Inspection on 04/01/07 for Carlton Gate

This inspection was carried out on 4th January 2007.

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 2 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 27/06/06

Carlton Gate 24/02/06

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 4th January 2007 11:00 Carlton Gate DS0000065285.V319322.R01.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 Gate DS0000065285.V319322.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 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.V319322.R01.S.doc Version 5.2 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.V319322.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th June 2006 Brief Description of the Service: Carlton Gate is a registered care home providing personal care and accommodation for one man and four women with a learning disability. There is one vacancy. Westminster City Council leases the property from the health authority 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. All accommodation is on the ground floor and the home is fully accessible to people using wheelchairs. 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. The flat in Florey Lodge contains the staff office. Carlton Gate DS0000065285.V319322.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place on Thursday 4th January 2007 from 11:00 – 14:00. The Inspector spent time talking with people living in the home, care staff and the home’s Manager. The Inspector also checked care records and saw all communal parts of the home. One person living in the home and one social care professional returned confidential questionnaires and their comments are included in this report. Carlton Gate is well staffed to meet the care needs of each person living in the home. The weekly fee for the service is £1,313 - £1,416. 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. The summary of this inspection report can be made available in other formats on request. Carlton Gate DS0000065285.V319322.R01.S.doc Version 5.2 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.V319322.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s Statement of Purpose has been reviewed and provides service users and care professionals with accurate information about the services provided at Carlton Gate. EVIDENCE: Following a Requirement made after the last inspection, the home’s Statement of Purpose has been updated to show that the Westminster Society is now the registered provider. Since the last inspection, one person living in the home has died and there is now a vacancy. The home’s Manager confirmed that the Society is working with the local Social Services Department to identify people whose needs can be met appropriately at the home. The Society’s admission procedures include visits to the home before admission. Carlton Gate DS0000065285.V319322.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home have a care plan that is regularly reviewed. Staff know the main care needs of each service user and how these will be met in the home. EVIDENCE: During this visit the Inspector spoke with care staff who were able to describe the main care needs of people living at Carlton Gate. Staff knew about agreed goals for each person and how these would be met in the home. Since the last inspection, the standard of recording in service users’ daily logs has improved. The logs now refer to care plan goals and there is more information about individual’s social care needs, as well as their personal and health care needs. The Inspector spoke with 2 service users who said that they had enjoyed the Christmas and New Year celebrations. In a confidential questionnaire completed with support from a member of staff, a service user commented ‘I do what I want to do’. A social care professional who returned a questionnaire commented that staff demonstrate a clear understanding of individual’s care needs, care plans are in place, are followed and regularly reviewed. Carlton Gate DS0000065285.V319322.R01.S.doc Version 5.2 Page 9 The standard of risk assessment and risk management in the home has improved since the last inspection. The manager confirmed that all risk assessments have been updated using a new format and the Inspector checked some of these during this visit. The risk assessments seen by the Inspector covered transfers with a hoist, use and care of a peg feed tube and use of the bath / shower. The Inspector also saw an individual fire safety risk assessment for one person living in the home. The assessments were well written and included a judgement of the likelihood and severity of each risk. Clear guidelines are in place for staff to make sure that risks to individual service users are minimised. Carlton Gate DS0000065285.V319322.R01.S.doc Version 5.2 Page 10 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 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from staff support that enables them to take part in a range of activities in the home and the wider community. EVIDENCE: The Inspector checked two service users’ care plan files during this visit. Both files included an up to date care plan, daily log sheets completed by staff on duty in the morning, evening and night time and monthly summaries of care provided for each person. The care plans included good information about each person’s life history, likes and dislikes, interests and significant people. The daily logs and monthly summary sheets were good evidence that staff support individuals to take part in appropriate activities. Some people living at Carlton Gate choose to attend a local day service and one person told the Inspector how much they enjoyed this activity. Information about individual’s relatives and friends is well recorded as part of the essential information about each person living in the home. The daily log sheets and monthly summaries included information about contact with Carlton Gate DS0000065285.V319322.R01.S.doc Version 5.2 Page 11 relatives and friends. Two service users told the Inspector about friends and relatives they had seen during the Christmas and New Year holidays. The home does not keep a central menu and the daily log sheets are used by staff to record the food eaten by individuals each day. The logs show that people are able to choose a varied and nutritious diet and guidelines for staff make sure that healthy eating is encouraged. During this visit, staff asked three people living in the home what they wanted for lunch. All three people chose soup and bread and they were able to eat this at the dining table or on individual tables in front of their wheelchair or armchair. The Inspector noted that care staff made sure people were offered choices and were given time to decide what and where they wanted to eat their lunch. Carlton Gate DS0000065285.V319322.R01.S.doc Version 5.2 Page 12 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 and 20. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The significant health care needs of one person are well met in the home and there is evidence of excellent joint work with health care professionals. EVIDENCE: Each of the two care plan files reviewed by the Inspector included a Health Action Plan (HAP) completed within the last six months. The HAP included excellent information about each person’s health care needs and how these would be met in the home. Details of contacts and appointments with relevant clinicians are also included in the HAP. The health care needs of one person living in the home have increased significantly since the last inspection. This person’s care plan file showed that Managers and staff have been proactive in making appropriate referrals to health care professionals. There is also evidence of excellent joint work with health care professionals, including the District Nursing Service, Occupational Therapists, Physiotherapists and Speech and Language Therapists. This joint work has resulted in the development of clear guidelines for staff, enabling the person to remain living at Carlton Gate. Carlton Gate DS0000065285.V319322.R01.S.doc Version 5.2 Page 13 During this visit the Inspector checked the Medication Administration Record (MAR) sheets in one flat. The records were well maintained and the Inspector found no gaps or errors. Carlton Gate DS0000065285.V319322.R01.S.doc Version 5.2 Page 14 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 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are dealt with appropriately and staff follow the local adult protection procedures. EVIDENCE: During this visit the Inspector checked the home’s complaints record and talked to staff about adult protection issues. The complaints record is well maintained and includes information about actions taken in response to complaints from service users, relatives and other people. Information provided by the Manager before this inspection is evidence that all complaints are dealt with promptly and investigations are carried out appropriately. Following a Requirement made after the last inspection, the home’s Manager and staff have notified the Commission of all incidents affecting service users’ welfare. Staff who spoke with eh inspector during this visit were aware of the local multi-agency adult protection procedures and how these should be used to protect people living in the home. There have been no adult protection referrals since the last inspection. Carlton Gate DS0000065285.V319322.R01.S.doc Version 5.2 Page 15 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, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides a satisfactory standard of accessible accommodation, but some redecoration work is needed. EVIDENCE: During this visit the Inspector saw all communal parts of the home. The home provides a satisfactory standard of accessible that is fully accessible to people who use wheelchairs. Two service users told the Inspector that they are very happy with the accommodation provided at Carlton Gate. The Manager confirmed that the hallway in Florey Lodge will be redecorated and the bathroom floors in both flats will be replaced in the next few weeks. The manager also confirmed that a Building Development Plan and Fire Safety Risk Assessment for 2007 – 2008 would be completed shortly. The Society must make sure that the redecoration of communal areas is included in the Building Development Plan. The last inspection report included a requirement that the assisted bath in Florey Lodge must be repaired. Despite visits from service engineers, parts are still needed and this requirement is repeated. Carlton Gate DS0000065285.V319322.R01.S.doc Version 5.2 Page 16 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 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well staffed to meet the care needs of service users. EVIDENCE: During this visit the Inspector felt that a sufficient number of staff was available to meet service users’ care needs. One member of staff who was due to work was sick and this meant that the home’s Manager needed to support the male service user with his personal care. This was well managed by the staff team and the Inspector felt that all staff worked well together to cover the temporary shortage. Following the last inspection, a Requirement was made that staffing levels should be increased to provide two staff in each flat during the waking day. The Manager said that this level is usually achieved or exceeded and this has enabled service users to take part in more planned activities. Personal care is also provided more efficiently as staff do not have to wait for support from colleagues working in the other flat. Information provided by the Manager before this inspection is evidence that training is planned to cover First Aid; Food Hygiene; Manual Handling; Dementia; Person Centred Planning and Makaton. Carlton Gate DS0000065285.V319322.R01.S.doc Version 5.2 Page 17 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 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from clear leadership and management of the service. EVIDENCE: The home has a full-time, permanent Manager who is registered with the Commission. The Inspector felt that the manager provides clear leadership to the staff team, with a clear commitment to providing the highest standards of care for service users. Regular monitoring visits are made by managers from within the Westminster Society and a written report is sent to the home and the Commission after each visit. No health and safety issues were noted during this inspection. Carlton Gate DS0000065285.V319322.R01.S.doc Version 5.2 Page 18 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 2 29 2 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 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 3 3 X 3 X 3 X X 3 X Carlton Gate DS0000065285.V319322.R01.S.doc Version 5.2 Page 19 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 YA28 Regulation 23 Requirement The assisted bath in Florey Lodge must be repaired. Repeat Requirement, original timescale of 31/08/06 not met. The Society must make sure that the redecoration of communal areas is included in the Building Development Plan. Timescale for action 31/03/07 2. YA28 23 31/03/07 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.V319322.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 Gate DS0000065285.V319322.R01.S.doc Version 5.2 Page 21 - 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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