Inspection on 21/11/08 for Kean Street, 17

This inspection was carried out on 21st November 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Kean Street, 17 12/09/06

Kean Street, 17 16/01/06

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 13/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Kean Street, 17 17 Kean Street Covent Garden London WC2B 4AZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Wynne Price-Rees     Date: 2 5 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Kean Street, 17 17 Kean Street Covent Garden London WC2B 4AZ 02072408338 02072408558 oliverkemp@lookahead.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Look Ahead Housing & Care care home 31 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 31 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home Keane 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 selfcontained 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. People who use the service 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 Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 31 Brief description of the care home 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. Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. The inspection was unannounced and took eight hours over two days. It started on 21/11/2008 and finished on 25/11/2008. During the inspection we spoke with six people who use the service to get their opinions of the service they receive. We also spoke with staff, the management team, observed care practice and checked records and procedures. We also toured the premises. Care Homes for Adults (18-65 years) Page 6 of 26 We inspected all the key standards and the information seen was compared with that gathered since the last inspection including Regulation 37 notifications. Regulation 37 notifications let us know about any accidents or incidents that may affect people who use the service. The information gathered included an annual AQAA self assessment document that is completed by the home and assesses how they feel it is performing. Three peoples files were case tracked during the inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have their needs fully assessed before moving in and they choose if they want to move in. Evidence: I visited before I moved in. The home has an assessment policy and procedure that a sample of records show is followed. Referrals are solely from the Westminster Community Mental Health Team. The information forwarded ais detailed, accompanied by a risk assessment and enables the home to decide if needs of people who use the service can be met. The information includes departure notes, discharge summary and adult mental health assessments. The home then carries out an assessment with people who use the service that covers all aspects required by the standard. People who use the service visit the home to carry out the joint assessment and this enables them to better decide if this is where they want to live and the service is the right one for them. Initially there is a six week licence to see if the service is appropriate and this is then reviewed. Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: Three people who use the service were case tracked and the information on file showed they were thoroughly assessed before moving in. Care Homes for Adults (18-65 years) Page 11 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are comprehensive care plans that show how people who use the service are supported to develop their independent living skills. People who use the service are encouraged to make their own decisions within a risk assessed environment. Evidence: A sample of three case files showed that people who use the service have support plans in place that identify needs, goals, action needed to achieve them and by whom. They are agreed between key workers and people who use the service. The care plans are originally based on the assessment information and developed with people who use the service as they get used to living at the home and provide more information. The support plans are regularly reviewed, a minimum six monthly or as needs change and enabled by risk assessments that are changed to reflect the changing needs. People who use the service are encouraged to add written comments to the care plans if they wish. The home is currently considering a more proactive form of support planning that Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: incorporates future wishes regarding how people who use the service wish to live and where. This will be developed by introducing and developing social inclusion goals and supporting people who use the service to improve necessary life skills to achieve them. People who use the service are encouraged to become involved in the homes decision making process wherever possible through monthly house meetings and key worker sessions where they are encouraged to put their views forward. As well as participating in decision making regarding where they live, people who use the service are also encouraged and supported to make their own personal decisions and take responsibility for their actions to further develop the skills for independent living. They are also encouraged to become involved in the staff selection process. Care Homes for Adults (18-65 years) Page 13 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have their preferences observed and their social, cultural, religious and recreational needs and interests met, meaning they have fulfilling lifestyles. They also receive a variety of meals geared to their individual tastes. Evidence: The project supports people who wish to find employment, re-train or further their education. Whilst supporting people who use the service any possible barriers to achieving their goals are identified and discussed to maintain a realistic approach. Good use is made of courses provided by City Lit that include ceramics, acting, Japanese and yoga. One tutor put on three classes, at the project, so that people could better understand and decide if this was an area they wished to follow. The Royal Opera also provides free open sessions on Mondays with a pianist and opera Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: singer. I sometimes go to the Opera House. Some people make use of local sports facilities including running and swimming. There is also a gym with equipment on site. The New London Orchestra visits and provides workshops and there is a thriving art group that has exhibited and sold work in galleries. Currently they are making calenders in preparation for the new year. There were a number of art works on display within the building. The project provides a number of leisure activities that include well attended film nights at home and trips to the theatre and Tate Modern. Health awareness sessions take place including smoking cessation and there is a womans group. One person said that the project was not always a nice place to live. This was because of some of the other people living there rather than staff or the way the project was run. My sister is visiting over Christmas. There are procedures in place that encourage and support people who use the service to make and maintain appropriate contact with friends and relatives if they wish. People who use the service are supported to redevelop life-skills required for independent living with tasks such as cleaning having an agreed and day. The food is okay but the portions are small. People who use the service purchase meals that are prepared and cooked on site by a chef. Alternatively they can self-cater with kitchenettes available on each floor and some flats also having kitchenettes. Care Homes for Adults (18-65 years) Page 15 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have their physical and emotional health needs met. Medication is suitably administered and recorded although there had been some errors that were addressed. Evidence: The project does not generally provide personal care as part of life-skill development relates to personal hygiene and a healthy lifestyle that are included as goals in some care plans and therefore staff tend to offer support, prompts and encouragement. The people who use the service are registered with GPs and have access to community based health care services including district nurses and the community mental health team. Health needs and awareness are incorporated into the support plans. People who use the service are also offered annual health checks. Although the project has a medication administration cross referencing system, there were a number of medication recording errors. These were discussed during the team meeting and addressed on the second inspection day. Care Homes for Adults (18-65 years) Page 16 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can feel confident they are listened to and their complaints and concerns investigated with outcomes. They are safe and well protected by the adult protection procedures in place. Evidence: If Ive got a problem I tell staff. There is a written complaint policy and procedure that people who use the service said they were aware of. A record of complaints was kept that met the requirements of the standard and showed that people who make complaints have them taken seriously and fully investigated. The home has a suggestion box and people who use the service are also given the opportunity to discuss grievances during the monthly residents meetings. Incidents records are also kept and forwarded to us. These forms are called regulation 37 notifications. Currently there are no outstanding POVA issues at the home. POVA is the protection of vulnerable adults. POVA training is included as part of staff induction and there are annual refresher courses available. The recruitment interview also includes questions around adult protection and what someone would do in certain scenarios. Staff are also CRB cleared before starting work unsupervised. CRB is the Criminal Records Bureau. There is also a policy and procedure regarding aggression by people who use the service and a direct line to the organization should someone think abuse might be taking place. Care Homes for Adults (18-65 years) Page 17 of 26 Evidence: Personal finances are included as part of the support plan to encourage life skill development and gain confidence. Any monies held on behalf of people who use the service is fully documented with transaction, balance and receipt. Care Homes for Adults (18-65 years) Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service live in a safe, comfortable and homely environment. Everyone has their own bedroom and there are suitable communal areas provided. Evidence: The accommodation is alright. Sometimes it gets noisy here. A tour of the premises showed that it is suitable for the stated purpose. People who use the service have their own flats and the communal areas have been brightened up by hanging works of art that they have created. There is suitable communal areas on each floor and a main communal lounge in the basement that leads to a garden. The project was clean, tidy and well maintained. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitably trained, competent and diverse staff employed to meet the needs and wishes of people who use the service that have been properly vetted. People who use the service can be confident that they are protected by the homes robust recruitment policies and procedures. Evidence: Staff are mostly supportive and helpful. Care practices observed showed that staff adopt a patient and supportive approach towards people who use the service and encourage them to develop their life skills to help them eventually re-adjust to living within the community. The staff rota demonstrated there are staff in enough numbers during the day and night to meet the needs of people who use the service. Currently there are no staff vacancies. Staff receive localized as well as an organizational induction. They are given the opportunity to go through policies and procedures and receive mandatory training in health and safety, fire and medication administration. The induction consists of a series of modules all of which must be completed and signed off. This takes approximately twelve weeks. There is also two days of POVA training. Staff have access to a rolling training programme that is reviewed in consultation with front line staff to make sure their needs are met. It was identified that dual diagnosis Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: training would be useful for staff working at the project. The management team have attended train the trainers courses that enables them to provide training identified as needed within the project rather than organization wide. Staff also have access to training provided by Westminster City Council. All staff have attained NVQ level 2 or above. There is a thorough recruitment policy and procedure that a sample of staff records showed is followed. It meets the requirement of the standard. Wherever possible people who use the service are involved in the recruitment procedure sitting in on interviews and conducting premises tours. Staff receive a handbook with their contracts outlining duties and expectations. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed in the best interests of people who use the service and the quality assurance system is effective. Health and safety is well managed meaning people who use the service live in a safe environment. Evidence: The new Care Manager arrived in August 2008 and possesses and NVQ level 4 management qualification. They have extensive previous management experience and head up a management team. The project has a quality assurance system that contains identifiable performance indicators. These identify action to be taken and action plans. The system includes monthly person in control visits during which a minimum of two people who use the service and staff must be interviewed. There is an annual two day quality assurance audit and surveys are sent out to people who use the service. Monthly house meetings also take place and there are three monthly contract monitoring meetings. The management team have put together a comprehensive strategic work plan after Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: consultation with staff and people who use the service. This includes key areas such as service delivery, staff, quality assurance, regulatory compliance and customer involvement with a strategic plan and timescales. There was an annual up to date building risk assessment in place, fire evacuations take place six monthly, fire point tests regularly and the fire fighting equipment was checked and serviced in May 2008. The PAT tests of portable electrical goods took place in July 2008 and are updated whenever someone brings an appliance to the project. Fridge and freezer temperatures are checked and recorded twice daily and the fire alarm was checked during our visit. COSHH procedures have recently been updated as part of quality assurance. COSHH is control of exposure to hazardous waste. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!