Inspection on 26/04/05 for Charlton Road

This inspection was carried out on 26th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Charlton Road 30/04/07

Charlton Road 05/05/06

Charlton Road 04/11/05

Charlton Road 01/10/04

Charlton Road 21/04/04

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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 Charlton Road 30a Charlton Road Blackheath London SE3 8TY Lead Inspector Pauline Lambe Announced 26th April 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. Charlton Road Version 1.10 Page 3 SERVICE INFORMATION Name of service Charlton Road Address 30a Charlton Road Blackheath SE3 8TY 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) 0208 305 2425 0208 305 2425 Milbury Care Services Ltd Vacant CRH 5 Category(ies) of LD(E) 5 registration, with number of places Charlton Road Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: The home had a variation to provide care and accommodation for one named service user over the age of 65. Date of last inspection 1/10/04 Brief Description of the Service: 30a Charlton Road is a registered care home providing accommodation and nursing care for four adults with a learning disability. It is situated near to “Blackheath Standard” and a local shopping centre that has good public transport links. The home is one of a group of six homes for adults with learning disabilities situated in the London Borough of Greenwich and managed by Milbury Community Services Ltd. The property is a detached bungalow which provides four single bedrooms, a lounge / dining room, kitchen, laundry room, toilet and bathing facilities. The property had small gardens to the front and rear. The home has links with the Greenwich Community Learning Disabilities Team (C.L.D.T) to provide a multidisciplinary service. Members of the C L D T are involved in placements in the home, monitoring resident care and progress and provide day care services and links to specialist health care. Charlton Road Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was undertaken as part of the routine inspection programme and was completed in 6.25 hours. The last inspection was on 1st October 2004. Four residents were in the home at the beginning and end of the inspection. For the remainder of the day residents were at the day centre or on an outing to Margate. The inspection included a tour of the premises, inspecting records, talking to residents, the manager and three of the staff team. No relatives were seen but two comment cards had been received from relatives and two from visiting professionals. What the service does well: What has improved since the last inspection? What they could do better: More attention was needed to ensuring homely remedy medications were correctly recorded. Recruitment procedures must include checking nurses employed are registered with the Nursing & Midwifery Council. Staff must have access to a clear policy and procedure as to evacuation of the home in the event of a fire. More attention was needed to ensuring the home had a quality review system in place with outcomes of such a review available to the residents, relatives, the Commission and other stakeholders. Charlton Road Version 1.10 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Charlton Road Version 1.10 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 Charlton Road Version 1.10 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 to 5. The home provided adequate information about the service. Introductory visits were part of the admission process. EVIDENCE: The statement of purpose had been updated and the document complied with regulation. How well the home meets these standards has yet to be assessed in practice as no new residents had been admitted to the home since the introduction of the National Minimum Standards. The contract for service must be amended to reflect the fees paid and show who is responsible for paying these. Requirement 1. Charlton Road Version 1.10 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 to 10. From the evidence provided and relative comments received staff worked positively to meet resident’s individual care needs. EVIDENCE: Care provided to two residents was tracked. Care plans were well written and were supported by up to date assessment of need. It was not evident in the care plans that residents or relatives were involved in care planning. However staff said they endeavoured to involve residents in decision making based on their individual communication and comprehension. Staff were observed communicating with residents and involving them in whatever was going on. Life plans were up to date and had been prepared in the presence of the resident. Life plans had clear goals set with planned achievement dates. Resident’s records were well maintained, safely stored and respectfully written. At the time of the inspection one service user was at a day centre and the others went out for the day to Margate. On return from their trip residents presented as happy and exhilarated. Those who spoke to the inspector said they had enjoyed their day out. None of the residents took responsibility for managing their own finances. Robust systems were in place to ensure staff and management did this safely on their behalf. Charlton Road Version 1.10 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 to 17. From the evidence provided and the information obtained staff worked towards providing residents with lifestyles suited to their ability and preference. EVIDENCE: All residents attended a day centre for some part of the week. The day centres provided opportunities for residents to develop individual skills. There were no plans for the current residents to attend further education or to seek employment. All residents had a bus pass and staff supported them to access local areas using public transport as an alternative to using the home’s mini bus. Staff planned outings and activities around resident preferences and records showed these included day trips, meals out, pub visits and support to access local entertainment and leisure activities. Family support was encouraged and staff said they had built positive relationships with relatives. The kitchen was well clean, tidy, well stocked with fresh and frozen foods. All staff had been trained in food safety and foods were stored properly. Menus seen showed a varied diet was provided. It was also evident nutritional advice had been obtained for residents from the G.P and dietician. Charlton Road Version 1.10 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 to 21. Care plans were well written showing how resident’s personal and healthcare needs were met. Medication management had improved since the last inspection. None of the residents managed their own medication. EVIDENCE: Care plans and daily records showed how personal care was provided. Staff spoke with knowledge and confidence about resident’s individual needs and preferences. For example around times for getting up, going to bed, whether they preferred to lie in, preferences for a bath or a shower and mood indicators. All residents were registered with a G.P and it was evident they were supported to access other health care such as dental, optical, dietician and chiropody. Specialist health care was accessed through G.P referral. Residents had access to an aromatherapist on a privately funded basis and most of them used and benefited from this therapy. Medicines were generally well managed. Because there were concerns with drug errors in the past the manager had introduced a system to check medicines weekly. The management of homely remedy medication needed improvement to ensure records were kept for receipt and administration. Residents could stay at the home in their final days provided the home could meet their needs. The home had a variation to care for one older person and were meeting their health and social care needs. All but one resident had a funeral bond. Requirement 2. Charlton Road Version 1.10 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. Adequate systems were in place to ensure residents were protected from abuse and to manage complaints about the service. EVIDENCE: The home had policies and procedures to deal with complaints and allegations of abuse. Staff received training on adult protection and displayed their understanding of this. Any suspicions or allegations of abuse were referred to the CLDT for investigation Accidents records were well maintained and unexplained injuries were referred to CDLT for investigation. Robust systems were in place to safely manager resident’s personal finances and none of the staff acted as appointee for a resident. There were no complaints or allegations of abuse made about the service to the home or the Commission since the last inspection. Charlton Road Version 1.10 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 to 30. The home was clean and provided a pleasant and homely environment. The home had been fully redecorated since the last inspection. Equipment provided met the resident’s needs and was maintained and serviced. EVIDENCE: As mentioned the home had been fully redecorated since the last inspection. The communal areas were homely and had orientation aids provided. The manager said he had an agreement from senior management to purchase new dining room furniture and lounge seating suited to the resident’s needs. The lounge carpet needed cleaning and the manager had organised this to be professionally cleaned the week after the inspection. Since the last inspection the home did not provide any shared rooms. All the bedrooms had been redecorated to reflect the resident’s choice. Bedrooms were furnished and arranged so that resident’s physical and personal needs could be comfortably met and to reflect the occupants interests. All bedrooms had ceiling hoists, which were last serviced on 5/1/05. The bath and shower rooms were clean, had hand washing facilities and were fitted with equipment appropriate to meeting the needs of the residents. Charlton Road Version 1.10 Page 14 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) 31 to 36. The staff team had the skills, support and training to meet the resident’s needs. There was no evidence to show that management had checked that the nurses employed were registered with the Nursing & Midwifery Council. EVIDENCE: The staff team comprised of a manager, qualified nurses and support workers. Staff said they received training relevant to their role and benefited personally and professionally from having regular formal supervision. Staff spoke confidently and knowledgeably about residents, their needs and life styles. Staff rotas seen showed adequate staffing levels were maintained and levels were varied based on resident commitments. Staff interacted appropriately with the residents and encouraged them to make choices. Staff were clear as to their role, their responsibility and input to the service. Since the last inspection staff had the opportunity to attend training such as fire safety, first aid, health & safety, risk assessment and protection of vulnerable adults. Two staff files were inspected. These were generally well maintained but did not include evidence that a check had been undertaken to show that nurses employed were registered with the Nursing & Midwifery Council. Requirement 3. Charlton Road Version 1.10 Page 15 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 to 43. The manager presented as running the home in an open and inclusive manner. Records, policies and procedures showed attention was given to ensuring the safety of residents and others. EVIDENCE: The manager had applied to register with the Commission. Staff were complimentary about the support they received from management. Two relative and two visiting professionals submitted comment cards, which indicated a positive and inclusive working relationship with the service. The policies and procedures in place ensured the safety and protection of residents were addressed. A sample of safety records including fire safety were inspected and showed systems and equipment were maintained and regularly serviced. The home did not have a clear policy on evacuation procedures in the event of a fire. The manager said that the Organisation carried out a satisfaction survey once a year. No quality review survey outcomes were available to view. Requirements 4 and 5. Charlton Road Version 1.10 Page 16 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 4 4 4 3 3 3 Standard No 11 12 13 3 3 4 Standard No 31 32 33 34 35 Score 3 3 3 2 3 Page 17 Charlton Road Version 1.10 14 15 16 17 4 3 3 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 2 Charlton Road Version 1.10 Page 18 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 5 Regulation 5 Requirement The Registered Person must ensure the contract for service complies with regulation. The contact must include the amount and who is responsible for fee payment. The Registered Person must ensure a record is kept for all medicines brought into the home and administered including homely remedies. The Registered Person must ensure the recruitment procedures comply with this regulation and include checking that nurses employed are registered with the Nursing & Midwifery Council. (Timescale of 30/11/04 was not met) The Registered Person must ensure a system is in place to review and improve the quality of care provided in the home. Outcomes on the quality assurance reviews must be made available to residents, relatives the Commission and others. The Registered Person must ensure the home has a clear policy and guidance in relation to Version 1.10 Timescale for action 3oth June 2005 2. 20 13 31st May 2005 3. 34 19 31st May 2005 4. 39 24 30th June 2005. 5. 42 13 30th June 2005. Charlton Road Page 19 evacuation of the home in the event of a fire. 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 None Good Practice Recommendations Charlton Road Version 1.10 Page 20 Commission for Social Care Inspection Riverhouse 1 Maidstone Road Sidcup DA14 5RH 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. 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