Inspection on 05/12/05 for Carlton House (30)

This inspection was carried out on 5th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 House (30) 27/04/06

Carlton House (30) 16/08/05

Carlton House (30) 02/11/04

Carlton House (30) 21/06/04

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 HOMES FOR OLDER PEOPLE Carlton House (30) 30 Chatsworth Road Croydon Surrey CR0 1HA Lead Inspector James Pitts Unannounced Inspection 13:55 5 December 2005 th 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 House (30) DS0000025763.V266311.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 House (30) DS0000025763.V266311.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Carlton House (30) Address 30 Chatsworth Road Croydon Surrey CR0 1HA 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 8688 7801 020 8688 7801 cakuffo@hotmail.com Dr Emmanuel Owusu Akuffo Mrs Celia Erica Akuffo Mrs Celia Akuffo Care Home 15 Category(ies) of Learning disability over 65 years of age (0) registration, with number of places Carlton House (30) DS0000025763.V266311.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to seven (7) residents may be 50 to 64 years of age. Date of last inspection 16th August 2005 Brief Description of the Service: Carlton House is a privately owned home for 15 people with learning disabilities, at present there are twelve service user’s residing at the home whose ages range from fifty upwards. Carlton House comprises of two large houses made into one with connecting corridors. It is situated in a residential area a few minutes walk from the centre of Croydon and the main railway station. There is off street parking for a number of cars. There are eleven single rooms and two twin rooms. Carlton House (30) DS0000025763.V266311.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An additional visit to the home took place on 6th May 2005 and an announced inspection took place on 16th August this year. Both of those visits involved checks on the progress for the 15 requirements that had remained outstanding for some time. This report covers specific standards that were inspected both at the additional visit and at this inspection. To requirements remain to be met from the previous inspection. It is disappointing to note that an additional four requirements have been made of the home as a result of this inspection. Other visits have also occurred in the last year where service users gave their views. This inspection visit also involved service users, conversations with the management team, looking at policies and records as well as reviewing the progress on outstanding requirements that arose at the announced inspection home. What the service does well: What has improved since the last inspection? The home has improved the diligence with which pre employment background checks are carried out on new staff. Individual staff supervision has also improved. The home is now on track to ensure that each member of staff has individual supervision at least six times in each calendar year as required under the national minimum standards. Carlton House (30) DS0000025763.V266311.R01.S.doc Version 5.0 Page 6 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 House (30) DS0000025763.V266311.R01.S.doc Version 5.0 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 House (30) DS0000025763.V266311.R01.S.doc Version 5.0 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): 1, 4 & 6 Service users and other people are told what the home does and how it will do it. The service user guide should still, however, be written in a clear way so that everyone can understand it. The service users cannot feel confident that the home will properly consider all new admission to the home. This could compromise the well being of the person’s admitted and also have an impact on the other service users who already live here. EVIDENCE: The home has admitted two new service users since the previous announced inspection. It is of serious concern that, having previously achieved these standards that the home has admitted one service users who has needs that the home is not able to meet. This person has an enduring mental health difficulty and there is no indication that they have any significant learning disability. The home was left with an immediate requirement that they should seek to secure a more appropriate placement for this person in liaison with the placing authority. Carlton House (30) DS0000025763.V266311.R01.S.doc Version 5.0 Page 9 The other person who was admitted is here to receive temporary respite care and this person’s assessed needs are in line with the registration status of the home. It is of concern that for both new service users there is no pre placement risk assessment, or even a subsequent risk assessment in place. These must be completed in the case of everyone who comes to live at the home. Carlton House (30) DS0000025763.V266311.R01.S.doc Version 5.0 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 Service users can still feel confident that their personal care needs and physical and emotional health needs will be well met by this home. This ensures that the service users have the opportunity to maintain their dignity, have their rights respected and continue to enjoy a good quality of life. Service users can also have confidence that their health care needs will be attended to and that will receive the support and treatment that they need. EVIDENCE: It was reported at the previous inspection that all of the service users continue to have a detailed care plan. The care plans tell the staff in a lot of detail about the best ways to support each person who lives here. It also tells the staff about what each service user likes to do each day, the things that they like and how the staff should do the best things to help in the right way. A senior member of staff looks at the care plans each month to make sure that each of the service users is being supported in the right way. The care plans are Carlton House (30) DS0000025763.V266311.R01.S.doc Version 5.0 Page 11 reviewed regularly. However for newly admitted service users the home must complete a care plan, even if someone is only here for short term respite care. All of the people who live at the home usually go to see a local GP if they are not feeling well. The service users can see any local GP but most see the same one. The staff are still very good at writing down anything that happens if anyone becomes unwell. If any of the service users have an illness or something else is wrong with them then the staff do know what this is and how to help them to get the treatment that they need. If anyone needs to take medicine then the staff help him or her to do this. None of the service users can do this without help and the staff have written down why this is so on each of the care plans. The staff are very good at making sure that people take their medicines so that they can stay well. The staff are also good at making sure that no one can get hold of any medicine that they should not have and so they keep medicines locked away. The service users who spoke during this inspection again said that they feel as if the staff treat them well. Carlton House (30) DS0000025763.V266311.R01.S.doc Version 5.0 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): 14 The service users can feel assured that their rights, and the way in which the staff team uphold these rights, is usually well managed. EVIDENCE: The home has shown improvement in seeking to recognise and understand the need to uphold the rights of the people who live here. The home’s attempts to secure an advocate, particularly for service users who may not have close contact with their family or friends, is referred to later in this report. Carlton House (30) DS0000025763.V266311.R01.S.doc Version 5.0 Page 13 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, 17 & 18 The service users can feel confident that the staff team at the home know what to do if there are complaints or concerns about abuse. The home has clear guidance for staff about the procedures to be followed in either of these circumstances. EVIDENCE: The service users, and others, are given clear information about how to complain and what happens when they make a complaint. No complaints have been made to the home or to the Commission since the previous inspection. At the last inspection the manager of the home was asked to make contact with an advocacy organisation. This was to see if an independent advocate could be provided to any service user who does not have close contact with their family or friends. The manager did this and was told that there is a shortage of advocates, but that the home would be put onto the waiting list. It is again recommended that the manager keep in regular contact with the advocacy organisation to remind them about the home wanting an advocate for service users when one becomes available. The staff team are still good at making sure that all of the service users are protected from abuse (this means that the staff at the home do everything that they can to stop any of the service users from being hurt by someone else). There is also clear written information for staff about what to do if they Carlton House (30) DS0000025763.V266311.R01.S.doc Version 5.0 Page 14 think that a service user is being hurt or abused by another person. The staff know what they then have to do to keep people safe. None of the service users who spoke with the inspector said that they are being hurt by anyone else. The programme of training for staff is still ongoing to ensure that all of the staff are eventually trained about protecting vulnerable people from abuse. Carlton House (30) DS0000025763.V266311.R01.S.doc Version 5.0 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 service users can feel confident that they live in a safe, well maintained and clean home. EVIDENCE: There have been continuing improvements to the home’s environment over the last year. Maintenance of the home is now given more diligent attention and the environment is a safe, clean and pleasant enough one in which to live. Carlton House (30) DS0000025763.V266311.R01.S.doc Version 5.0 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 home is mostly good at the way in which staff are recruited and trained. However, the management team must remain aware that if they do not ensure that all the required background checks on staff are always carried out then this could place service users at risk. EVIDENCE: The manager previously provided details of staff that had completed their NVQ level 2 training. Four have done this, three are still doing it and two more will start this training once the current group have finished. The deputy manager of the home started their NVQ assessor training on the same day as this inspection visit. It is good to see that the home has taken action on this, as it had been a requirement at the previous unannounced inspection. The staff files for new staff at the home were looked at to see if they were properly recruited and that all of the correct checks had been done before they started work. It was found that one member of staff who was employed in July had a CRB Disclosure certificate on file. There was a previous requirement that was made in relation to CRB checks and it is positive to note that this is now being complied with. As was reported at the previous inspection, all staff have an individual training and development profile, which is included on their staff files. This covers the Carlton House (30) DS0000025763.V266311.R01.S.doc Version 5.0 Page 17 National Training Organisations workforce training targets and shows that staff are fulfilling the aims of the home and are able to meet the individual and changing needs of service users. Carlton House (30) DS0000025763.V266311.R01.S.doc Version 5.0 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, 33,34, 35, 36, 37 & 38 The management and administration of the home has continued to show signs of improvement in many areas. The management team should, however, remain mindful that they risk undermining the good direct care work of the home if further progress is not made. However, the service users can feel confident that the home carries out all of the necessary health and safety checks to make sure that the house is a safe place in which to live. EVIDENCE: The registered manager of the home, Mrs Akuffo, is also one of the joint owners. Mrs Akuffo has previously been assessed as being a fit person to run the home at the time that she was first registered. Carlton House (30) DS0000025763.V266311.R01.S.doc Version 5.0 Page 19 It was required at the previous inspection that there needed to be a specific Quality Assurance system in the home. A Quality Assurance system is now in place and this includes questionnaires that are given to service users, relatives and other people who have contact with the home. There remains one concern that minutes of service users monthly house meetings could still be better at showing how the staff tell service users about the progress on things that have been talked about. It was noted at a previous annual inspection that where the money that was withdrawn for service users was then paid to a company providing a holiday, this had not been entered through the service users financial records at the home. This must be done in all cases, and as no further monies have since been withdrawn this requirement will not again appear in this report but service users financial records will continue to be checked at random again at a future visit. The home has continued to get better at carrying out staff supervision or appraisal (Staff supervision is a time that each member of staff can meet individually with the manager to discuss how they are progressing in their work and to resolve any employment and training matters). There are now records in place that show that the home is on track to achieve the minimum required six staff individual supervision sessions in each calendar year. It was reported at the previous annual inspection that not all of the records required by Schedules 3 and 4 of the Care Homes Regulations 2001 for the protection of service users and for the effective and efficient running of the business are not entirely appropriately maintained, or being kept up to date and accurate. The proprietors have clearly continued to make a number of positive strides in this direction; however, it is still necessary for staff to sign the records showing that they have read and understood the policies and procedures that are in use at the home. The following health and safety checks have been carried out within the last year: Fire Alarm System: 28/09/04 Fire Extinguishers: 06/05/05 Gas Safety Check: 06/01/06 Electrical Installation: 17/07/04 Carlton House (30) DS0000025763.V266311.R01.S.doc Version 5.0 Page 20 Legionellosis: 25/07/05 Portable appliances: 29/07/05 On the 12th May 2005 an environmental health officer also visited. The report that this person sent to the home did not show any cause for concern. Carlton House (30) DS0000025763.V266311.R01.S.doc Version 5.0 Page 21 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 2 X x 1 X 3 HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 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 2 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 1 3 3 3 1 1 Carlton House (30) DS0000025763.V266311.R01.S.doc Version 5.0 Page 22 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 OP4 Regulation 14 (1) (d) Requirement The home must also ensure that it keeps within its approved registration category and does not admit any person who has needs that the home is not able to meet. Pre placement risk assessment must be completed in the case of everyone who comes to live at the home. The home must complete a care plan for all newly admitted service users, even if someone is only here for short term respite care. The minutes of service users monthly house meetings must still be better at showing how the staff tell service users about the progress on things that have been talked about. (This is an outstanding requirement from the previous inspection) It is still necessary for staff to sign the records showing that they have read and understood the policies and procedures that are in use at the home. (This is DS0000025763.V266311.R01.S.doc Timescale for action 05/12/05 2 OP4 14 (1) (d) 05/12/05 3 OP7 !5 (1) 05/01/06 4 OP33 24 (3) 05/12/05 5 OP37 18 (4) 05/12/05 Carlton House (30) Version 5.0 Page 23 an outstanding requirement from the previous inspection) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP1 OP17 Good Practice Recommendations As recommended at the previous unannounced inspection, the service user guide should be made to be more understandable for service users. It is recommended that the manager keep in regular contact with the advocacy organisation to remind them about the home wanting an advocate for service users when one becomes available. Carlton House (30) DS0000025763.V266311.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 House (30) DS0000025763.V266311.R01.S.doc Version 5.0 Page 25 - 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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