Inspection on 27/02/06 for Chelsea House

This inspection was carried out on 27th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chelsea House 15/05/07

Chelsea House 23/11/06

Chelsea House 30/01/06

Chelsea House 24/02/05

Chelsea House 29/06/04

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 Chelsea House 4 Winchelsea Road London N17 6XH Lead Inspector Caroline Mitchell Unannounced Inspection 27th February 2006 09:00 Chelsea House DS0000010823.V287711.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 Chelsea House DS0000010823.V287711.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. Chelsea House DS0000010823.V287711.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Chelsea House Address 4 Winchelsea Road London N17 6XH 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) 020 8885 1898 Mr Wilhelm Dale Lewis Mr Wilhelm Dale Lewis Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Chelsea House DS0000010823.V287711.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th January 2006 Brief Description of the Service: Chelsea House is a small care home registered to provide accommodation and personal care for a maximum of three adults with learning disabilities. Mr Dale Lewis owns the home and is registered as the manager. Mr Lewis also provides a separate specialist outreach service for people with learning disabilities, under the umbrella name of Pashun Care Services. The home is a terraced house with three bedrooms. On the ground floor, there is a lounge, bedroom, toilet, kitchen and a separate dining room. On the first floor there is a bathroom with a toilet, two bedrooms and a small office. There is a small paved area at the front of the house and a back garden, which is accessible to service users. The house is located near the busy Philip Lane and close to a sports centre. There is easy access to shops, restaurants and transport facilities located along the high street at Seven Sisters. The stated aim of the home is to provide a holistic and high quality of care to service users with learning disabilities. The home also aims to provide practical help for service users and maximise their individual potential while adhering to the core values of showing respect for service users, encouraging local community participation and promoting independence. Chelsea House DS0000010823.V287711.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection. However, due to service users and staff being out during the day time, the inspector had given a couple of days notice to the provider to ensure that there would be someone at home and that the inspector could have access to the necessary records. This is a small home for people with learning disabilities. The home tends to specialise in providing care to people with autism and there are currently three men living there. The registered provider and a number of senior staff members were present representing the management team. The inspector was able to briefly tour the home and view a number of written records. What the service does well: What has improved since the last inspection? 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 Chelsea House DS0000010823.V287711.R01.S.doc Version 5.1 Page 6 contacting your local CSCI office. Chelsea House DS0000010823.V287711.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 Chelsea House DS0000010823.V287711.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): These standards were not inspected on this occasion. EVIDENCE: Chelsea House DS0000010823.V287711.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&9 Service users’ assessed and changing needs, and personal goals are reflected in their individual plan and they are supported to take risks as part of an independent lifestyle. EVIDENCE: The inspector noted that there are good quality service user plans in place for each service user, and thorough risk assessments, with guidance for staff about how to minimise the risks. Chelsea House DS0000010823.V287711.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): 13, 14 & 15 Service users are supported to be part of their local community, they engage in appropriate social and leisure activities and maintain appropriate family links. EVIDENCE: Records reflect that the service users have full social lives. The service users like to go swimming regularly, bowling and other ad hoc activities, depending on what the individual would like to do. Appropriate records are maintained of these activities. Service users are enabled to use the resources in the local community and take part in a range of ordinary, day-to-day activities. These include going shopping, attending the day centre, walks in the park, going to the cinema and going to the pub. The inspector noted that positive progress had been made in respect of the home supporting one particular service user to maintain positive family links. He is now having more regular contact with his mother, who appears to be more comfortable talking to a female staff member and who is talking to the acting manager regularly. Chelsea House DS0000010823.V287711.R01.S.doc Version 5.1 Page 11 Chelsea House DS0000010823.V287711.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): 19 & 20 The registered person ensures that the healthcare needs of service users are assessed and recognised, and that procedures are in place to address them. The home’s policy and procedure for the receipt, recording, storage, handling, administration and disposal of medicines protect service users’ best interests. EVIDENCE: The inspector noted that the registered person had sought support and advice regarding one service user, who has some behaviours that are challenging to the service, and was being provided by several health care professionals at Goodmayes Hospital and a behaviour management plan had been agreed upon. This is included in the service users’ records, for the guidance of the staff. Records also reflect that there has been some improvement in the way in which the service user communicates, and a decrease in challenging behaviour as he has settled in the home. Staff receive specific training about working with this particular service user, as part of their induction, and prior to starting work in the home. The arrangements for storing, administering and recording the medication prescribed to service users in the home are satisfactory. The Boots bubble packs are used and the arrangements that were in place were acceptable. The temperature that the medication is stored at is monitored and kept below 25oC. Chelsea House DS0000010823.V287711.R01.S.doc Version 5.1 Page 13 Chelsea House DS0000010823.V287711.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 & 23 There is a clear and effective complaints procedure in place. The policies and procedure in place ensure that service users are safeguarded from forms of abuse, exploitation or neglect. EVIDENCE: The inspector noted that there is a clear complaints procedure in place and that no complaints had been recorded as being received in the home since the previous inspection. At a previous inspection the registered person was required to ensure that all care staff undertake training in adult protection procedures. The inspector was able to confirm that staff had received training in the protection of vulnerable adults and the registered person explained that two of the newer staff in the team were also doing this training on the day of the inspection. Chelsea House DS0000010823.V287711.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, 26, 27 & 30 The home is homely and generally safe and well maintained, although the bathroom would benefit from freshening up. People’s bedrooms are suitable for their individual needs and lifestyles. The home is kept clean, hygienic and free from offensive odours throughout. EVIDENCE: The home is a terraced house with three bedrooms. On the ground floor, there is a lounge, bedroom, toilet, kitchen and a separate dining room. On the first floor there is a bathroom with a toilet, two bedrooms and a staff office. There is a small paved area at the front of the house and a small patio garden, which is accessible to the service users. The inspector observed that the home was pleasantly decorated and furnished and was warm, comfortable and inviting. There were no offensive odours. The washing machine and dryer are located in an outhouse at the back of the house. Service users’ bedrooms are individualized to meet personal styles and tastes. At the previous inspection requirements were made, for the registered person to ensure that the paintwork in the bathroom is freshened up, and there is also a need to re-grout some of the tiles. These requirements remain within their timescales for action and will be reviewed at the next inspection. Chelsea House DS0000010823.V287711.R01.S.doc Version 5.1 Page 16 Chelsea House DS0000010823.V287711.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): 33, 34 & 35 There are sufficient numbers of staff employed to meet the needs of the service users. Service users are generally protected by the homes recruitment practices. However, the need remains for further development of the home’s recruitment practices in order to further protect the well being of service users. Progress has been made in providing training to staff. EVIDENCE: The copy of the staffing rota seen by the inspector at the time of the inspection reflected that staffing levels are satisfactory to meet the needs of current service users. The staff personnel records were generally well organised and presented. At the previous inspection the registered person was required to have a thorough recruitment procedure, which is in place for the protection of the service users in their care, ensuring that all information required by regulations is obtained for each individual prior to them commencing employment in the home, particularly in relation to applicants declaring previous criminal convictions. At this inspection it was noted that this particular aspect of the recruitment procedure has been tightened up. However, there is still room for improvement in ensuring that a full history of employment is obtained from applicants, and a requirement is made for the application form to be revised in order to address this. A requirement was made previously, in relation to providing staff with training in food and hygiene, health and safety and fire. The inspector noted that the Chelsea House DS0000010823.V287711.R01.S.doc Version 5.1 Page 18 registered person has made good progress in this area and a training schedule is in place to ensure that to ensure that all care staff undertake all of the necessary core training. Chelsea House DS0000010823.V287711.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 & 42 A manager has been recruited and is due to commence duty. Service users can be reasonably confident that the home protects their physical safety and security through a proactive approach to health and safety. EVIDENCE: At the previous inspection it was noted that the home would benefit from the appointment a full time manager and at this inspection the registered person told the inspector that a manager has been recruited and was due to start work on 1st March. A requirement is made that the new manager apply to be registered with the Commission upon commencing work in the home. In terms of health and safety in the home, at the last inspection the inspector noted that some of the internal doors were being propped open and a requirement was made, for this practice to be stopped. The inspector was pleased to note that this has been appropriately addressed by the registered person. Chelsea House DS0000010823.V287711.R01.S.doc Version 5.1 Page 20 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 X 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 3 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 3 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 3 X 2 X X X X 3 X Chelsea House DS0000010823.V287711.R01.S.doc Version 5.1 Page 21 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 YA27 Regulation 23 (2) (d) Requirement The registered person must ensure that the paintwork in the bathroom on the first floor is redecorated. This requirement remains within the given timescale for action and will be reviewed at the next inspection. Timescale for action 01/04/06 2 YA27 23 (2) (d) The registered person must 01/04/06 ensure that the tiles in the bathroom on the first floor are re-grouted where necessary. This requirement remains within the given timescale for action and will be reviewed at the next inspection. 30/05/06 3 YA34 The registered person must ensure that the staff application form is revised to ensure that applicants provide a full employment history including a 7,9,17,19 written explanation of any gaps Sch. 2 & 4 in employment and their reasons for leaving each post where they have worked with children or vulnerable adults. Chelsea House DS0000010823.V287711.R01.S.doc Version 5.1 Page 22 4 YA37 8 The registered person must ensure that the newly appointed manager applies to be registered by the Commission. 30/04/06 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 Chelsea House DS0000010823.V287711.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Chelsea House DS0000010823.V287711.R01.S.doc Version 5.1 Page 24 - 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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