Inspection on 01/06/05 for Charles Curran House

This inspection was carried out on 1st June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 but made no statutory requirements on the home.

Other inspections for this house

Charles Curran House 15/02/07

Charles Curran House 03/10/06

Charles Curran House 30/11/05

Charles Curran House 27/10/04

Charles Curran House 17/05/04

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Chatsworth Care - Tudor Lodge

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

CARE HOME ADULTS 18-65 Charles Curran House 36 Boniface Road Ickenham Middlesex UB10 8BU Lead Inspector Robert Bond Unannounced 1st and 3rd June 2005 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 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 Stationary 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. Charles Curran House G61-G10 s32472 Charles Curran v227704 010605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Charles Curran House Address 36 Boniface Road, Ickenham, Middlesex, UB10 8BU Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01895 674 935 01895 622 113 lgarlick@Hillingdon.gov.uk London Borough of Hillingdon Mrs Laraine Barbara Garlick Care Home 22 Category(ies) of Learning disability (0), Physical disability (0), registration, with number Sensory impairment (0) of places Charles Curran House G61-G10 s32472 Charles Curran v227704 010605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27 October 2004 Brief Description of the Service: Charles Curran House is a purpose built two storey care home for adults with profound learning disabilities, operated by Hillingon Council and opened in 1981. It is located at the end of a cul-de-sac, very close to the centre of Ickenham village and hence is close to all local facilities and public transport. The home is divided into four units and can accommodate 22 permanent service users of either sex who have usually a mixture of learning and physical disability and sensory impairment. All service users attend day centres upto four days per week and the home has the use of three vehicles to take them out. Charles Curran House G61-G10 s32472 Charles Curran v227704 010605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspector conducted this unannounced inspection over two days undertook case tracking and spoke to four service users, a relative, a student on placement and most of the staff on duty. On the second day he only met the Registered Manager who was unavailable on the first day when he was assisted by a senior care worker. Everyone spoken to is thanked for their help during this inspection. The home had one vacancy for a new service user, but approximately one third of the permanent staff posts were vacant and covered by agency staff. A recruitment drive is underway, but the last drive only produced one new member of staff. Staff morale and that of one service user and her mother was not as high as it might have been due to rumours that the home might close in three to five years time to be replaced by smaller group homes. Some of the bedrooms are not of the required size for service users who might require to use wheelchairs or mobile hoists within them. However standards within the home are generally good and improving. Of the 17 requirements and 6 recommendations made at the last inspection, all but 4 requirements had been met. A further 6 requirements were made at this inspection. The home was inspected against 29 of the National Minimum Standards, 19 were fully met, 8 were partially met and 2 were not met. What the service does well: What has improved since the last inspection? Individual Care Plans are being improved and extended. Person Centred Planning including Health Action Plans are being introduced throughout the home. Staff training including NVQ’s for care staff has been extended. A new staff recruitment drive has been launched. Parts of the home have been redecorated, a maintenance programme instigated and a shed for storage erected. Medication storage and record keeping has been improved. Several electrical beds. new chairs for the activity room , new carpet for the hall, stairs and landing, and a new computer for the office have all been purchased. Charles Curran House G61-G10 s32472 Charles Curran v227704 010605 Stage 4.doc Version 1.30 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. Charles Curran House G61-G10 s32472 Charles Curran v227704 010605 Stage 4.doc Version 1.30 Page 7 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 Standards Statutory Requirements Identified During the Inspection Charles Curran House G61-G10 s32472 Charles Curran v227704 010605 Stage 4.doc Version 1.30 Page 8 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 standard(s) 1 In order to meet the outcome for service users and their families the following is required. The Statement of Purpose and welcome brochure must be updated to refer to the CSCI. The whole certificate of registration must be displayed in a public place, such as the entrance foyer of the home. EVIDENCE: The ‘Welcome to Charles Curran’ leaflet is dated March 2003 and refers to the NCSC and not the successor Commission for Social Care Inspection. The Statement of Purpose is dated April 2004 and also refers to the NCSC. There is a Service User Guide in a pictorial format that could be understood by the existing service users. One page only of the certificate of registration was displayed, and this was on an office wall rather than in a public space. No new service user had moved in to the home since the last inspection. Charles Curran House G61-G10 s32472 Charles Curran v227704 010605 Stage 4.doc Version 1.30 Page 9 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 standard(s) 6, 7, and 9 All the above standards and outcomes are fully met to the benefit of service users. EVIDENCE: A Person Centred Care Plan and Personal Planning Book have been created for one service user, and a second is being worked upon as the programme is rolled out across the home. So far 12 care staff have been trained in Person Centred Planning and a further three are to be trained next month. The home is commended for taking this initiative. Service users were involved in the above and in their review meetings. Independence is promoted as evidenced by the service user who has made substantial progress towards more independent living. Charles Curran House G61-G10 s32472 Charles Curran v227704 010605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15 and 16 All the above standards and outcomes are fully met, to the benefit of service users. EVIDENCE: None of the service users are able to engage in paid or voluntary work, however all go to day centres on three or four days per week, and some are able to engage in college activities whilst there, including cookery and art. Service users are able to go for pub lunches, visit the cinema and go bowling. The home has three vehicles, two of which can take wheelchairs, and the vehicles are driven by staff from the home. Garden parties and Christmas pantomimes are held at the home which is also visited by local boy scouts. Relatives are fully involved. The provision of food will be inspected next time but it is noted that the cook has left, the temporary staff agency has been unable to provide a satisfactory replacement, and so care staff are themselves doing the cooking on a temporary basis pending recruitment of a new cook. Charles Curran House G61-G10 s32472 Charles Curran v227704 010605 Stage 4.doc Version 1.30 Page 11 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 standard(s) 18, 19 and 20 All the above standards and outcomes were fully met to the benefit of service users. EVIDENCE: Care plans demonstrate that personal care and personal preferences are appropriately dealt with, and this was observed to be happening in practice. Person Centred Plans include Health Action Plans. Although bedroom doors are often open, personal care is delivered privately thus maintaining service user’s privacy. A choice of four GPs is possible, the dentist visits the home as do district nurses for two service users, and occupational therapist and physiotherapist as required. Enhanced procedures have been implemented for the administration of controlled medication. Charles Curran House G61-G10 s32472 Charles Curran v227704 010605 Stage 4.doc Version 1.30 Page 12 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 standard(s) 22 and 23 The complaints procedure must be amended in order to refer to the role of the CSCI so far as ‘registered care services’ are concerned. The investigation and recording of complaints within the home must meet the requirements of Standard 22. The home must have an up to date adult protection policy that accords with the Care Standards Act, 2000. EVIDENCE: There are no formal service user meetings as few would be able to engage in them. However service users are consulted on a one to one basis by their link worker and at review meetings. Questionnaires are sent to relatives. One complaint letter has been placed on file since the last inspection. It is from a relative and involved the loss of an article of clothing whilst the service user was at a day centre. Although the issue appears to have been resolved successfully, the record does not show how that was done, and no letter was sent to the complainant acknowledging the complaint, explaining the outcome, or giving the complainant information about the next stage in the complaints process if they remained dissatisfied. The complaints policy seen is dated 1997 as is the Hillingdon Social Services Department one. As such it does not mention the role of the CSCI in complaints investigations. The Adult Protection policy seen is dated 2001 as is the Multi Agency Hillingdon policy. This document is very out of date. The home do have however the Department of Health’s Practical Guide for Care Homes, and Hillingdon’s adult protection co-ordinator is due to provide training for the home’s staff during August 2005. The ‘whistle-blowing’ policy for staff was displayed on a notice board. Charles Curran House G61-G10 s32472 Charles Curran v227704 010605 Stage 4.doc Version 1.30 Page 13 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 standard(s) 24, 25 and 30 As the home was built before the present environmental Standards were enacted, it is exempted from them and therefore technically meets the standards 24 and 25, particularly as risk assessments have been done. Also, the Registered Manager reported that the home has a limited life. However some bathroom and toilet floors must be replaced, and damage to doors and walls made good in order to fully meet Standard 24. Standard 30 is not met as the Water Supply (Water Fitting) Regulations 1999 are not met. This is a Health and safety issue, see Standard 30. EVIDENCE: If Charles Curran house were a new home, it would not be registered as the number of service users exceeds 20, the bedrooms are not en-suite, and 11 of the bedroom are less than 10 square meters in size. Indeed where service users require to use wheelchairs or mobile hoists in their bedrooms, these rooms should be 12 square meters. Only two bedrooms at Charles Curran House are this size. However few service users use wheelchairs within their bedrooms and those who do are given the largest rooms. In three instances, ceiling mounted hoists have been fitted as a way around the difficulty. Risk assessments have also been undertaken in undersized rooms used by those needing to use wheelchairs in order to measure the extent that service users Charles Curran House G61-G10 s32472 Charles Curran v227704 010605 Stage 4.doc Version 1.30 Page 14 and staff may be in danger of injury, and to take appropriate preventative action as possible. A planned maintenance programme is now in place, and most decoration required has now been undertaken, and some chairs and carpet have been replaced. However the flooring of two bathrooms and one toilet are in need of replacement, and some doors and walls are badly scarred by wheelchairs. There remains a Health and Safety issue in the laundry as it appears that nonreturn valves have never been fitted to the washing machines. Charles Curran House G61-G10 s32472 Charles Curran v227704 010605 Stage 4.doc Version 1.30 Page 15 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35 and 36 The use of temporary agency staff due to the number of vacant posts is too high. It is to be hoped that most posts will be filled by the recruitment drive currently under way as service users will receive a higher standard of service from staff who are permanent, know the needs of service users, and have the appropriate training and qualifications. Training of the care staff in NVQ’s is progressing. When the current trainees have qualified, 42 of the staff will be trained. The nationally set target is to exceed 50 . Satisfactory recruitment processes are being followed. There needs to be a home-wide training and development plan. Formal supervision of staff is occurring EVIDENCE: The extent and number of vacant posts in hours per week is as follows: Team Leader 22; Care Workers 168; Night Care Workers 66; Administration 4; Handyman 20; and domestic 40; that is 320 hours in total or 9 whole time equivalent posts. This equates to 30 of the staff establishment being covered by agency staff. Out of the 24 permanent care staff in post, 6 have obtained NVQ level 2 or 3 and a further 4 are undertaking the qualification. One new member of staff had started since the last inspection. References were taken up, a CRB obtained, and her training comprised of induction, PCP Charles Curran House G61-G10 s32472 Charles Curran v227704 010605 Stage 4.doc Version 1.30 Page 16 awareness, food hygiene, and moving and handling. She is booked onto epilepsy awareness training. All permanent staff and those agency staff, who do regular hours and are based in a unit of the home, have ‘employee performance , development and review plans’ in place. There is however no home wide training and development plan. Formal supervision of all staff is planned to take place on a monthly basis. Charles Curran House G61-G10 s32472 Charles Curran v227704 010605 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 40, 41, 42 and 43. Standards and outcomes are met except Quality Assurance as there is no Business Plan and Health and Safety due to the Water Supply (Water Fittings) Regulations not being met in the laundry. This potentially could adversely affect service users and staff if dirty water was able to contaminate the drinking water supply. EVIDENCE: The Registered Manager is undertaking the Registered Manager’s Award. Staff meetings, senior staff meeting, and unit staff meetings each take place 6 weekly. The use of quality assurance questionnaires has been introduced but there is no resulting business plan for the current year. There is however an action plan for the division as a whole. New policies have been added as per the requirement of the last inspection report. Record keeping was found to be generally good. Charles Curran House G61-G10 s32472 Charles Curran v227704 010605 Stage 4.doc Version 1.30 Page 18 Health and safety checks made included risk assessments, use of a weekly check list, fire system checks, and a Legionella free water test. However the washing machines do not appear to have the required non-return valves. Charles Curran House G61-G10 s32472 Charles Curran v227704 010605 Stage 4.doc Version 1.30 Page 19 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x x x x Standard No 22 23 ENVIRONMENT Score 1 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 x x x x 2 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score x 2 2 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Charles Curran House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 2 3 3 2 3 G61-G10 s32472 Charles Curran v227704 010605 Stage 4.doc Version 1.30 Page 20 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. 2. Standard 1 22 Regulation 4 and schedule 1 22 Requirement The Statement of Purpose must be updated, and refer to the role of the CSCI. The complaints procedure must refer to the role of the CSCI. THIS IS RESTATED FROM THE LAST INSPECTION. THE PREVIOUS TIMESCALE OF 1/01/05 WAS NOT MET. The detail of the investigation and outcome of all complaints must be recorded. An adequate Adult Protection Policy must be in place Areas of flooring identified must be replaced and damaged doors and walls made good. THIS IS PARTIALLY RESTATED FROM THE LAST INSPECTION. THE PREVIOUS TIMESCALE OF 1/01/05 WAS NOT MET.. There must be evidence that the home fully complies with the Water Supply (Water Fittings) Regulations 1999. THIS IS RESTATED FROM THE LAST INSPECTION. THE PREVIOUS TIMESCALE OF 1/12/04 WAS NOT MET.. 50 of the care staff team must Timescale for action 1 August 2005 1 December 2005 3. 4. 5. 22 23 24 22 13 (6) 23 (2) (b) 1 July 2005 1 December 2005 1 September 2005 6. 30 and 42 13 (3) 1 July 2005. 7. 32 18 (1)c 1 January Page 21 Charles Curran House G61-G10 s32472 Charles Curran v227704 010605 Stage 4.doc Version 1.30 8. 9. 33 39 18 (1) a 24 10. 35 18 (1) c be undertaking or have obtained NVQ level 2 or 3 in care by the end of this year The home must recruit an effective staff team and have low usage of agency staff An annual business or development action plan is required specifically for this home. THIS IS RESTATED FROM THE LAST INSPECTION. THE PREVIOUS TIMESCALE OF 1/01/05 WAS NOT MET. There needs to be a home-wide training and development plan 2006 1 October 2005 1 October 2005 1 October 2005 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. Refer to Standard Good Practice Recommendations Charles Curran House G61-G10 s32472 Charles Curran v227704 010605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Ground Floor 58 Uxbridge Road Ealing London W5 2ST 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 Charles Curran House G61-G10 s32472 Charles Curran v227704 010605 Stage 4.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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