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Inspection on 30/11/05 for Carlton Dene Elderly Resource Centre

Also see our care home review for Carlton Dene Elderly Resource Centre for more information

This inspection was carried out on 30th November 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides a warm, persona, safe and caring atmosphere for residents to live in.

What has improved since the last inspection?

The care plan recording has improved substantially since the last inspection with the staff team now getting to grips with an effective way to record progress made towards goals set. The new method of having a rota for each unit, as well as the main rota, has meant staff can identify the tasks they are required to carry out and can more usefully plan their day and spend more time with residents` individually and in groups.

What the care home could do better:

The home must continue to improve on the standards they have now set themselves.

CARE HOMES FOR OLDER PEOPLE Carlton Dene Elderly Resource Centre 45 Kilburn Park Road London NW6 5XD Lead Inspector Wynne Price-Rees Unannounced Inspection 30th November 2005 10:30 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.V257921.R01.S.doc Version 5.0 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.V257921.R01.S.doc Version 5.0 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 Mr Amaechi Nwaenie 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.V257921.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th May 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 two respite beds vacant. The proprietors are Westminster City Council and the home is well located for transport links, shops and other local amenities. It is purpose built with a day centre as part of the building and the majority of people receiving respite care attend the day centre. 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.V257921.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A well run home that provides a service focused on the needs of individual residents in a homely, caring and warm environment. The inspection took place over four hours during which six care plans were case tracked and a number of residents and staff spoken with to ascertain their views. The care plans were taken from each unit. What the service does well: What has improved since the last inspection? 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. Carlton Dene Elderly Resource Centre DS0000036330.V257921.R01.S.doc Version 5.0 Page 6 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.V257921.R01.S.doc Version 5.0 Page 7 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 Residents have their needs fully assessed prior to moving into the home and those receiving intermediate care are supported to maximise their independence with a view to returning home. EVIDENCE: The case files inspected contained assessment information that showed full assessments are carried out prior to a resident moving in. The home has a dedicated respite unit and those receiving this type of care undertake the same assessment process as those moving in permanently. Greater attention is now placed on making sure the assessment process is balanced to incorporate needs regarding interests and activities as well as health care considerations. The respite residents have access to the same care and amenities as the permanent residents. In a number of instances residents receiving respite care have moved over to permanent status as their needs make them more dependent. Carlton Dene Elderly Resource Centre DS0000036330.V257921.R01.S.doc Version 5.0 Page 8 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 and 10. The health, personal care and social needs of residents were set out within their care plans except one monthly review that was missing and therefore standard seven was not met. Standard ten was met with the residents spoken with feeling they are treated with respect and their privacy upheld. EVIDENCE: The care plans sampled showed a great improvement in the way information is recorded and it was far easier to track progress made towards goals set. These were also regularly reviewed, updated as required and underpinned by risk assessments that enabled the goals to be worked towards. The reviews take place monthly in-house and annually with external agencies. The major area of improvement was within the recording of daily observations that were referenced to the numbered goals set rather than being prescriptive of a resident’s day. Only one area did not meet standard seven regarding one missing monthly review on a file. Observation of the support and care provided demonstrated that the dignity and privacy of residents is upheld and they are respected. This was confirmed by conversations with the residents and staff. Carlton Dene Elderly Resource Centre DS0000036330.V257921.R01.S.doc Version 5.0 Page 9 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): 14 The residents are supported to exercise choice and control over their lives. EVIDENCE: The care plans and risk assessments in place enabled residents to make their own choices and decisions. This was reflected in the choices they made regarding activities they wished to pursue as a group or individually. Quarterly minuted residents’ meetings take place and feedback questionnaires are regularly sent out to permanent and respite residents as well as their relatives and representatives. The key worker system is also used to relay the views and wishes of residents. Currently only one resident is in charge of their own finances and they are being re-assessed for appointeeship. Residents entering the home can bring any personal possessions they wish provided they can be accommodated within their rooms. Personal records were securely kept and available to residents as required. Carlton Dene Elderly Resource Centre DS0000036330.V257921.R01.S.doc Version 5.0 Page 10 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 Residents, their relatives and friends are confident any complaints are listened to and acted upon. They are also protected from abuse. EVIDENCE: There is a full complaints procedure that residents, staff, relatives and friends have been made aware of and the complaints book is kept in the reception for easy accessibility. The last recorded complaint was made on 21/04/05, actively pursued and responded to within the twenty-eight day timescale. Residents’ have access to the Westminster City Council complaints procedure as well as that of the home. These are available in different languages and formats as required. All staff have partaken of adult protection training and this is regularly reviewed and discussed during monthly staff meetings. All CRB and POVA checks are carried out prior to staff working unsupervised. A copy of the checklist is sent to the Care Manager and updated by the Westminster City Council Human Resources Team. Abuse identification and procedure to follow if encountered is also part of core induction training and contained in the staff handbook. A sample of funds held on behalf of residents was checked and found to be suitably recorded with regular audits taking place. Any authorisation of funds over £100 is made by the Care Manager. Carlton Dene Elderly Resource Centre DS0000036330.V257921.R01.S.doc Version 5.0 Page 11 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): 26 The home is clean, pleasant and hygienic. EVIDENCE: A tour of the building found it to be clean, hygienic and pleasant. Carlton Dene Elderly Resource Centre DS0000036330.V257921.R01.S.doc Version 5.0 Page 12 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): 27,28,30 The residents’ needs are met by the numbers and skill mix of staff, they are in safe hands and staff are trained and competent to do their jobs. EVIDENCE: The staff rota demonstrated that there are sufficient staff numbers on duty at all times to meet the needs of the residents and this was reflected in conversation with residents and observation of care practices. As well as the main rota there is a daily one, broken down unit-by-unit that informs staff of where they are working and tasks to be carried out. This has resulted in a better more relaxed working environment that means staff are not rushing from one task to another and can plan their day and spend more time with residents’ doing activities. An idea of the improvement is reflected in the excellent display cabinets made together by local primary school children and residents that were overseen by staff and greater use of the reminiscence room. Currently 80 of care staff have achieved NVQ level 2 or above and the professional, caring way they carried out their duties reflected this level of training. Staff have also embarked on dementia and mental health training that reflects the changing needs of the client group and anticipates future demand. Six staff have also completed a diploma in medication administration course run by Hackney College. The staff team have full access to the Westminster City Council rolling training programme. The home has recruited a new activity officer who is to commence in post as soon as all the required checks have been completed. Currently many activities have been carried out jointly with day centre staff. Room carers have also Carlton Dene Elderly Resource Centre DS0000036330.V257921.R01.S.doc Version 5.0 Page 13 been recruited to free up care staff so they can spend more time engaged in activities with residents. Carlton Dene Elderly Resource Centre DS0000036330.V257921.R01.S.doc Version 5.0 Page 14 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): 31,35,38 Residents’ live in a home that is well managed, by an experienced Care Manager whom has met the registration criteria and where their financial interests and health, safety and welfare are safeguarded. EVIDENCE: The Care Manager has attained the NVQ level 4 management qualifications and has three and a half years experience as the home’s manager as well as similar previous experience in a post in a resource centre elsewhere. There is currently one resident who controls their own finances. See previous sections. Bank accounts for residents are held by the Westminster City Council Appointeeship Section. An inventory of residents’ possessions is carried out on entering the home. Any monies are valuables are securely kept. The fire fighting equipment is tested annually and call points are randomly checked weekly. The fridge and freezer temperatures are checked and Carlton Dene Elderly Resource Centre DS0000036330.V257921.R01.S.doc Version 5.0 Page 15 recorded daily. There is a weekly health and safety check carried out that covers the entire building and this is submitted to the council’s health and safety officer quarterly. The lift is serviced annually. Staff have been fully trained in all the aspects of standard thirty-eight (2) as part of core induction training and PAT tests of electrical appliances are carried out. Carlton Dene Elderly Resource Centre DS0000036330.V257921.R01.S.doc Version 5.0 Page 16 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 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X 3 Carlton Dene Elderly Resource Centre DS0000036330.V257921.R01.S.doc Version 5.0 Page 17 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 OP7 Regulation 14 (2) Requirement All monthly review minutes must be made available on file. Timescale for action 07/12/05 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.V257921.R01.S.doc Version 5.0 Page 18 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.V257921.R01.S.doc Version 5.0 Page 19 - 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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