Inspection on 26/10/05 for Churchill House

This inspection was carried out on 26th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Churchill House 01/09/06

Churchill House 02/12/05

Churchill House 18/08/04

Churchill House 27/04/04

Similar services:

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

Clovelly House Residential Home Ltd

Abbey Road [53]

Cherry Tree House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Churchill House 48-50 Mawney Road Romford Essex RM7 7HT Lead Inspector Helen Fontaine Unannounced Inspection 26 October 2005 15:00 Churchill House DS0000027836.V261687.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 Churchill House DS0000027836.V261687.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. Churchill House DS0000027836.V261687.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Churchill House Address 48-50 Mawney Road Romford Essex RM7 7HT 01708 732505 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) Mr Kulwant Singh Mann Mr Ramjit Nunkoo Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (12) of places Churchill House DS0000027836.V261687.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. To include 4 named people over 65 years of age Date of last inspection 18 August 2004 Brief Description of the Service: 48 Churchill House is a care home providing personal care and accommodation for six Service Users who are younger adults, all of whom have a mental illness. The home provides a service to both men and women. It is privately owned and managed facility and accepts service users on the basis that they meet the home’s criteria for admission. The home is located in a residential area of Romford near to Romford High Street Shops, local transport, banks, hospitals, post office, parks, leisure centres a market and cinema. Opened in 1996, Churchill House consists of a three-storey building that is separated into two distinct units via an activity room. There is a large garden with a shared patio area and swimming pool for the enjoyment of the Service Users. All the bedrooms are single, one of which is sited on the ground floor with the rest on the second and third floors. Two of the bedrooms contain en-suite facilities. There is a lounge on the ground floor in which Service Users relax, smoke and watch television or engage in activities of their choice. Care and support is provided within a supportive framework with Service Users having access to individual key-workers, who are on hand to assist them in achieving their goals. There is multi-disciplinary input from the various community resources that compliments the provision of the specialist needs of Service Users. Churchill House DS0000027836.V261687.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over two hours and was the first inspection of the current inspection year. The last inspection took place in August of 2004, where a number of Requirements and Recommendations were identified. The inspector looked around some parts of the building and a number of records were inspected. A number of the Key standards were not inspected in enough detail, to be able to evidence that they met the standards. These will be looked at in depth at the next Inspection. The Responsible Person was present for the first part of the inspection and the Manager was also present and assisted with the inspection. Most of the Service Users were seen and so were the staff that were on duty, but none of them was spoken to individually. What the service does well: What has improved since the last inspection? What they could do better: During the inspection a tour of the home was undertaken and it was noted that in a number of areas of the home there was an odour. Several of the Service Users living in the home had needs around personal hygiene and one Service User has incontinence problems, which are currently being investigated by Health. However, the home does need to find ways of improving the home, so that all area of the home is free from odours. All the communal areas of the home had Service Users and staff smoking in them, the home does need to Churchill House DS0000027836.V261687.R01.S.doc Version 5.0 Page 6 make sure that the home is a healthy environment for the Service Users and staff to be in. It was noted during the inspection that the Medication Administration Records (MAR sheets) had not been completed, the member of staff said they had forgotten. The home is not therefore safeguarding the Service Users and needs to make sure that all medication is kept appropriately and administered in strict accordance with prescriber’s instructions. The home have recently had an incident between a member of staff and a Senior Support worker. There was an accusation that the Senior Support worker had intimidated the other member of staff. This was investigated and the Senior Support Worker disciplined. 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. Churchill House DS0000027836.V261687.R01.S.doc Version 5.0 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 Churchill House DS0000027836.V261687.R01.S.doc Version 5.0 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 The home undertakes a full assessment prior to Service Users moving into the home. EVIDENCE: During the inspection documents were seen for the newest Service User living at the home. The Service User, it was documented on the pre-assessment form visited the home twice and had lunch. It was documented that the Service User said he liked the home and would like to move in. The assessment was in-depth and covered, personal details, Social/family, medical history, psychiatric history, communication, breathing, nutrition, personal hygiene, elimination, mobility. This assessment gave the home good insight into the needs of any Service User moving into the home and identified that the home could meet their needs. Churchill House DS0000027836.V261687.R01.S.doc Version 5.0 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 The Service Users know their assessed and that changing needs are reflected in their individual plan. The home supports Service Users to make decisions about issues in their lives. Staff support Service Users to take risks as part of an independent lifestyle. EVIDENCE: The home does have good and well-documented care plans, with each care plan individualized around each Service Users’ needs. The individual support plan has written on it at the beginning “all staff to read and be familiar with Diagnosis, past history and to read all CPA’s.” One support plan for a Service User had a section around Paranoia and said what it was that the Service user was affected by and advised staff of what to be aware of and how to interact with them. Another section was about the one to one with their key worker and that this time must not be interrupted. The individual support plan also covered areas of risk, which covered for example risk assessment of suicide, for one Service User. The support plan is reviewed at the CPA and the key worker also updates it from daily events on a regular basis. Churchill House DS0000027836.V261687.R01.S.doc Version 5.0 Page 10 The key worker meets with each Service User individually and goes through their support plan, the Service User is present for the CPA and the CPA forms seen had the Service Users signature on it. Two of the Service Users at the home attend supported employment twice a week and another Service User has been assessed to begin the process of moving into support accommodation. One Service User has had a risk assessment and has their own keys to the home and to their room. This allows them to come and go as they wish to and staff assist the Service User with the risk of loosing the keys. Churchill House DS0000027836.V261687.R01.S.doc Version 5.0 Page 11 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): None EVIDENCE: The key standards for this area were not looked in enough detail to evidence that they had met the standard. This area does need to be looked at in much more detail at the next inspection. However, see also standards under the heading of Concerns, Complaints and Protection. Churchill House DS0000027836.V261687.R01.S.doc Version 5.0 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): 20 The home’s practices around the administration of medication are not following the homes policies and procedures. The home could not evidence that medication was given to service users as prescribed. This puts service users at risk. EVIDENCE: The Medication Administration Records (MAR sheets) were looked at during the inspection and it was noted that one morning medication was missed. The member of staff when talked to said that they had given the Service User their medication but had forgotten to initial the sheet. The home must make sure that the policies and procedures are followed and it was of concern that this member of staff said that had been on training re medication. Only suitably competent staff can administer medication. Churchill House DS0000027836.V261687.R01.S.doc Version 5.0 Page 13 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 The home does listen and act on complaints and concerns, the home does make sure that the Service Users are protected from abuse. Notifications to the Commission about significant events are not managed properly. The home could not evidence that service users were having outings in line with their wishes. This means they are not being sufficiently fulfilled. EVIDENCE: The home has policies and procedures around complaints and adult abuse. The complaint book was looked at during the inspection. It was noted that there had been an incident between a Senior Support Worker and another member of staff. This was investigated and documented and the Manager said that when the Senior Support Worker was talked to, they walked out of the home and have not returned. It is of concern that a Senior Support Worker should be found to be intimidating another member of staff and that the home did not inform the Commission for Social Care Inspection of this incident. The Manager was advised to inform the Commission immediately of the details of this incident and the outcomes. The Manager said that all complaints and concerns are picked up in the Service Users one to one meetings with their key workers. Residents meeting minutes were looked at and it was seen that Service Users were concerned that their request for outings was not being actioned, just talked about. The Manager felt that the Service Users outings had been arranged, however no Service Users were talked to, to establish that they were satisfied with the outcome. The home must ensure there are sufficient opportunities for outings for service users and evidence this is the case. Churchill House DS0000027836.V261687.R01.S.doc Version 5.0 Page 14 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, 25 and 30 The home is comfortable and a safe environment, with bedrooms that suit their needs. The home was clean but in a number of areas are not hygienic. EVIDENCE: During the inspection a tour of both the houses was undertaken and with the consent of a Service User one of the bedrooms was seen. Quite a number of Service Users smoke in the communal areas of the home, this gives the home a bad odour of cigarette smoke. In each of the houses there were areas around the toilet and bathrooms that again had an odour. The home does need to make sure as a matter of urgency that the home is healthy and hygienic with no odours. A Service User was visited in their room, which was accessed through two personal doors one of which the Service User could have a key for. The room was not very clean and was also untidy and cluttered with a very dirty cup on the table. The room did however have all the Service Users belongings and was adequate for their needs. The Manager said that staff assist the Resident to clean and tidy their room, but it soon gets back in a mess again. The room did not have an odour but the home does need to make sure that the Service Users live in a clean and hygienic home. The Service User spoken to was asked if they liked their room and said they were happy as they are. Churchill House DS0000027836.V261687.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): 34 and 35 Service Users needs require staff to have appropriate and continuing training, including NVQ2. Service Users are protected by the homes recruitment policies and practices. EVIDENCE: Staff files of the newest member of staff and a member of staff who had worked in the home for sometime were looked at. Both files had two references and CRB’s, personal details with a photograph, contract of employment, which was signed. Staff training was also looked at for these two members of staff and staff that had been working at the home for sometime, had training for Adult Abuse, Medication, Introduction to Mental Health and NVQ 2. When asked by the inspector, the Manager said that only six members of staff out of the thirteen had done their NVQ2. On the file for both staff members were supervision notes and a programme of dates for supervision. Churchill House DS0000027836.V261687.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): 0 These standards were not inspected on this occasion, although some management issues are reported on elsewhere in this report. EVIDENCE: The inspection of records found that there had been an incident in the home, where it was alleged that a Senior Support Worker had intimidated another worker. The Manager said that it was investigated and the when spoken to the Senior Support Worker walked out. The Manager of the home at the time of the inspection had not reported this to the Commission for Social Care Inspection. This has been reported on elsewhere in this report. Churchill House DS0000027836.V261687.R01.S.doc Version 5.0 Page 17 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 3 X X X Standard No 22 23 Score 2 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 X X X X 1 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Churchill House Score X X 1 X Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000027836.V261687.R01.S.doc Version 5.0 Page 18 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 Regulation 13(2) Timescale for action The registered person must 15/11/05 make arrangements for the safe administration of medicines in the home. Medication must be administered as prescribed The registered person must 20/12/05 ensure there are sufficient opportunities for outings for service users and evidence this is the case. It must also ensure all complaints are followed up. The registered person must make suitable arrangement for maintaining satisfactory standards of hygiene in all areas of the home. The registered person must make sure that all areas of the home is odour free. An annual development plan must be available for inspection. The registered person must develop a business and financial plan and it must be available for inspection. 20/12/05 Requirement 2 YA22 16 (2), (m) 22 3. YA30 16(2)(J) 4. 5. 6. YA30 YA39 YA43 16(2)(K) 24 25 20/12/05 03/01/06 03/01/06 Churchill House DS0000027836.V261687.R01.S.doc Version 5.0 Page 19 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 Churchill House DS0000027836.V261687.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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