Inspection on 24/02/06 for Carlton Gate

This inspection was carried out on 24th 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 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Carlton Gate 26/11/09

Carlton Gate 17/11/08

Carlton Gate 19/11/07

Carlton Gate 04/01/07

Carlton Gate 27/06/06

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 08/07/2008.

CARE HOME ADULTS 18-65 Carlton Gate 10 Florey Lodge Admiral Walk, Harrow Road London W9 3TF Lead Inspector Tony Lawrence Unannounced Inspection 24 February 2006 12:00 th Carlton Gate DS0000065285.V280596.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 Carlton Gate DS0000065285.V280596.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. Carlton Gate DS0000065285.V280596.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Carlton Gate Address 10 Florey Lodge Admiral Walk, Harrow Road London W9 3TF 020 7289 2352 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) The Westminster Society Mr Stephen Paul Golden Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Carlton Gate DS0000065285.V280596.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th May 2005 Brief Description of the Service: Carlton Gate is a registered care home providing personal care and accommodation for one man and five women with a learning disability. The home provides care for an older client group and all six service users are aged 57 – 88. Westminster City Council leases the property from the health authority. The home is staffed and care is provided by the Westminster Society, a voluntary organisation. The home is well located to enable residents to use facilities in the local community and is close to shops and transport links. The home is split into two flats, Florey Lodge and Barnard Lodge, each for three people. The accommodation is on the ground floor and is fully accessible to people using wheelchairs. The flat in Florey Gate contains the staff office. Each person living in the home has a single room and these are well decorated and furnished. Each flat has an assisted bathroom and accessible shower room. Carlton Gate DS0000065285.V280596.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Friday 24th February 2006 from 12:00 – 14:00. The Inspector spent time talking with service users, staff and the manager. He also checked care records and saw all parts of the home. Four of the five requirements and all six recommendations made at the last inspection have been met. The home provides good standards of care for older people in accommodation that is fully accessible. 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 Gate DS0000065285.V280596.R01.S.doc Version 5.1 Page 6 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 Gate DS0000065285.V280596.R01.S.doc Version 5.1 Page 7 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): EVIDENCE: The key Standard was met at the last inspection in May 2005. Carlton Gate DS0000065285.V280596.R01.S.doc Version 5.1 Page 8 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 and 7 There have been improvements to the home’s care planning and care recording. Service users are supported to make decisions about the care they receive. EVIDENCE: To assess these two Standards the Inspector reviewed the care plan files for two people living in the home. He also spent some time talking with both people. Since the last inspection, management of the home has transferred from Heritage Care to the Westminster Society. Work has begun to implement the Society’s policies and procedures and existing care plans are being used to create new Individual Support Profiles. Care plan review meetings are being held and service users told the Inspector that they are fully involved in the meetings. Good use is made of photographs to enable service users to contribute to the review. Daily care notes have improved since the last inspection and staff have also produced good monthly summaries of individual’s care need and how these are met. Carlton Gate DS0000065285.V280596.R01.S.doc Version 5.1 Page 9 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 14. Service users are supported to take part in a range of activities in the home and the local community. EVIDENCE: During this visit five service users were at home and one person was out at a day service. One person also told the Inspector that she had been shopping with staff in the morning. Monthly care summaries show that each person is supported to take part in activities in the home and the community. Some people make use of day services and one person told the Inspector they enjoyed going to sessions at the Greenhouse day service. Care records show that staff from the home support other people to use local shops, cafes etc. Two service users also told the Inspector about holidays they had enjoyed with support from staff. The Inspector felt that care staff must take more care to support people appropriately when they are spending time in the home. For example, one service user with a visual impairment was sitting in the lounge between the TV and the radio, both of which were turned on. This must have been confusing for the person concerned and staff should have realised this. Carlton Gate DS0000065285.V280596.R01.S.doc Version 5.1 Page 10 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 and 20. The health care needs of service users are well known to staff but the recording of these needs should be improved. EVIDENCE: Key Standards 18 and 20 were met at the last inspection in May 2005. The two care plan files reviewed during this inspection included detailed information about each person’s health care needs. One person’s file included a Health Action Plan that had been completed in the last 12 months. This included good information about the person’s needs but this was not followed up in other records. For example, the record of the person’s health appointments was not completed for the whole of 2005 and their weight chart has not been completed since May 20045. This was despite a specific care plan goal that required staff to check for significant weight loss / gain. The Inspector checked the arrangements for managing medication in one flat. All prescribed medication was securely stored and the Medication Administration record (MAR) sheets were well completed by staff. Carlton Gate DS0000065285.V280596.R01.S.doc Version 5.1 Page 11 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Service users feel they are consulted and involved in making decisions about their care. EVIDENCE: Two service users talked with the Inspector about the care and support they get at Carlton Gate. Both people were very positive about the staff team and the ways in which they are supported to take part in activities. The Inspector also saw a quality assurance questionnaire that staff had supported a service user to complete. The questionnaire covered daily routines, accommodation, activities and staffing. The last inspection report included a requirement that a service user should be refunded money they had paid for the redecoration of their bedroom. The Manager explained that this had not yet happened and the requirement is repeated in this report. Carlton Gate DS0000065285.V280596.R01.S.doc Version 5.1 Page 12 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. The home offers good standards of accessible accommodation. EVIDENCE: During this visit the Inspector saw all communal parts of the home and two service users’ bedrooms. All parts of the home were clean, tidy, well furnished and decorated. Bedrooms are well decorated, comfortably furnished and highly personalised. Carlton Gate DS0000065285.V280596.R01.S.doc Version 5.1 Page 13 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): 33 and 34. There is a need to review staffing levels to make sure that the care needs of service users are met. EVIDENCE: During this inspection, the home’s Manager was on duty with two support workers. The last inspection report included a requirement that staffing levels should be reviewed to make sure that individual’s care needs are met. The manager confirmed that this review is taking place and this now needs to be concluded. During this visit, one agency member of staff was supporting two people with significant care needs in one flat while the second worker was supporting three people in the second flat. While the Manager was available to assist both staff, he was also helping the Inspector and the Contract Monitoring Officer from Westminster City Council who was also visiting to complete. Most of the people living at Carlton Gate are elderly and some also have a physical disability. Each person has significant care needs and the Inspector’s view is that more support is needed. The Westminster Society must notify the Commission of the results of the review of staffing levels and any proposals to make sure service users receive the care and support they need. The Manager confirmed that all staff must have a Criminal Records Bureau Disclosure before they start work in the home. Carlton Gate DS0000065285.V280596.R01.S.doc Version 5.1 Page 14 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): 39, 41 and 42. The home is well managed and service users are involved wherever possible in making decisions about the services they receive. EVIDENCE: During this visit the Inspector spent time talking with two service users about their experiences of living at Carlton Gate. Both people were very positive about the accommodation, especially their bedrooms. Both people also commented that staff are always very helpful and said that they enjoy regular outings with staff. The Inspector also saw a good quality assurance questionnaire on one person’s care plan file. This was completed in March 2005 and made good use of photographs and Plain English to establish the views of the service user. Most records checked during this visit were well maintained and up to date, but staff must make sure that health records are completed (see Standard 19). No health and safety issues were noted during this inspection. Carlton Gate DS0000065285.V280596.R01.S.doc Version 5.1 Page 15 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 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 2 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 2 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 2 3 X X X 3 X 3 3 X Carlton Gate DS0000065285.V280596.R01.S.doc Version 5.1 Page 16 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 YA14 Regulation 16 Requirement Timescale for action 31/05/06 2 3 YA19 YA23 12 23 4 YA33 18 Staff must make sure that appropriate activities are provided for people spending time at home. Staff must make sure that health 31/05/06 care records are maintained. Money paid by a service user for 31/05/06 the redecoration of their bedroom must be refunded. Repeat requirement – original timescale of 31/07/09. The Westminster Society must 31/05/06 notify the Commission of the results of the review of staffing levels and any proposals to make sure service users receive the care and support they need. 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 Gate DS0000065285.V280596.R01.S.doc Version 5.1 Page 17 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 Gate DS0000065285.V280596.R01.S.doc Version 5.1 Page 18 - 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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