Inspection on 30/01/06 for Chelsea House

This inspection was carried out on 30th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 8 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 27/02/06

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 30th January 2006 04:30 Chelsea House DS0000010823.V265852.R01.S.doc Version 5.0 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.V265852.R01.S.doc Version 5.0 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.V265852.R01.S.doc Version 5.0 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.V265852.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th October 2005 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.V265852.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, it took around two hours and the inspector left at around 6 pm. This is a small home for people with learning disabilities, and tends to specialise in providing care to people with autism. There were three men living there, and at the time of the inspection they were all at home. There were three care staff on duty. The inspector had the opportunity to be shown around by two of the service users and the third was having a rest so didn’t meet the inspector on this occasion. The inspector met all three of the staff and spoke to one, who was relatively new, in some depth. He spoke positively about his induction, the home and the way that it is run. 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 contacting your local CSCI office. Chelsea House DS0000010823.V265852.R01.S.doc Version 5.0 Page 6 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.V265852.R01.S.doc Version 5.0 Page 7 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.V265852.R01.S.doc Version 5.0 Page 8 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 reviewed the records for one service user, who has some behaviours that are challenging to the service. The inspector noted that there is a good quality service user plan in place, and very thorough risk assessments, with guidance for staff about how to minimise the risks. At the previous inspection the registered person was required to ensure that one service user’s plan was reviewed and that that all service users’ plans and risk assessments were signed and dated. These requirements were found to have been satisfactorily addressed. Chelsea House DS0000010823.V265852.R01.S.doc Version 5.0 Page 9 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 Service users are part of the local community they engage in appropriate social and leisure activities. 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 was unable to discuss progress with the requirement that was made at the previous inspection, regarding strategies for supporting one particular service user to maintain positive family links. This requirement will be reviewed at the next inspection. Chelsea House DS0000010823.V265852.R01.S.doc Version 5.0 Page 10 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 reviewed the records for one service user, who has some behaviours that are challenging to the service. The inspector noted that support and advice had been sought by the registered person, 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. The staff member who spoke to the inspector said that they had received specific training about working with this particular service user, as part of their induction, and prior to starting work in the home. The inspector saw the arrangements for storing, administering and recording the medication prescribed to service users in the home. The Boots bubble packs are used and the arrangements that were in place were acceptable. At the previous inspection the registered person was required to ensure that the Chelsea House DS0000010823.V265852.R01.S.doc Version 5.0 Page 11 temperature that the medication is stored at is monitored and kept below 25oC. This had been as addressed and a monitoring record is now kept. This indicated that the temperature at which medication was being stored was within acceptable limits. At the last inspection the registered person was required to ensure that all staff receive medication training and that the certification for this is retained in each staff members’ personnel file. As this was an unannounced inspection the inspector could not have access to the staff files and this requirement will be reviewed at the next inspection. Chelsea House DS0000010823.V265852.R01.S.doc Version 5.0 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 the following standard(s): 22 There is a clear and effective complaints procedure in place. 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 the previous inspection the registered person was required to ensure that all care staff undertake training in adult protection procedures. As this was an unannounced inspection the inspector could not have access to the necessary files to review progress with this requirement and it will be reviewed at the next inspection. Chelsea House DS0000010823.V265852.R01.S.doc Version 5.0 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 the following standard(s): 24, 26, 27 & 30 The home’s premises are 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. One service user showed the inspector their bedroom and the ground floor of the home and another showed the inspector their bedroom and the first floor. The rooms were individualized to meet personal styles and tastes. The service users said that they were happy with their rooms and comfortable with the surroundings. Chelsea House DS0000010823.V265852.R01.S.doc Version 5.0 Page 14 At the previous inspection minor requirements were made, for the registered person to ensure that the extractor fan in the bathroom was cleaned and serviced and to ensure that the ceiling in the downstairs toilet was repainted and the inspector was able to confirm that these issues had been dealt with satisfactorily. During the tour of the building the inspector noted that the bathroom paintwork is in need of freshening up, and there is also a need to regrout some of the tiles. Requirements are made in respect of these issues. Chelsea House DS0000010823.V265852.R01.S.doc Version 5.0 Page 15 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): These standards were not inspected on this occasion. EVIDENCE: 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, and to ensure that all care staff undertake training in food and hygiene, health and safety and fire training. As the inspector was unable to discuss progress with these requirements, they will be reviewed at the next inspection. Chelsea House DS0000010823.V265852.R01.S.doc Version 5.0 Page 16 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, 40 & 42 Although the home is reasonably well run, it would benefit from the appointment a full time manager. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. The health, safety and welfare of service users would be better protected if internal fire doors were not propped open. EVIDENCE: As the registered person’s business commitments have gradually increased, and no longer allow him to personally manage the home on a full time basis an acting manager has been put in place, and the management team do work hard to ensure that the service provided is of a good quality. However, it is acknowledged that the home would benefit from the appointment a full time manager and a requirement is made in respect of this. The inspector noted that the home’s written policies and procedures were in good order, had been reviewed and were dated. Chelsea House DS0000010823.V265852.R01.S.doc Version 5.0 Page 17 In terms of health and safety in the home, the inspector noted that some of the internal doors were being propped open. A requirement is made for this practice to be stopped to increase fire safety. Chelsea House DS0000010823.V265852.R01.S.doc Version 5.0 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X 3 2 X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 3 15 2 16 X 17 Standard No 31 32 33 34 35 36 Score X X X 2 2 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Chelsea House Score X 3 3 X Standard No 37 38 39 40 41 42 43 Score 2 X X 3 X 2 X DS0000010823.V265852.R01.S.doc Version 5.0 Page 19 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 YA15 Regulation 16 (2) (m) The registered person is required 30/04/05 to seek support from the social worker involved and to meet with the parent concerned to produce strategies for supporting this particular service user to maintain positive family links. This requirement will be assessed at the next inspection. 2 The registered person must ensure that all care staff undertake training in adult protection procedures and once 13(6) completed a copy of each 18(1)(c)(i) individual’s certificate must be retained on file. This requirement will be assessed at the next inspection. 23 (2) (d) The registered person must ensure that the paintwork in the bathroom on the first floor is redecorated. Requirement Timescale for action YA23 30/04/05 3 YA27 01/04/06 Chelsea House DS0000010823.V265852.R01.S.doc Version 5.0 Page 20 4 YA27 23 (2) (d) The registered person must ensure that the tiles in the bathroom on the first floor are re-grouted where necessary. 01/04/06 5 The registered person must 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. The manager must ensure that staff applicants are aware the policy requirement that they declare any previous convictions and of action that will be taken in any case of failure to comply. This requirement will be assessed at the next inspection. 30/04/05 YA34 7, 9, 19 Schedule 2 6 The registered person must ensure that all care staff undertake training in food and hygiene, health and safety and fire training. Once completed a 18(1)(c)(i) copy of the certificates must be placed on each individual’s file. This requirement will be assessed at the next inspection. 8 The registered person must ensure that a full time, permanent manager is recruited to manage the home and applies to be registered by the Commission. 30/04/05 YA35 7 YA37 30/04/06 Chelsea House DS0000010823.V265852.R01.S.doc Version 5.0 Page 21 8 YA42 13 (4) (a) 23 (4) (a) The registered person must ensure that internal fire doors are not propped open. 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.V265852.R01.S.doc Version 5.0 Page 22 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.V265852.R01.S.doc Version 5.0 Page 23 - 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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