22nd November 2007, we checked the food and fluid monitoring charts for one person and these were poorly completed. At the time of this random inspection on the 22nd November 2007, it was not possible to evidence the amount of food or fluids taken by the Carlton Bridge DS0000065284.V361979.R02.S.doc Version 5.2 Page 14 person concerned. During the random inspection, the monitoring sheets were not being audited to make sure that the person received the food and fluids they needed. During this key inspection, we checked the food and fluid charts also and found similar issues. There were still gaps appearing in these charts and the volume of liquid consumed was not specified. For example on one particular day, there were no entries in the diet and fluid monitoring chart until 3pm when an entry was made in the record to illustrate that the resident had a cup of tea. Another entry was made at 7pm on the same day to illustrate that the resident had a cup of tea and an Ensure, but no further entries made for the day. The volume of liquid was not specified in the records for example the volume referred to a cup. In addition to this, we checked the daily notes for this particular day and found the records for the morning shift uncompleted. In the dietician’s letter, they advise staff to continue encouraging diet and fluids and encourage a large breakfast of high calorie/high protein option. It was not always possible to evidence this through checking the documentation in the home. The Speech and Language Therapist and the dietician have been involved in this residents’ plan of care and the dietician requested that the home contact them should there be any changes in body weight. We asked to see records of the resident’s weight, but none have been kept. Staff must ensure that they monitor residents’ weights so that and weight loss can be identified early and the appropriate steps be taken. Record keeping must be improved and audited regularly. This requirement is being repeated in the report. Residents’ prescribed medication was securely stored at the time of the inspection. The Medication Administration Records (MAR) were checked for this cycle and for the cycle starting on 03/03/08. These records were well completed by staff. The home had medication profiles for residents, which have been recently updated and include information such as side effects and what to do in the event of a missed dose. There were no controlled drugs stored in the home. There were some liquid medication in use but did not have the date of opening recorded on the label. It is a good practice recommendation to note the date of opening on all liquid medicines to ensure they are not used past their expiry date and to aid the medication auditing process. The designated Manager confirmed that all but one of the staff working in the home have received training in the safe administration of medication. Carlton Bridge DS0000065284.V361979.R02.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents have access to the home’s complaints policy and staff at the home support residents to share their complaints and concerns. Staff have received training in the area of protection. EVIDENCE: The Society’s complaints policy has recently been updated to include the Commission’s regional contact details. The policy makes good use of pictures and symbols in an effort to make the documentation more accessible to people who live at the home. During the inspection we saw evidence within residents’ files that staff have spent time with them explaining the content of this policy. Each of the residents whose care was tracked had a copy on their file, and we also saw a copy on the main notice board on the ground floor. The home has received five complaints within the last twelve months. We saw that when complaints are received, they are logged in the complaints book and are also logged electronically on the computer. Senior managers have access to the electronic records so that they can monitor the outcomes and to identify any patterns that may emerge. The home has also recently produced a new and more accessible complaints record for supporting residents to record their complaints. We saw evidence that staff had helped residents to complete the records and the outcome of the complaint was entered onto this form, which was then kept in residents’ personal files. Feedback from staff indicated that they are aware of what to do if a resident is not happy with the service. The Manager confirmed during the inspection and also within the AQAA, that there have not been any incidents requiring investigation under the Protection of Vulnerable Adults Policy. We also confirmed this through checking the accident and incident books. Staff training records show that all staff have Carlton Bridge DS0000065284.V361979.R02.S.doc Version 5.2 Page 16 received training in the protection of vulnerable adults from abuse. Residents’ money and valuables are stored securely. The finance records for two of the four people living in the home were checked. The records were well kept and receipts kept for any expenditure involving people’s money. Carlton Bridge DS0000065284.V361979.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27, 30. People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is now better furnished and provides a pleasant environment to live in. These improvements have impacted positively on the wellbeing of the residents. EVIDENCE: The service is located near the Harrow Road, close to shops and other community facilities. Transport links are very good with both tube and buses near by. The home is a modern, terraced four-storey property. Residents’ rooms are arranged over the first, third and fourth floor. Lounge/dining rooms and kitchens are situated on the ground and second floors. There is a spacious lift to all floors and all parts of the home are accessible to wheelchair users. At the home’s last key inspection, we found that essential refurbishment and redecoration works had not been completed. We toured the building during this inspection and noticed a significant improvement in the standard of accommodation provided. The furniture in the home is now comfortable and of better quality. The lighting in the home has improved resulting in a brighter and more positive environment for residents. The bathrooms have undergone refurbishment work and are now fitted with assisted baths. New flooring has been installed in various locations throughout the home. Staff commented Carlton Bridge DS0000065284.V361979.R02.S.doc Version 5.2 Page 18 that improvements in the environment have made a big difference in the home. One commented “I have seen vast improvements in the facilities such as new bathrooms and redecorated bedrooms, lounges and kitchens. I feel the improvement have had a good effect on the well being of staff and residents alike.” There are now two laundry areas in the home, situated close to residents’ bedrooms. We asked residents if the home is fresh and clean, and they commented that it is. We also observed the home to be clean and fresh during our inspection. Information within the Annual Quality Assurance Assessment (AQAA) completed by the designated Manager, confirmed that cleaning rotas are in place, and the Manager checks that tasks are completed. The home has a policy in place for the prevention and managing the control of infection. Carlton Bridge DS0000065284.V361979.R02.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35, 36. People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home benefit from good staffing levels. Staff are well supported and receive relevant training to help them understand and meet the needs of the residents they care for. EVIDENCE: When we arrived at the home on the morning of the inspection, there were two support workers on duty. The Manager was at the Society’s Head office and later returned to the home. There are only four residents living at the home at the present time. The staffing rotas were checked and showed that the staffing levels allowed for a minimum of two support workers on duty in the morning with an overlap of staff between the early and late shift. A minimum of two support workers are on duty on the late shift and a waking night staff is on duty each night. There are no staffing vacancies within the team at the moment. The Westminster Society has a training programme, which was shown to us during the inspection. The Manager confirmed that training needs and preferences are discussed during supervision. Staff commented positively on the training that the Society provides and made the following comments: “I feel I have good support with regard to the training available to develop my skills as a support worker” and “I have recently been on courses around the Mental Capacity Act and how it applies here. Training is generally service specific and relevant.” Other comments with regard to training included “I have Carlton Bridge DS0000065284.V361979.R02.S.doc Version 5.2 Page 20 found the training to be quite extensive covering much of the needs of the service users” and “much emphasis on up-to-date methods of working and person-centred approach”. We checked the files of three members of staff and saw that each had attended the Learning Disability Award Framework Induction training. We checked the AQAA and saw that fifty five percent of the staff team have either obtained a National Vocational Qualification (NVQ) in Care at level 2 or above or are working towards this qualification. The designated Manager confirmed within the AQAA that staff have Criminal Records Bureau (CRB) checks prior to starting work. Staff confirmed and said they had “CRB and protection of vulnerable adults checks completed and references too”. The information within the AQAA told us that one resident has been involved in recruitment process within the last 12 months and that plans are in place to involve residents more in this process in the future. Records within the staff files show that staff receive formal supervision and the designated Manager confirmed that in the future the aim is to offer supervision on a monthly basis. Staff also confirmed this and commented “We do have supervision once a month where we talk about our support needs and ways to improve on our duties.” Carlton Bridge DS0000065284.V361979.R02.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41, 42. People using the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents live in a well run home, where staff feel well supported. The views of people living in the home are sought. Some gaps are evident in the home’s recording such as daily notes, food and fluid records and health and safety records, which could impact negatively on the health and safety of residents and on the continuity of care. Health and safety d EVIDENCE: Since December 2007, the home has a new Manager in post. At the time of the inspection, the Manager was not yet registered with the Commission as the Registered Manager. The Manager confirmed however that steps have been taken to start this process, in that he has obtained a CRB through the Commission and has obtained a reference from his General Practitioner. It is a requirement that the home’s new Manager lodges an application with the Commission’s Regional Registration Team to become the Registered Manager of the home. The manager confirmed that he is waiting dates to start the NVQ level 4 course. Staff commented positively on the support they receive from the Manager and Carlton Bridge DS0000065284.V361979.R02.S.doc Version 5.2 Page 22 the Management team. One of the staff commented: “my present manager always have time to put aside to help and support me with any queries that might arise.” The views of people living in the home were sought as part of the Society’s annual service audit in 2006. Their views are included in the audit report, which has been produced in an accessible format, using Plain English and pictures. Staff confirmed that there had not been a service audit in 2007. In the AQAA it was documented that “residents were supported to participate in a society wide survey to identify what they would want from their dream home using visual and tactile resources.” Residents’ meetings take place in the home and the minutes from these meetings were seen during the inspection. Visits on behalf of the registered provider take place on a monthly basis to check the standards of care in the home. The home’s daily records were checked during the inspection. These documents make good use of pictures and encourage the involvement of residents in writing about their daily activities. We noticed gaps in the recording of daily logs with information lacking about how staff had supported residents. Details of support given to residents with their personal care for example had not been completed on a number of occasions. There were also occasions when the daily records had not been completed at all for the shift. These gaps could impact negatively on the continuity of care of residents. A previously discussed in this report, gaps were evident also in the food and fluid monitoring records. Steps must be taken to make sure that the daily notes are fully completed and audited for quality. There is a policy in the home for maintaining the health and safety of residents and staff. Risk assessments were also seen in place for identifying any areas of risk within the building including the risk of fire. The necessary certificates were in place including the electrical installation certificate and the gas certificate. A certificate was in place to show that portable electrical appliances have been tested for safety, and a certificate was in place to show the thermostatic mixer valves have been checked. The home’s records showed that the fire alarm is not being tested weekly. The fire alarm must be tested weekly to make sure that the system is working. Gaps were also evident in the recording of water temperatures. Although there are mixer valves fitted to regulate the temperature of water, these can fail and it is a requirement that these are tested weekly. We saw during our inspection that cleaning materials and other potentially dangerous liquids are now securely stored to make sure that people living in the home are safe. Staff training files showed that two out of three staff have not received training in fire safety and one staff is in need of manual handling Carlton Bridge DS0000065284.V361979.R02.S.doc Version 5.2 Page 23 training and food hygiene training. Steps must be taken to ensure staff receive this training so that they are clear on how best to support residents safely. All staff are now qualified to give first aid. Carlton Bridge DS0000065284.V361979.R02.S.doc Version 5.2 Page 24 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 3 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 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 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 2 3 X 2 X 3 X 2 2 X Carlton Bridge DS0000065284.V361979.R02.S.doc Version 5.2 Page 25 Yes 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. 1. Standard YA19 Regulation 12 Timescale for action Steps must be taken to make 01/06/08 sure that residents’ weights are regularly monitored so that any weight loss can be identified early and the appropriate steps be taken. Managers must make sure that 01/06/08 health care monitoring charts are accurately completed by care staff. Charts must be regularly monitored to make sure that residents are receiving the care they need. Original timescale of 31/01/08 not met, this is a repeat requirement. The home’s new Manager must 01/06/08 lodge an application with the Commission’s Regional Registration Team to become the Registered Manager of the home. Steps must be taken to make 01/06/08 sure that the daily notes are fully completed and that they are audited to ensure quality. The water temperature must be 01/05/08 checked weekly to ensure that the thermostatic mixer valves are working. Fire alarm tests must be carried 01/05/08 DS0000065284.V361979.R02.S.doc Version 5.2 Page 26 Requirement 2. YA19 12 3. YA37 9 4. YA41 17 5. YA42 13 & 23 6. YA42 13 & 18 Carlton Bridge 7. YA42 18 out weekly to make sure that the fire alarm is working. Steps must be taken to ensure 01/08/08 staff receive all training in safe working practices so that they are clear on how best to support residents safely. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA20 Good Practice Recommendations The date of opening should be written on all liquid medicines to ensure they are not used past their expiry date and to aid with the medication audit process. Carlton Bridge DS0000065284.V361979.R02.S.doc Version 5.2 Page 27 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Carlton Bridge DS0000065284.V361979.R02.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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