Inspection on 16/01/06 for Kean Street, 17

This inspection was carried out on 16th 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 no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kean Street, 17 21/11/08

Kean Street, 17 12/09/06

Kean Street, 17 17/10/05

Kean Street, 17 15/03/05

Kean Street, 17 04/08/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Kean Street, 17 17 Kean Street Convent Garden London WC2B 4AZ Lead Inspector Ann Gavin Unannounced Inspection 16th January 2006 12:00 Kean Street, 17 DS0000010865.V278442.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 Kean Street, 17 DS0000010865.V278442.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. Kean Street, 17 DS0000010865.V278442.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Kean Street, 17 Address 17 Kean Street Convent Garden London WC2B 4AZ 020 7240 8338 020 7240 8558 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) Look Ahead Housing & Care William Campbell Care Home 31 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (93) of places Kean Street, 17 DS0000010865.V278442.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th October 2005 Brief Description of the Service: Kean Street is a care home for 31 people with severe and enduring mental health needs encouraging people to live as independently as possible. Peabody Trust owns the property with the care provided by Look Ahead Housing and Care. There are 31 self-contained flats on four floors with lift access to all floors. Each flat has a lounge/bedroom, kitchen and an en suite bathroom and toilet. On each floor there is a communal lounge, kitchen and bathroom. Service users have the facilities to prepare meals in their flats and a choice of meals is also provided in the lower ground floor dining area. In the basement there is a large dinning area which holds a pool table and table football. There are two communal lounges and also a small well equipped gym. Externally, there is an attractive patio and garden area to the rear of the home and a balcony with potted plants on the same level as the reception area. Kean Street, 17 DS0000010865.V278442.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 carried out on Monday 16th October from 12 noon through to 5pm.The assistant manager was available throughout the inspection and the manager for the last hour and a half. The focus was to review those standards not covered at the annual inspection. The staff and service users were welcoming to the inspector. Four requirements were made and one recommendation. 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. Kean Street, 17 DS0000010865.V278442.R01.S.doc Version 5.1 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 Kean Street, 17 DS0000010865.V278442.R01.S.doc Version 5.1 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): 1,2 Keane Street is continuing their redevelopment plan with planned meetings. Current service users will be fully involved. They are clear as to their current criteria for admission EVIDENCE: The future meeting to continue the process of redeveloping the project was spoken about by the assistant manager and manager. It was clear that service users will be fully informed and involved in any planned changes. The managers discuss all possible referrals and whether Keane Street can meet their persons assessed needs. A recent referral highlighted this as the persons diagnosis was felt to be beyond that of the services and support offered at the project. Kean Street, 17 DS0000010865.V278442.R01.S.doc Version 5.1 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 The joint assessment form used by service users and staff to identify and plan support is developing. Risk assessment seen had good clear details and action plan. EVIDENCE: Look ahead have developed a joint assessment form for service users and staff to identify and plan support. This has been running for three months and the deputy manager is about to review it. Going through one of the assessment with a support worker showed that they have developed since the last inspection. The risk assessment had good details with action plans. The support worker said that both service users and staff felt that they were more used to them and found them useful though some areas could still be worked on to be more specific to the needs of people in a care home setting. The manager has been working with the key worker identified in the previous report to make sure they had the ability to carry out their role. They have undergone tests that indicated areas they need to develop and these are being dealt with. Kean Street, 17 DS0000010865.V278442.R01.S.doc Version 5.1 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): 14 The managers and staff are enthusiastic and motivated. They create, together with service users, continual leisure opportunities. EVIDENCE: The staff at Kean Street plan leisure activities with the service users at the fortnightly house meetings. The minutes seen recorded the various ideas most of which were able to be followed through. Over the Christmas break service users had a medieval banquet on Christmas day with staff and later service users being dressed in medieval costumes and decorating all the dinning room for the occasion. The photographs seen showed the transformation of the basement area. Other activities took place over the Christmas period including attending midnight mass at a local church, a carol concert, and the local fair in Covent Garden. Kean Street, 17 DS0000010865.V278442.R01.S.doc Version 5.1 Page 10 Plans were being made to take part in Chinese New Year celebrations towards the end of January and the London motorcycle show, which is running from the end of January to the beginning of February. Kean Street, 17 DS0000010865.V278442.R01.S.doc Version 5.1 Page 11 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 Kean Street is clear on assessing and meeting service users emotional needs. A more detailed health profile needs to be developed. EVIDENCE: The joint assessment form used enables service users and staff to agree the level of support required in each area of their lives. There may be differences in the assessment and this is talked though between the service user and key worker and action agreed. The area covering physical health needs to be developed to make sure that there is a good healthcare profile of service users with action plans. Staff spoken with were in agreement and could see ways of developing this. Kean Street, 17 DS0000010865.V278442.R01.S.doc Version 5.1 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): 23 There is a clear policy for staff on supporting service users with managing their finances. The process for CRB clearance should be clarified and the manager notified in writing of CRB clearance. EVIDENCE: There has been a recent POVA investigation following a service users loss of money. The outcome was unsubstantiated. The policy Kean Street has introduced for staff supporting service users with managing their bank accounts, cash cards and pin numbers is clear and designed to ensure accountability. Discussing criminal record bureau checks (CRB) I was unclear about the decision making process in the assessment of the relevance of CRB disclosures for staff who are working with vulnerable adults and how this was recorded. The manager did not have anything, which said that staff had CRB checks. The manager must have in writing that a staff member has had a CRB check. Kean Street, 17 DS0000010865.V278442.R01.S.doc Version 5.1 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): 27 The work identified in the bathrooms has not be done a date must be agreed for completion. EVIDENCE: The last inspection reported poor standard of repair to the bathroom floors and tiling. The work has been approved by the housing association but a date for its completion must be forwarded to the commission. The hydraulic bath on the ground floor bathroom has been repaired though a final adjustment is required this must be finalised. Kean Street, 17 DS0000010865.V278442.R01.S.doc Version 5.1 Page 14 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 Kean Street must make sure that staff are able to relate to service users and communicate effectively their assessed needs. A more project specific interview processes may be helpful in achieving this. EVIDENCE: Part of this inspection was planned to look at the recruitment process at Keane Street. Look Ahead advertise all post internally first then externally. Interviews can take place in any of the care homes and staff are then identified for a specific project according to their abilities, preferences and the service needs. Serviced users are involved whenever possible on the interview panels. There are set questions for interviews which are arranged after three managers have short listed candidates. In the light of recent experiences of a staff member not be able to effectively carry out their role it may be useful to develop a more specific project based interview process for prospective staff. Kean Street, 17 DS0000010865.V278442.R01.S.doc Version 5.1 Page 15 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): 39 Keane Street promotes service user involvement. There is a need to make sure that the monthly monitoring visits are carried out. EVIDENCE: Look Ahead actively promote service users involvement and are about to carry out their yearly service users feedback survey. At Keane Street they hold monthly service users meetings that are minuteted. Service users are encouraged to take minutes but it is normally staff. Records showed that the ideas and suggestions for activities over the Christmas period were in the main carried out. Supporting People monitor Kean Street every quarter and they were expecting an inspection shortly. The monthly unannounced visits from the person in control have not been carried out these need to return to being regular with a copy sent to the commission. The fire log seen was up to date. Kean Street, 17 DS0000010865.V278442.R01.S.doc Version 5.1 Page 16 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 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 2 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 2 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 3 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 2 X X X X 2 X X X X Kean Street, 17 DS0000010865.V278442.R01.S.doc Version 5.1 Page 17 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. 2 Standard YA19 YA27 Regulation 12 23 Requirement The manager must ensure that there is a detailed healthcare profile for each service user. A timescale for the repair and redecoration of the bathroom flooring and tiling must be given to the commission The provider must ensure that the manager has written confirmation of CRB clearance. The process for CRB clearance should be clarified and appropriate documentation kept Timescale for action 31/03/06 17/02/06 3. 4 YA23 YA23 19 19 28/02/06 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard 34 Good Practice Recommendations It may be useful to develop a more specific project based interview process for prospective staff. Kean Street, 17 DS0000010865.V278442.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Hammersmith Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 Kean Street, 17 DS0000010865.V278442.R01.S.doc Version 5.1 Page 19 - 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. 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