Inspection on 05/05/06 for Charlton Road

This inspection was carried out on 5th May 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Charlton Road 30/04/07

Charlton Road 04/11/05

Charlton Road 26/04/05

Charlton Road 01/10/04

Charlton Road 21/04/04

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 HOME ADULTS 18-65 Charlton Road 30a Charlton Road Blackheath London SE3 8TY Lead Inspector Ms Pauline Lambe Key Unannounced Inspection 5th May 2006 09:30 Charlton Road DS0000006756.V293185.R01.S.doc Version 5.1 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 Charlton Road DS0000006756.V293185.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Charlton Road DS0000006756.V293185.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Charlton Road Address 30a Charlton Road Blackheath London SE3 8TY 020 8305 2425 020 8858 5039 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) londonroad@tiscali.co.uk Milbury Care Services Limited Mr Paul Augustine Doyle Care Home 5 Category(ies) of Learning disability (3), Learning disability over registration, with number 65 years of age (2) of places Charlton Road DS0000006756.V293185.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2 places registered for LD (E) in respect of named service users only. Date of last inspection 4th November 2005 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. The manager confirmed that the current fees for the home are £1438.22 per week. Residents paid privately for personal clothing and toiletries, holidays and some leisure outings. Charlton Road DS0000006756.V293185.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit for this unannounced inspection was completed over 6.75 hours. The manager was on duty and he and the staff assisted with the inspection. One resident was in the home with a second resident returning from hospital during the morning. The other residents returned from the day centre in the afternoon. The service was last inspected on the 4th November 2005. Efforts had been made to address all requirements and recommendations made at the last inspection. The inspection included a review of information about the service, a tour of the premises, inspection of records, talking to residents, relatives and members of staff team. Following the inspection contact was made with relatives and other interested parties to get their views of the service. What the service does well: What has improved since the last inspection? Efforts had been made to identify resident interests and leisure preferences. The kitchen and lounge carpet were cleaner on this occasion. Improvements had been made to medicine management and records were kept for medicines due for disposal. All fire doors closed properly. A new assisted bath had been provided which enhanced resident care. A system was in place to ensure nurses employed in the home were registered with the Nursing & Midwifery Council and ensure residents were safeguarded. An evacuation procedure was in place in the event of a fire. Charlton Road DS0000006756.V293185.R01.S.doc Version 5.1 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. Charlton Road DS0000006756.V293185.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Charlton Road DS0000006756.V293185.R01.S.doc Version 5.1 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 the following standard(s): 2. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. Management were aware of the need to comply fully with this standard and its supporting regulations. EVIDENCE: Only one resident had been admitted to the home since the introduction of the National Minimum Standards. That was prior to the last inspection and the admission had not been particularly well managed. The manager was aware of his responsibility to only admit residents following access to relevant information about the resident, completion of a full assessment of need and confirmation that based on this the home could meet the resident’s needs. Charlton Road DS0000006756.V293185.R01.S.doc Version 5.1 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 the following standard(s): 6, 7 and 9. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. Systems were in place to assess resident needs and care plans were prepared to show how assessed needs were to be met in respect of their health and welfare. EVIDENCE: Care plans for two residents were viewed. These included assessments and the care plans showed how assessed needs were to be met. Most of the residents in the home were unable to participate with preparing care plans and there was little evidence to show they or their relatives had been involved in care planning. Relatives and residents were invited to participate in the preparation of life plans. Relatives contacted said that staff kept them informed about the resident’s health and welfare. A member of the Community Learning Disability Team contacted said that the service was well managed and resident’s received a very good standard of care. Resident records included risk assessments. In view of the dependency of the residents in the home they required staff to assist them with all aspects of their lives. Where risks were identified procedures and care plans reflected how these were being managed. Charlton Road DS0000006756.V293185.R01.S.doc Version 5.1 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 the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area was excellent. This judgement has been made using available evidence including a visit to the service. Residents were supported to participate in activities of their choice both in and out of the home, were treated respectfully and had their dietary needs met. EVIDENCE: None of the residents were involved in further education. All residents attended day centres where they were involved in hobbies and interests of their choice. This included arts and crafts, pottery and computers. All residents had one day off a week. On their day off they had a lie in and spent the day doing activities they enjoyed supported by staff. For example going shopping, having a meal out, going to the cinema or cooking. On the day of the inspection the resident at home got up late, had a manicure and was assisted to make and ice small cakes. The resident seemed to enjoy the personal attention and activities. A one-week holiday in Wales was planned for all residents this Summer. Neither of the care plans viewed contained a social care plan although there was adequate information held separately about each resident’s social interests both in and outside of the home. There was evidence to show that residents had the opportunity to enjoy those activities. Charlton Road DS0000006756.V293185.R01.S.doc Version 5.1 Page 11 From observation residents were welcomed home from the day centres, given personal care and left to relax in the lounge watching TV while waiting for supper. One resident returned home from a stay in hospital. The manager collected the resident to ensure they did not have to wait for hospital transport. While in hospital staff from the home stayed with the resident at all times. The resident’s relative was delighted with this level of support provided from the home. Other relatives made comments such as ‘staff gave the residents a lot of attention’ and ‘staff show concern for the residents and their care and are respectful to them’. Staff interacted appropriately with residents and spoke knowledgably about their needs. Relatives contacted said staff were friendly and kept them informed about resident’s health and welfare. The kitchen was clean and tidy. Records were kept of fridge and freezer temperatures. Menus were prepared with the residents and staff used pictures to help residents make choices. Menus seen indicated a varied diet was provided but did not include the vegetables served with the meal. However from hearing staff discussion it was evident they were aware of the need to provide these to ensure residents had a healthy diet. Two residents ate a normal diet and two were artificially fed. Residents being fed artificially had their dietary needs assessed by the community dietician. Suitable crockery and cutlery was provided for residents to enable them to maintain independence. Requirement 1. Charlton Road DS0000006756.V293185.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. Resident’s healthcare needs were met and some minor improvements were needed to medicine management. EVIDENCE: All bedrooms in the home were for single occupancy, which provided privacy for the residents. Care plans seen showed how personal care needs were to be met. It was not possible for all residents to comment on whether this suited them or not. Feedback from one resident and four relatives indicated satisfaction with how care was provided. Most of the residents in the home were unable to give feedback about any aspect of the service. Daily records were kept to show the care provided and activities the residents were involved with. All residents were registered with a GP and staff supported them to access other medical services such as dental and optical care. Residents paid privately for chiropody treatment. Links were maintained with the community learning disability team to support staff with meeting resident needs. Medicines were well managed and records checked for two residents were found to be correct. The medicine policy and procedure needed to be updated Charlton Road DS0000006756.V293185.R01.S.doc Version 5.1 Page 13 to reflect the change to disposal of medicines. Medicines were no longer being returned to the pharmacy for disposal but were disposed of under contract by a waste disposal company. The container provided for medicines waiting disposal was too small and to hold medicine bottles and jars. The home had a stock of homely remedies, which was agreed with the GP. Records were kept for receipt and administration of these. However the system to record administration of the homely remedies made it difficult to complete an audit trail. A change to the recording system was discussed with the manager. Requirement 2. Charlton Road DS0000006756.V293185.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area was excellent. This judgement has been made using available evidence including a visit to the service. Adequate procedures were in place to ensure complaints were appropriately managed and to ensure protection for residents. EVIDENCE: The home had policies and procedures in relation to complaint management. A system was in place to record complaints made a bout the service. No complaints had been made to the provider or the Commission since the last inspection. Only one resident had some ability to raise concerns and said if they had any they would talk to the manager or staff. Relatives seen or contacted were aware of the complaints procedure. One relative confirmed that a complaint they made some time ago had been managed to their satisfaction. The home had policies and procedures in relation to adult protection. No allegations of abuse had been made to the provider or the Commission since the last inspection. The home had copies of Greenwich adult protection procedures, a whistle-blowing policy and a copy of the Department of Health document ‘No Secrets’. Staff who spoke to the inspector indicated a good understanding of adult protection and how they would manage such a situation. Since the last inspection some staff had attended training on adult protection. Charlton Road DS0000006756.V293185.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27, 28 and 30. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. The environment was suitable to meet the needs of the residents and the home was clean and tidy. Since the last inspection a new assisted bath had been provided. The garden area could be better maintained. EVIDENCE: All areas of the home seen were clean, tidy and free of unpleasant odours. Bedrooms were nicely personalised and the home suitable to meeting the needs of the residents. Relatives said they found the home comfortable and could see their resident in private if they wished. Two residents had their own armchairs to ensure they were comfortable and properly supported. The property was satisfactorily maintained but the garden areas to the back and front looked unkempt. In view of the location of the property the home gets a lot of heavy traffic noise especially when the windows are open or when sitting in the garden. Some time ago efforts were made to look into reducing the noise levels but no solution was found. Since the last inspection a new assisted bath had been fitted. Staff said residents enjoyed and benefited from being able to have a relaxing bath. Charlton Road DS0000006756.V293185.R01.S.doc Version 5.1 Page 16 Hand washing facilities were provided where waste was handled and staff were provided with adequate supplies of protective clothing. The staff had access to policies and procedures on infection control. Requirement 3. Charlton Road DS0000006756.V293185.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. From the evidence available the staff team had the ability to meet the residents needs and received relevant training and supervision. Recruitment procedures were good with all the information required by regulation being included on the employee files seen. EVIDENCE: The staff team comprised of a full time manager, trained nurses and support workers. From the rotas inspected for a 3 week period adequate staffing levels were maintained. Relatives contacted said they felt there was adequate staff on duty in the home. One to one care was provided to one resident and was funded by social services. While one resident was in hospital recently staff from the home stayed with them 24 hours a day. Feedback from relatives was complimentary in relation to the staff team. One relative said ‘the staff are fantastic’ and another said ‘staff are jolly, friendly and informative’. Policies and procedures were provided on staff recruitment. Three staff files were inspected. These were well maintained and contained all the information required by regulation with the exception of a recent photo of the employee. Staff who spoke to the inspector said they had access to training appropriate to their role. The manager received notification of forthcoming training and Charlton Road DS0000006756.V293185.R01.S.doc Version 5.1 Page 18 identified staff to attend. Individual training records were kept and since the last inspection staff had access to training such as first aid, advanced medicine management, food hygiene, adult protection and moving and handling. The manager also attended relevant and update training as needed. Since the last inspection a system had been implemented to provided formal supervision for staff. Records seen supported this and staff said they benefited from these sessions both personally and professionally. Requirement 4. Charlton Road DS0000006756.V293185.R01.S.doc Version 5.1 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area was good. This judgement has been made using available evidence including a visit to the service. From evidence provided the home was well managed, the provider completed an annual quality audit of the service and attention was given to providing a safe environment. EVIDENCE: The home manager had almost completed the registered managers award and had the care skills needed to manage the service. He was registered with the Commission and ensured he attended training relevant to this role. As mentioned only one resident in the home would be able to voice some opinion on the service and indicated satisfaction with the service. The provider completed an annual audit of the service and sent a copy of this to the Commission. The audit for 2005 indicated that there was an overall satisfaction with the service. Regulation 26 reports were sent to the Commission regularly. Charlton Road DS0000006756.V293185.R01.S.doc Version 5.1 Page 20 A selection of safety records were inspected. These included the records for the mini bus, fire safety, gas, hoists, the assisted bath, hot water temperature checks and electricity. Records were up to date and showed attention was given to providing a safe environment for residents and others. The gas certificate had been dated incorrectly and the manager said he would get this amended. The electricity inspection completed in 2004 said a further inspection should be done a year later. There was no evidence to show this had been completed and again the manager said he would get this matter resolved. Fire drills were practiced and at times to include night staff. The home manager provided fire safety training for the staff team and it was felt this might not be appropriate, as he had not received any fire marshal, fir warden or specific fire safety training to enable him to do this. The advice from the fire service was that ‘fire safety training should be provided to staff by a competent person’. This information was passed to the regional manager who said she would look into the matter. Requirement 5. Charlton Road DS0000006756.V293185.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 3 28 2 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 2 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 2 X Charlton Road DS0000006756.V293185.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 YA12 Regulation 15 Requirement Timescale for action 30/06/06 2. YA20 13 3. YA28 23 The registered person must ensure a care plan is prepared to show how residents social needs will be met. 30/06/06 The registered person must ensure the medicine policy and procedure reflects current practice in the home. • The procedure must be updated to reflect the changes to disposal of medicines. • The container provided for medicines waiting collection for disposal must be large enough to hold the medicine bottles and jars. • Homely remedy medicine records must be kept in such a way as they enable an audit trail to be completed. The registered person must 30/06/06 ensure the premises are maintained internally and externally. The garden bust be kept tidy and provide a pleasant area for residents to use. (Timescale of DS0000006756.V293185.R01.S.doc Version 5.1 Charlton Road Page 23 23/12/05 was not met) 4. YA34 19 The Registered Person must ensure the recruitment procedures comply with this regulation. A recent photo must be kept for all employees. The registered person must ensure staff receive fire safety training from someone competent to do this. Advice must be obtained from the fire service as to the competency of trainers. 30/06/06 5. YA42 23 30/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Charlton Road DS0000006756.V293185.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Sidcup Local Office River House 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. Extracts may not be used or reproduced without the express permission of CSCI Charlton Road DS0000006756.V293185.R01.S.doc Version 5.1 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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