Inspection on 01/12/08 for Charleville

This inspection was carried out on 1st December 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Charleville 20/02/07

Charleville 04/09/06

Charleville 09/11/05

Charleville 02/11/04

Charleville 05/05/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Charleville 40 Charleville Road West Kensington London W14 9JH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ann Gavin     Date: 0 1 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Charleville 40 Charleville Road West Kensington London W14 9JH 02073856711 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): charleville@lch.org.uk London Cyrenians Housing Limited Name of registered manager (if applicable) Dan Oliver Appiah Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 9 The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home Charleville Road is a registered home for nine people of either gender with mental health support needs. The proprietors are London Cyrenians Housing Limited. The home is a terraced Victorian mansion block that has been converted with nine bedrooms six with en-suite bathrooms with another three bathrooms for general use. There is a staff sleep over room that also has a bathroom attached for staff use. The 9 Over 65 0 care home 9 Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home home is in West Kensington that is close to local shops, amenities and transport links. The fee for the service is #493.05 per week. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection on Monday 1st December 2008. The last unannounced inspection was on the 20th February 2007. This inspection was from 9.50 am to 5.10 pm. Time was spent talking individually with three of the people who live in the home. All the other people living in the home were met during the course of the day. The manager and deputy manager were available all day and were open and receptive to the inspection. Three staff were spoken with individually. Information was also gained form questionnaires that were returned. The comments have been used to inform the report. A tour of the communal parts of the home was undertaken and two of the people who Care Homes for Adults (18-65 years) Page 6 of 28 live in the house were happy to show their bedrooms. A variety of records were reviewed and the care of three people was tracked through talking with them, looking at their support plan and other records and talking with their key workers. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Chareville Road have good admission procedures. There is clear information about the home available to prospective residents. Evidence: The home has not had a new admission for the last three years. One of the last people to be admitted spoke of how they were approached by a member of the home when they were in hospital and given information about the home. They later visited and stayed overnight prior to being admitted. The manager says that they have two people who are being discharged into extra care housing within the next month. The home admissions policy has remained unchanged. Charleville oad have clear information about the home. Care Homes for Adults (18-65 years) Page 10 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are fully involved in creating their support plans which are reviewed regularly. People within the home are supported to take risks and management plans are in place for most areas of daily living. Risk assessment and management plans for people smoking must be completed. Evidence: The care of three people who live in the home was tracked. Case tracking involves talking with the people who live in the home,their key worker and reviewing all documentation linked to their care. The documentation seen was clear and informative. There were individual profiles and detailed care plans. The care plans were made up of individual support plans which gave a good picture of peoples needs in all aspects of daily living. There is a clear inclusion of equality and diversity throughout the care plans.Peoples health, social, personal and cultural and religious needs are assessed and a plan made with the Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: resident to cover each area. One persons support plan included help with managing money, another to support them to maintain contact with their family. Goals are set for the various areas with plans on how to achieve them. It was evident from the support plans that the people who live in the home are very much involved in creating their plans. Each support plan is signed by both the person and their key worker. The people in the home confirmed that they are involved in and are encouraged to meet their set goals. The three care plans seen were all reviewed regularly. The reviews involved the person and when appropriate the care managers and other professionals. The home record when peoples support and CPA needs to be reviewed and they manage the reviews within the set time scales.The staff record daily significant events and also monthly summaries which ensure that peoples needs are being met. The manager and staff were very aware of the need to have risk assessments and risk management plans in place.The care plans seen did address most areas of risk and had contingency plans in place. One area of potential risk not covered was around smoking. A high percentage of people in the home smoke. Following the new legislation earlier in the year people now smoke either outside in the small garden or in their rooms.There was evidence in a persons room of cigarette burns on the furniture, window sill and ciggerette ends on the carpet all of which could be a high fire risk.Discussing with the key worker and the manager it was clear that they aware of this risk and have been trying to address it. The home will seek advise and will also complete a risk assessment and risk management plan with this specific resident and all those who smoke to ensure their safety and the safety of all in the home. Care Homes for Adults (18-65 years) Page 12 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home develop their life skills and have good links with the local community. People create, cook and enjoy their meals. Staff support people in a way to enhance their skills. Evidence: One of the people who live in Charleville was at the door when the inspector arrived. They were welcoming and led the inspector to the office. Observing the people who live in the home, how they relate to one another and to the staff it was clear that people have respect for one another and that each person is encouraged and supported to be as independent as possible. People are encouraged to develop their life skills. Everyone in the home devise their own menu and prepare their meals, with support if needed. One person was observed asking for money to go out and buy their lunch. The staff member talked with them about their menu plans and the person Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: asked for suggestions about vegetables to accompany the meal. The manager explained that people have a daily budget for their meals. Staff spoke about peoples increased skills in cooking and how much everyone enjoys their achievements. They are a really good cook . I love it when they cook one resident commented about anothers cooking. A communal meal is cooked on Saturday night with two residents and a staff member. Sunday lunch is prepared together and is always a traditional full roast dinner which is enjoyed by all. During the day one of the residents was icing some of the seven Christmas cakes they had baked with one of the staff. One of the people spoke of how much they enjoyed the day centre they attend each afternoon. The staff are currently supporting another person to find further employment. They have successfully been employed as a receptionist and doing administrative work but need to find another place as there is currently no work available for them. Talking with the residents and the staff they plan a number of group activities. They usually plan a full day group activity each month. The Saturday before the inspection they had spent the day in Westfield a new shopping centre, eaten out and then went to the theatre. Other trips out are to the cinema, meals out, day trips. During the week there are various in house activities which include healthy eating and arts and crafts. Examples of peoples art work was on display as were calenders and cards which residents had made. The small garden has an array of winter plants which the residents have chosen and maintain. Currently the people who live at Charleville Road do not have access to a computer. It is recommended that a computer be made available to enhance peoples life skills and broaden their activities. There were posters up for their Christmas party and other external Christmas events. People confirmed that they keep up contacts with family and the staff support them in this. Care Homes for Adults (18-65 years) Page 14 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples are supported in meeting their emotional personal and health care needs. The medication policies and procedures help people to be as independent as possible in managing their medication. Evidence: The information received from the manager in their Annual Quality Assurance Assessment (AQAA) said that we aim to provide people with the relevant health care information to ensure that their emotional health needs are met. Everyone in the home have been registered with a local GP practice.There are close links with the local mental health services and people are supported to ensure that they take their medication regularly. All medication is kept in a locked cabinet in people rooms.Two people administer their own medication . One person showed me their cupboard and explained how they were supported to take their medication on their own. They described how they had made mistakes in the beginning and how happy they were that the staff helped them to understand their drugs better and to support them to the point that they are now Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: confident and self sufficient in handling their medication. All of the medication is delivered in blister packs which are kept in peoples rooms. Extra medication is kept in a locked medicine cupboard in the office. There are systems in place to monitor medication of all residents. The medication records were looked at and all were up to date and in order. One person is awaiting a hip operation. The staff have been supporting them with the preparation including making plans for how they can assist them post operatively and care for them in the home until their mobility returns. The person said how they felt safe and cared for. Peoples health and emotional well being is continually assessed and plans put in place to meet and support their needs. The home has a second hand rail on the stairs and one of the bathrooms has been adapted to help maintain peoples independence. Care Homes for Adults (18-65 years) Page 16 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home know who to talk to if they are not happy. There are regular house meetings where people can talk about any issues. The staff keep up to date on safeguarding and deprivation of liberty issues. Evidence: I can speak to my main key worker if I am not happy but I find all the staff are easy to talk to quote from a resident. From the feedback forms received and from speaking with the residents it was clear that people feel able to talk about things that they are not happy about. The home has a complaints policy and procedures but there have been no formal complaints since the last inspection. People say that they use the residents meetings or the meeting with their key worker to talk through things and resolve issues. The manager and staff are keeping up to date on the Mental Capacity Act and the implications of deprivation of liberty. They have attended training and have further training planned. All staff have received training on the safeguarding of adults. There have been no safeguarding issues. The manager has kept the commission informed of any incidents. Care Homes for Adults (18-65 years) Page 17 of 28 Care Homes for Adults (18-65 years) Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in the home are involved in the choice of decoration and furnishings. The home is clean and fresh. There are planned maintenance programs and the manager will inform the commission of the timescales to complete these. Evidence: Charleville Road is a well situated victorain house within easy reach of transport links and shops. Each person has their own room with communal kitchen and lounges plus a small quiet lounge. The kitchen and lounges are located in the basement access is via some steep stairs. Residents told me to take care and said that they have learnt to be extra careful. The home is not accessible for people with high mobility needs. All the communal areas of the home were clean and fresh. Everyone in the home is proud of the small attractive patio garden and the residents have chosen and planted the shrubs and flowers. Touring the communal areas it was clear that the lounge and the kitchen were in need of decorating. The manager has plans to redecorate the lounge and replace the sofas.It is a requirement to include the kitchen in the planned redecoration. Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: Two peoples bedroom were seen and both required new furniture. The manager was aware of this and plans to renew the furniture. One of the people may be moving into a room which will soon become vacant and the manager wanted to wait until they moved to see with the resident the best furniture for the room. The manager will send to the commission the timescales for the redecorating and replacing of the furniture. The staff have a sleep in room beside the office on the ground floor. This has no form of ventilation. A glass panel was put in place to allow natural light though this would need to be made into a window to allow minimum ventilation. The ventilator in the staff en suite bathroom also needs to be repaired or replaced to allow for ventilation. Care Homes for Adults (18-65 years) Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Charleville Road has an experienced staff team. They have regular training and good management support. Observation showed positive relationships with the people in the home. Evidence: Charleville Road is currently recruiting for a permanent member of staff. The manager is involved in the process and is talking with the people in the house to see if they wish to be part of the panel. All the recruitment processes are dealt with by the Human Resources team based at head office. They ensure that all the relevant checks and gaps in employment are checked and completed. The current shortfall of staff is covered by bank staff. The organisation does not employ agency staff to ensure continuity of care for the residents. The staff spoken with felt that bank staff works well. There is a dedicated and experienced team of staff. They are all qualified and have good training and updates. The deputy manager is starting their NVQ level 4 having already gained NVQ level 3. All the staff spoken with said how the organisation was good at providing and supporting training. Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: The staff said how they are well supported by the manager.They have regular supervision and staff meetings. Observation throughout the day showed that residents and staff related well. People were given the time and support to manage their day and meet the goals they had set. Residents spoken with spoke positively of the support the staff how they are helpful and easy to talk with. The organisation has a service users reference group which meets monthly and people from Charleville Road are involved. Three staff files were seen. The main files with their application references and checks are held in the head office. The files held in the home contain supervision notes and training records. Care Homes for Adults (18-65 years) Page 22 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Charleville Road is a well managed home. There is a quality assurance system in place. Records are well kept but staff need to ensure that they maintain all records up to date Evidence: Charleville Road is well run by an experienced and registered manager. He keeps up to date with current practice, legislation and training. The staff spoke well of him and he showed an open and accommodating manner throughout the inspection. The ethos of the home is centred on the people who live there on supporting them to develop and enhance their life skills and independence. Since the last inspection a comments and suggestion box has been put in place. There are regular house meetings to involve residents in all aspects of the house. The manager is working on an updated resident questionnaire that was recommended from the last inspection to include more aspects of life in Charleville. Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: The health and safety records seen were up to date. There was a planned fire drill in the morning which everyone took part in. Letters were seen in residents personal files when they did not respond to the fire drill stressing the reason and importance of such drills. There have been no accidents/ incidents outside those reported to the commission. There are thorough regular monthly unannounced visits by the provider and these reports are forwarded to the commission. The staff are aware of the importance of record keeping and generally this was up to date. All care plans, reviews, updates are typed and given there is only one computer staff said that they cannot complete or update plans easily as the demand on the computer is too great. Speaking with one of the senior managers in the organisation they felt that one computer should be sufficient if staff use the quiet times of the day to access the computer. The manager must review the use of the computer ensure that staff have access during their shift in order to maintain up to date records. The manager needs to keep this situation under review. Care Homes for Adults (18-65 years) Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The manager must ensure 19/12/2008 that there is a risk assessment and risk managemet plan in place for all people who smoke in their rooms to minimise the risk of fire and ensure their own and others personal safety. 2 24 23 The manager must give the timescale for the redecoration of the lounge and kitchen so that the people who live in the house know when to expect the decoration 31/01/2009 3 26 23 The manager must give the 31/01/2009 timescale for the replacement of peoples bedroom furniture, bed linen the lounge furniture and curtains. in order that people receive their furniture in a timely fashion. Care Homes for Adults (18-65 years) Page 26 of 28 4 28 23 The manager must change 31/01/2009 the glass panel into a window in the staff sleepover room to allow for ventilation.The ventilation in the staff en suite bathroom must be repaired or replaced In order that staff can regulate the temperature and have some ventilation for health and safety reasons Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 12 The people who live in the home would benefit form the use of a computer to further their life skills and independence A more detailed service user survey should be designed so that service users can comment on all aspects of their care and home environment. The manager must ensure that staff have access to the computer in order that they may maintain up to date records 2 39 3 41 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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