Inspection on 18/12/08 for Chatfield Lodge

This inspection was carried out on 18th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chatfield Lodge 15/06/09

Chatfield Lodge 06/12/06

Chatfield Lodge 10/11/05

Chatfield Lodge 30/11/04

Chatfield Lodge 23/09/04

Similar services:

Ashlong House

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Spring Lane Care Home

Avenues (The) (Neave Crescent)

Delrose House Ltd

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Chatfield Lodge 3 Chatfield Road West Croydon Croydon Surrey CR0 3LA     The quality rating for this care home is:   zero star poor 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: Janet Pitt     Date: 1 8 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. the things that people have said are important to them: They reflect 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 29 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 29 Information about the care home Name of care home: Address: Chatfield Lodge 3 Chatfield Road West Croydon Croydon Surrey CR0 3LA 02086801395 02086861009 unitycommunityltd1@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Barbara Asiama Type of registration: Number of places registered: Mrs Barbara Asiama care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia physical disability Additional conditions: For people who have a mental disorder and have a physical disability Date of last inspection Brief description of the care home Chatfield Lodge is a small domestic-sized home registered to provide a service to adults who are pre-lingually deaf and have mental ill health, past or present. The house is a standard Victorian property, in an ordinary street close to West Croydon rail station, tram stop and bus services. It is particularly convenient for the numerous facilities that central Croydon has to offer.The house is of sufficient size to accommodate four service users all in single rooms. Toilet and bathroom facilities are slightly below the minimum national standard, however the proprietor has purchased the house next door and work is underway to renovate it and then knock the two together. Once this is done, the existing home can be refurbished. At present, the Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 0 5 5 Brief description of the care home existing building provides a lounge, kitchen/diner, a small games/smoking room and a small yard to the rear of the house. Parking is at the front of the house, and is metered. Care Homes for Adults (18-65 years) Page 5 of 29 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: zero star poor 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: The quality rating of this service is 0 stars. This means the people who live in the home experience poor quality outcomes. This unannounced inspection was carried out by two inspectors. We spent a total of five hours at the service on two site visits. During the visits we spoke with people who live there and the manager. We examined records relating to medication, care planning and staff recruitment and training. A tour of the environment was made. Care Homes for Adults (18-65 years) Page 6 of 29 What the care home does well: What has improved since the last inspection? What they could do better: The registered provider told us that two people had recently been referred to the service and admitted at short notice and this was the reason for the lack of some documentation and information requested at this site visit. Nonetheless CSCI expects that appropriate information and documentation should be in place before admitting people to the service. Immediate requirement were served to the registered provider to make sure that all members of staff employed to work at the service have a Criminal Record Bureau check before commencing employment. This makes sure that people are protected from potential harm or abuse. The other immediate requirement was for the fire alarm system to be checked, to make sure it was in working order. The Statement of Purpose should be updated. People must have a contract detailing the terms and conditions of the service provision and what is included in the fee. People must have their needs fully assessed before they move in. Care plans and risk assessments must be in place so that people can live as independently as possible. A record of food served must be kept and made available for inspection. Medication must be handled and administered safely, in line with current guidance, according to individuals needs. Copies of the duty roster of persons working at the service and a record of hours worked must be available for inspection. Recruitment checks must be completed on staff before they are allowed to work with people who use the service. The manager should attend refresher training on safe guarding adults. Policies and procedures require reviewing and updating, to make sure that they provide current information. Health and safety and fire safety arrangements must be in place, to make sure that people live in a safe environment. Care Homes for Adults (18-65 years) Page 7 of 29 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 29 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 29 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People must be assessed correctly to make sure their needs are identified fully. Evidence: The registered provider reported that the home was closed for refurbishment in late 2005. We noted that Statement of Purpose and Service Users Guide had not been reviewed since that time. The registered provider must update the Statement of Purpose and Service Users Guide. The registered provider told us that three people had recently moved in. Two people had been referred at short notice. One of these people had a recent Community Psychiatric Nurse assessment and the home had partially completed their own assessment. An assessment for the other individual was due to be sent by their care manager. However, the home had not completed a needs assessment on this person. Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: The registered provider must make sure people have a needs assessment carried out before offering them a service. This will make sure that the home can demonstrate whether they are able to meet individuals needs. The registered provider informed us that both people had visited the home before moving in. One person was privately funded, but there was no assessment or information on their needs and the registered provider was unsure of this individuals diagnosis. The registered provider must make sure people have a mental health assessment carried out by a qualified person before offering them a service. The registered provider must carry out an assessment to make sure that peoples mental health needs can be met. The registered provider told us that she was negotiating funding for two people with Croydons Mental Health team. None of the people living at the home had a contract. The registered provider must make sure that people have a contract detailing the terms and conditions and what they should expect to receive and pay for facilities and services provided. This contract should be agreed and signed by people at the point of admission. Care Homes for Adults (18-65 years) Page 11 of 29 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Making sure that care plans and risk assessments are completed fully will ensure that peoples needs are met. Evidence: We examined peoples files. The registered provider told us that she was developing care plans for the people who live in Chatfield. A programme of skill development had been agreed with individuals and included budget training, laundry, washing up and personal hygiene. The privately funded person did not have an assessment, a care plan or any risk assessments. The registered provider must make sure that all of the people who use the service have a care plan in place. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: None of the people who use the service had any risk assessments in place. The registered provider produced a risk assessment and risk management format previously used when the service was operating. The provider stated that she would use these to risk assess individuals. The registered provider must make sure that all of the people who use the service have risk assessments in place. One person told us that they had only moved it and liked the place. Staff working at the home were nice and treated them well. Care Homes for Adults (18-65 years) Page 13 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appropriate arrangements are made so that individuals can have contact with their friends and families. Evidence: As previously stated people had only recently moved in. Day centres and drop in clubs were being contacted to see if these would be appropriate for the people who use the service. One person told us that they attend a day centre one day a week. Another person told us they were quite new there and was getting to know the local area. We were informed that visiting arrangements are between the hours of 2pm and 8pm, Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: but other times can be arranged. One person had recently been visited by their father and other people have family in North London and Northampton. Individuals are asked what they would like to eat and shopping is carried out to meet their requests. The home does not currently offer a menu or keep a record of what people have to eat. The registered provider must develop a menu and keep a record of what has been eaten. Care Homes for Adults (18-65 years) Page 15 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People need to be confident that their needs are being met. Medication is not being managed in line with care plans and risk assessments. This places individuals at risk of harm. Evidence: Medication was seen to be stored in a locked cabinet in the office. The registered provider told us that she had contacted a local General Practitioners surgery to register them with a Doctor. Staff administers medication to these people. The registered provider told us that one person keeps their medication in their bedroom. This person has not had a mental health assessment or a Doctors report. The registered provider must move the medication to the locked cabinet in the office until an assessment is carried out to establish whether they are capable of self administration of medication. Care Homes for Adults (18-65 years) Page 16 of 29 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are not protected from harm and abuse as Criminal Record Checks are not being carried out on staff before they are allowed to work in the home. Evidence: The registered provider indicated that the complaints procedure available in the home was previously used when the service was operating and needed updating. However the policy could not be located at the time of the site visit. The registered provider told us that she had not received any complaints about the service. CSCI have not received any concerns. The registered provider produced copies of Croydon Councils Adult Protection Policy and the services adult protection procedure. She was advised that Croydon Councils Adult Protection Policy had been replaced by Croydon Councils Safe Guarding Adults procedure. It is recommended that the registered provider obtain a copy of Croydon Councils Safeguarding Adults procedure. Currently one member of staff is employed. Examination of their record showed that they had attended training on adult protection in December 2008. The registered provider told us that she attended training on adult protection a few years ago when the home was operating. It is recommended that the registered provider attend Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: refresher training on adult protection. The registered provider was asked to produce a Criminal Records Bureau Check for the member of staff. She told us that they had applied for a check and had not yet received it. The registered provider had not obtained a POVA 1st check. We express our concern that these checks had not been carried out. An immediate requirement was served to the registered provider that they must make sure that all members of staff employed to work at the service complete a Criminal Record and Protection of Vulnerable Adults Check before commencing employment. This will make sure that people who use the service are protected from potential harm or abuse. Care Homes for Adults (18-65 years) Page 18 of 29 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 home has been completely refurbished; people live in a clean, comfortable, and homely environment. Evidence: The home closed for refurbishment in late 2005 and has only recently admitted people. People have single bedrooms with good quality furniture and fittings. Three people have an en suite facility and the home has one bathroom and one toilet. There is a dining room with a table and chairs and a lounge with comfortable furniture and a television; there is also a computer room that people who use the service can access if they wish and a staff room. The premises are clean and decorated to a high standard throughout. Care Homes for Adults (18-65 years) Page 19 of 29 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People need to have confidence in the staff that care for them. Appropriate checks must be in place to make sure that staff are suitably skilled and qualified. Evidence: As previously stated one member of staff is employed at the home, this person was working at the home without a Criminal Record and Protection of Vulnerable Adults Check being carried out. An immediate requirement was served to the registered provider that they must make sure that all members of staff employed to work at the service complete a Criminal Record and Protection of Vulnerable Adults Check before commencing employment. The registered provider was advised that this member of staff could not work at the service until she obtained the above clearance. She immediately contacted an employment agency to recruit staff to cover the service on a temporary basis. We were unable to view the staff members file. We were informed that the file was incomplete. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: It is important that all information required in the Regulations and Schedules is obtained on employees prior to them commencing employment. We are not clear how the home is staffed. The one member of staff works twenty five hours per week and the registered provider stated that they work the remainder. on questioning the registered provider could not state what arrangements are in place for weekend and evening cover. We are not satisfied that there are sufficient number of staff available to meet need. There was no roster available in the home to demonstrate how the provider plans to staff the home and ensure the safety of those people living and working there. Care Homes for Adults (18-65 years) Page 21 of 29 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager needs to develop better organisational skills to run and manage the service. Lack of health and safety arrangements puts people at risk of harm. People must be assessed correctly to make sure their needs are identified fully. Evidence: The registered provider is also the registered manager for the service. She told us that she was a Registered Mental Nurse and had started the Registered Managers Award when the home was last occupied but had not completed the course. She plans to apply to a college to complete the award. A number of policies and procedures were produced during the course of our visit. It was evident that these were in use when people had occupied the service in 2005. It is recommended that the homes policies and procedures are reviewed and updated. We requested a landlord’s gas safety certificate, but the certificate could not be Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: located. A certificate was duly produced for examination when we returned for the second part of the site visit. We asked for evidence that an engineer had checked the fire alarm system, this was faxed to us after the site visit, as it could not be found at the home. We looked at two fire extinguishers, one had last been serviced in 2005 and the other in 2006. The registered provider must ensure that the homes fire extinguishers and fire alarm system are in working order. During the period between our first and second site visit the fire extinguishers had been checked. We made an immediate requirement for domestic type smoke alarms to be fitted in the interim, until the alarm system could be checked by an engineer. We are awaiting confirmation from the provider that this has been done. Care Homes for Adults (18-65 years) Page 23 of 29 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 24 of 29 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 1 42 13 There must be appropriate fire safety systems in place. This will make sure that people are protected from harm 31/12/2008 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 1 4 There must be a Statement of Purpose that reflects accurately the service provision. This will make sure that people are able to make informed choices about where they live. 15/05/2009 2 2 14 Information from other 15/05/2009 health professionals must be obtained as part of the assessment process. This will make sure that that all needs are appropriately identified and planned for. 3 2 14 There must be a full 15/05/2009 assessment of peoples need prior to them moving into the home. Care Homes for Adults (18-65 years) Page 25 of 29 This will make sure that need is identified and the home can demonstrate that it is able to plan how to meet an individuals need. 4 5 5 Each person who lives in the 15/05/2009 home must be provided with a contract that details what the service provision is and what is included in the fee. This will make sure that people are aware of what the weekly fee covers and what monies will be required for extras. 5 6 15 There must be care plans in 15/05/2009 place which lead from a persons assessment of need. these plans must be reviewed at regular intervals. This will make sure that people can be confident that their needs will be met consistently. 6 9 12 Each person must have individualised risk assessments in place. This will make sure that individuals are able to take risks as part of their daily lives 7 17 17 There must be a menu plan in place and a record of what food is prepared and served. 15/05/2009 15/05/2009 Care Homes for Adults (18-65 years) Page 26 of 29 This will make sure that there is evidence that people are able to chose what they eat. 8 20 13 Medication must be handled 15/05/2009 in accordance with current guidance. The homes policy must include sections on self medication and appropriate risk assessments should be in place. This will make sure that individuals are able to manage their own medications when they have the ability to 9 22 22 There must be a complaints policy accessible within the home. This will make sure that people are aware of how to raise any concerns they may have. 10 32 17 There must be a roster in place to demonstrate who will be meeting care needs. This will make sure that the health and safety of individuals is protected. 11 34 19 There must be a clear recruitment procedure in place and necessary checks carried out. This will make sure that staff are recruited in a safe manner and people are not placed at risk of harm 15/05/2009 15/05/2009 15/05/2009 Care Homes for Adults (18-65 years) Page 27 of 29 12 42 13 There must be appropriate fire safety systems in place. The existing fire alarm system needs checking to make sure it works. This will make sure that people are protected from harm 27/02/2009 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 2 3 23 23 40 It is recommended that the home obtain the local authorities current Safeguarding Adults policy. It is recommended that the provider attends refresher Safeguarding training. It is recommended that all polices and procedures are reviewed and updated as needed to reflect current guidance. Care Homes for Adults (18-65 years) Page 28 of 29 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. 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