Inspection on 29/06/06 for Carlton Dene Elderly Resource Centre

This inspection was carried out on 29th June 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

Carlton Dene Elderly Resource... 02/11/07

Carlton Dene Elderly Resource... 30/11/05

Carlton Dene Elderly Resource... 25/11/04

Carlton Dene Elderly Resource... 17/06/04

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Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Carlton Dene Elderly Resource Centre 45 Kilburn Park Road London NW6 5XD Lead Inspector Wynne Price-Rees Unannounced Inspection 29th June 2006 10:00 X10015.doc Version 1.40 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 Dene Elderly Resource Centre DS0000036330.V292415.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 Older People. 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 Dene Elderly Resource Centre DS0000036330.V292415.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Carlton Dene Elderly Resource Centre Address 45 Kilburn Park Road London NW6 5XD 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 7641 4890 Westminster City Council Care Home 37 Category(ies) of Dementia - over 65 years of age (37), Old age, registration, with number not falling within any other category (37) of places Carlton Dene Elderly Resource Centre DS0000036330.V292415.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th November 2005 Brief Description of the Service: Carlton Dene is a purpose built home registered for up to thirty-seven older people of either gender, who may suffer with dementia, six of whom can receive respite care. There are currently thirty-five residents. The proprietors are Westminster City Council and the home is well located for transport links, shops and other local amenities. It is purpose built and contains a day centre that is currently being relocated. It is laid out over ground and first floors with lift and stair access. The home is accessible throughout for people who use wheelchairs or have restricted mobility. Each resident has their own room and there are adequate numbers of bathroom and toilet facilities that are located close to residents’ rooms and communal areas. Carlton Dene Elderly Resource Centre DS0000036330.V292415.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one day during which three residents’ files were case tracked from each unit including respite care. A number of staff and residents were spoken with during the course of the inspection and a building tour also took place. The fees for the home are £528-62 per week with the individual resident contribution varying depending on means. What the service does well: What has improved since the last inspection? What they could do better: Carlton Dene Elderly Resource Centre DS0000036330.V292415.R01.S.doc Version 5.2 Page 6 There are two areas requiring some work regarding information supplied by placing officers when an emergency referral is made and recording of administered medication on one unit. 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. Carlton Dene Elderly Resource Centre DS0000036330.V292415.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Carlton Dene Elderly Resource Centre DS0000036330.V292415.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 6. The quality outcome for this area was good. This was arrived at as part of the inspection process. Residents, needs are fully assessed prior to moving including those receiving respite care. EVIDENCE: The home has a written assessment policy and procedure. A sample of residents’ files showed that a thorough assessment of individual residents’ needs is carried out prior to entry to the home. Assessment information is forwarded to the home by Care Package Managers’ that is analysed by the assessment team and once it is initially determined if needs can be met, from this information, the prospective resident is visited and the home’s assessment carried out. In the case of respite care the same procedure is followed. However, in the case of an emergency referral by a duty social worker there have been some instances where not even basic information accompanied the resident and this makes it difficult for the staff to ascertain if needs can be met and other residents are safe. Lack of basic information can mean that a Carlton Dene Elderly Resource Centre DS0000036330.V292415.R01.S.doc Version 5.2 Page 9 resident may not come within the category of care that the home is registered to provide and therefore they might contravene their registration. The home has five designated respite beds and when these are full there is no further capacity. The day centre has now moved and builders are currently converting this area to increase dedicated respite by a further four bedrooms. Care is provided to respite residents in the same manner as permanent residents and they have access to the same facilities. Carlton Dene Elderly Resource Centre DS0000036330.V292415.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): . 7, 8, 9 & 10. The quality outcome for this area was good. This was arrived at as part of the inspection process. Residents needs are identified within their individual care plans, medication is generally appropriately administered and monitored and they are treated with respect and their dignity observed EVIDENCE: All residents have care plans including those receiving respite care and a sample of three case tracked from each unit showed they contained identified needs from which numbered goals were set that were fed by daily case notes and updated at review. These were underpinned by up to date risk assessments. The quality of the information was well recorded on each unit, clear, easy to access and track. The care plans addressed all areas required by the standards. They are the responsibility of identified key workers and residents are encouraged to participate in their own care planning, which they do as much, or as little as they wish. The residents have access to community based health care services including designated visiting services. These include optician, dentist, hearing tests and chiropodist on request. There is a new GP contracted to the home that currently visits a minimum of once per week and they are looking to increase Carlton Dene Elderly Resource Centre DS0000036330.V292415.R01.S.doc Version 5.2 Page 11 their surgery to twice per week. The medication administration records were checked for all residents at the home and found to be up to date and correctly entered apart from one unit that had some gaps in the recording. The residents spoken with confirmed they felt that their privacy and dignity is respected and that staff conducted themselves in a caring, friendly and appropriate way. This was confirmed by observation of care practices. Privacy and dignity are part of core induction training and there are policies and procedures in accordance with this. Reference is also made to them in the staff handbook. Carlton Dene Elderly Resource Centre DS0000036330.V292415.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above 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, 14 & 15. The quality outcome for this area was good. This was arrived at as part of the inspection process. Residents pursue their preferred lifestyle, with appropriate family contact maintained and they are supported to make their own choices and decisions. They are provided with a suitable choice of meals and balanced diet. EVIDENCE: The residents’ spoken with and case files examined demonstrated that there are a range of activities provided inside and outside the home focused on the group and individual. Interests and activities are an important component of the care plan process to ensure that quality of life is provided as well as good health care. Although group activities are enjoyed, the main activity identified by residents was being able to have a chat with staff and others. This has greatly improved as staff have now been specifically employed for cleaning duties and this enables care staff to spend more time with the residents. The residents who wish make use of local facilities such as the park, Paddington Recreation ground, shops, pubs and restaurants. They also visit the hairdressers. All residents are registered with dial-a-ride and have access to transport provided by the local authority. If residents wish to attend the church next door on a Sunday, extra staff are put on duty to accompany them. Mass Carlton Dene Elderly Resource Centre DS0000036330.V292415.R01.S.doc Version 5.2 Page 13 is held at the home on the first Wednesday of each month and if residents of other religious persuasions wish to attend places of worship, this is organised. Residents spoken with and observation of care practices confirmed that residents are encouraged and supported to make their own choices and decisions. Currently no one handles their own financial affairs although there is a facility to do so if they wish. Most residents have Westminster City Council as their appointees although the family looks after some affairs. Currently the home is introducing a new menu and experimenting with quantities and portions to determine the preference of individual residents. Residents are provided with a good choice of meals throughout the day and those suffering with dementia are shown visual samples of the actual meals available so that they can make their own choice. Showing the actual meal rather than in picture form is a great improvement as it employs other cognitive senses as well as sight. The meals are freshly made on the premises daily. There are two areas specifically designated for activities and the home is currently advertising to recruit a new activities officer. Some of the activities provided within the home include a visiting musician, bingo, ball games and dominoes. Staff also carry out one to one activities to promote interaction. One resident bought a TV from Argos the day before the inspection that was being picked up by staff the following day. Carlton Dene Elderly Resource Centre DS0000036330.V292415.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. The quality outcome for this area was good. This was arrived at through the inspection process. Residents’ complaints are listened to, investigated and they are protected from abuse. EVIDENCE: There is a complaints policy and procedure that is contained in the resident’s handbook and that they have been made aware of. The residents’, relatives and friends also have recourse to the Westminster City Council complaints procedure. The complaints book is kept in the entrance hall for easy access for anyone wishing to use it and there is also a suggestions box. There are friends of Carleton Dene meetings that take place quarterly as well as monthly minuted residents’ meetings that are both used as discussion and suggestion forums and where any grievances or complaints may also be aired. Residents can also complain via their key workers or direct to the Care Manager. There were no recorded complaints since the last inspection visit. All staff have received adult protection training and there is a policy and procedure in place that is also contained in the staff handbook. Training is provided by the local authority and staff have also attended an anger management course in respect of aggression displayed by residents. No POVA referrals have been made since the last inspection and the home fully understands how the referrals can be made. Funds held on behalf of residents and any transactions made were fully documented with receipts. Carlton Dene Elderly Resource Centre DS0000036330.V292415.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 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 & 26. The quality outcome was good. This was arrived at by a premises tour. The home is suitable for its stated purpose, clean, pleasant and hygienic. EVIDENCE: The home is suitable for its stated purpose and a tour of the premises showed it to be clean, hygienic and well decorated with good furniture. There were nice outside places to sit in and enjoy the sunshine as well as a strawberry patch that is tended by the gardening group. Where possible residents are encouraged to bring their own possessions to make the home feel more like their home. The residents’ spoken with said they liked their accommodation. Carlton Dene Elderly Resource Centre DS0000036330.V292415.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. The quality outcome was good. This was arrived at as part of the inspection process. There are enough staff to meet residents’ needs, they are safe, protected by the recruitment procedure and staff are trained and competent to do their jobs. EVIDENCE: Currently there are two vacancies, one for an activities officer and the other for a cleaner. Both posts are currently being recruited to. The rota showed there were adequate staff on duty at all times to meet residents’ needs. If holidays or unforeseen circumstances arise such as sickness, the rota is covered by agency staff. Wherever possible the same staff are used to maintain continuity of care, as they are familiar with the routines of the residents, how the home runs and the residents are familiar with them. There are twenty-eight permanent care staff of which one is yet to undertake NVQ level 2. The recruitment procedure is that of Westminster City Council and meets all the requirements of the standard. This includes CRB clearance and no one starts work until this is obtained. Staff have full access to the rolling training programme provided by the council including a full induction covering all the required courses under the standard. Those spoken with felt the training of good quality, focused on the client group they work with and that it enables them to carry out their roles and function Carlton Dene Elderly Resource Centre DS0000036330.V292415.R01.S.doc Version 5.2 Page 17 well. In house dementia modules have been taking place that have enabled staff to debate the merits of various types of care in this area. The residents’ spoken with spoke highly regarding the friendliness, helpfulness and professionalism of the staff team. Carlton Dene Elderly Resource Centre DS0000036330.V292415.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, & 38. The Quality outcome for this area was good. This was arrived at as part of the inspection process. A well managed home, run in the best interests of the residents where their financial interests are safeguarded as well as their health, safety and welfare. EVIDENCE: The Care Manager has not changed since the last inspection, holds NVQ level 4 in management, has been in post for a number of years and has extensive previous experience. Some of the inspection was conducted by one of the four unit managers who displayed thorough knowledge and competence. There is an extensive quality assurance system in place that is incorporated as part of the overall council one and contains identifiable performance indicators. Carlton Dene Elderly Resource Centre DS0000036330.V292415.R01.S.doc Version 5.2 Page 19 The home currently holds an “Investors in People” award. There is an annual business plan with set objectives and internal audits are carried out. Weekly health and safety checks take place throughout the building that include the fire system and are fully documented. Any problems are recorded, reported and there is a designated health and safety officer. Carlton Dene Elderly Resource Centre DS0000036330.V292415.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 X X X 2 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Carlton Dene Elderly Resource Centre DS0000036330.V292415.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NO 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 OP6 Regulation 14 (1) Requirement Timescale for action 29/06/06 2 OP9 13 (2) Basic information must be forwarded by placing officers so that the home can determine if the needs of the prospective resident can be met, other residents are kept safe and the registration criteria is met. All medication administered must 29/06/06 be correctly recorded. 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 Carlton Dene Elderly Resource Centre DS0000036330.V292415.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Hammersmith Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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. Extracts may not be used or reproduced without the express permission of CSCI Carlton Dene Elderly Resource Centre DS0000036330.V292415.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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