Inspection on 22/06/06 for Chalton Street

This inspection was carried out on 22nd June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Chalton Street 19/12/05

Chalton Street 23/08/05

Chalton Street 13/12/04

Chalton Street 10/06/04

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

CARE HOME ADULTS 18-65 Mary Wollstonecraft House 99 Chalton Street London NW1 1SP Lead Inspector Pearlet Storrod Unannounced Inspection 22nd June 2006 10:00 Mary Wollstonecraft House DS0000010325.V287977.R01.S.doc Version 5.2 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 Mary Wollstonecraft House DS0000010325.V287977.R01.S.doc Version 5.2 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. Mary Wollstonecraft House DS0000010325.V287977.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mary Wollstonecraft House Address 99 Chalton Street London NW1 1SP 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 7388 4137 020 7388 4137 charltonst@yahoo.co.uk Umbrella Ms Joann Superville Care Home 9 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (9) of places Mary Wollstonecraft House DS0000010325.V287977.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. For the provision of Mental Health Nursing Care for up to 9 adults, who are not required to be detained at the home under any section of the Mental Health Act The staffing notice Date of last inspection 19th December 2005 Brief Description of the Service: Mary Wollstonecraft House is a purpose built care home, which offers a nursing service for up to nine people with mental health needs. The registration of the home enables it to take service users from the age of 18 years up to 65 years. The home offers support with personal care, cooking, cleaning, shopping and claiming benefits. As the home is registered to provide nursing care, then a registered mental health nurse is available on shift over a twenty-four hour period. The building is owned and maintained by St Pancras and Humanist Housing association. The service is operated by Umbrella, which is a mental health charity providing a full range of care and support services in North London. The home is sited within a residential area. Information about the home states that it is five minutes walk either from Euston Station or Mornington Crescent. It is also on several bus routes including the 253 between Hackney and Euston Station and passes via Eversholt Street and Camden High Street. The number 168 bus, Hampstead Heath and Waterloo passes Eversholt Street, Euston Station and Camden High Street. The house has been designed over three floors. There is level access to the main entrance and the interior of the home is wheelchair accessible. A walled patio garden is at the rear of the property. Access to the garden is via french windows allowing egress by service users in wheelchairs. All the bedrooms are single occupancy with wash hand basins. A shaft lift ensures access to the upper floors. The fees per bed space is £458.81 Mary Wollstonecraft House DS0000010325.V287977.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted over one day and was unannounced. The inspection looked at mainly the key standards and scrutinised the policies and procedures necessary to ensure a smooth running service. The inspector also spoke with service users and staff and received feedback from a GP, a social worker and a family member about their experiences and views of the home. What the service does well: What has improved since the last inspection? There were no deficiencies recorded at the two previous inspections. Mary Wollstonecraft House DS0000010325.V287977.R01.S.doc Version 5.2 Page 6 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. Mary Wollstonecraft House DS0000010325.V287977.R01.S.doc Version 5.2 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 Mary Wollstonecraft House DS0000010325.V287977.R01.S.doc Version 5.2 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): 1 and 2 The quality in this outcome area is good. The judgment has been made using evidence available at this inspection visit. Active choices are made by service users about whether to move into the home. However, the aims and objective needs to be included in the Statement of Purpose so that care commissioners and potential service users are more informed about the service on offer. Service users needs are assessed and trial periods take place before a placement is made permanently. EVIDENCE: Chalton Street has a Statement of Purpose and client information document, which contains an abundance of useful date for guidance but which do not fully reflect the aims and objective of the service and philosophy of care. A requirement is made in this regard. The files of three service users were examined, all of which contained an assessment of needs comprehensively drawn up, an up to date care plan and risk assessment used in conjunction with the individuals’ plans of care. Mary Wollstonecraft House DS0000010325.V287977.R01.S.doc Version 5.2 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 quality in this outcome area is excellent and the judgment is made using the evidence available, including information and observation gathered from this inspection visit. Service users changing needs and personal goals are reflected in the care plans. Service users are consulted and supported about all aspects of life at the home and to take risks relative to independent living. EVIDENCE: All service users benefit from a care plan developed from the assessments initially generated and from which individuals’ goals are identified and included in the said plans. Service users spoken to confirmed their involvement in the process and care plans are amended according to changing needs. Service users are encouraged and supported to make their own decisions as necessary; for example, a service user recently admitted to the home talked to the inspector about his interest and hobbies and about his desire to attend pop concerts at various venues. The manager affirmed that they would support the service user to follow his social, educational and leisure pursuits once they have the information beforehand so that they can plan the events to accommodate the service user. Mary Wollstonecraft House DS0000010325.V287977.R01.S.doc Version 5.2 Page 10 Another service user talked emphatically about his forthcoming holiday in Holland. A Regulation 37 Notice and information contained in the file of the individual demonstrates that the service user had previously absconded to Holland. He was unaware that staff would make attempts to support him to fulfil his dream to visit Holland where he hopes to settle down one day. Appropriate risk assessments are in place for all service users. Another service user was soon to begin work with a voluntary organisation as a receptionist. This is a remarkable achievement, in terms of encouraging and supporting service users to find paid or unpaid employment. Mary Wollstonecraft House DS0000010325.V287977.R01.S.doc Version 5.2 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): 12, 13, 15, 16 and 17 The quality in this outcome area is excellent and this judgment is made using evidence available including this inspection visit to the home. Service users participate in social and education activities that enable them to develop skills and interest as well as to develop relationships and to maintain family contacts. Service users are supported to have a healthy diet, which they enjoy. EVIDENCE: Key working sessions are used to ascertain service users individual goals, likes and interest. Attempts are made by staff that ensures service users participate in age appropriate and. cultural activities. Some service users attend courses at the local college and staff liaises with exte3rnal agencies, job centres, voluntary organisations with the emphasis of supporting a number of service users to develop or to maintain individual skills. A service user spoken to on the inspection day confirmed that he was attending the local Working Men’s’ College to study; another service user was about to begin attending a day centre. Service users have the opportunity to use local community resources and some service users confirmed that they use the British Library and visit leisure Mary Wollstonecraft House DS0000010325.V287977.R01.S.doc Version 5.2 Page 12 centres. Service users are encouraged and supported to maintain family contacts and individual agreements are drawn up to facilitate this. One individual spoke impressively about being brought up in the locality and he pointed out the school that he attended as a young pupil. The dietary needs of service users are well catered for with a choice of meals and a balanced and varied selection of food available that meets service users satisfaction. Any objections about the planned meals are relayed at the service users meetings. Mary Wollstonecraft House DS0000010325.V287977.R01.S.doc Version 5.2 Page 13 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): 18, 19 and 20 The quality in this outcome area is good; the judgment is made using available evidence, which includes this inspection visit. Service users health and personal care needs are met using the comprehensive care planning and review systems in place. The arrangements for the administration of medication appear satisfactory; however, information received about the running of the service suggests that a review of the practice whereby staff request small amounts of prescriptions occasionally from a practice nurse, needs review. EVIDENCE: Service users are supported to do as much for themselves as possible and where necessary, individual service users are encouraged and supported accordingly. There is evidence seen in two service users files that staff ensures that individual service users are appropriately supported around their emotional health as needed and particularly around issues of disharmony between service users and their family. An example of this is demonstrated in a service user’s file and in discussion with the individual concerned. The service user is reluctant to have his father invited to his review meetings because he alleges that his father’s presence at a previous meeting prevented him from securing independent accommodation. Mary Wollstonecraft House DS0000010325.V287977.R01.S.doc Version 5.2 Page 14 The systems for the administration of medication are good with clear and comprehensive arrangements in place that ensures service users medication needs are met. One person self medicates and appropriate processes are in place to facilitate this. It is important to note that a general practitioner commented, “The practice nurse at times gets frustrated by being asked for very small prescriptions.” This home is asked to review this practice. Mary Wollstonecraft House DS0000010325.V287977.R01.S.doc Version 5.2 Page 15 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 quality outcome in this area is good and the judgment is made using evidence that is available in the home and from the inspection process. Service users are protected by the home’s practices though the policy and procedures needs to be updated. EVIDENCE: There is no evidence of complaint being made since October 2002. A whistle blowing policy is in place and a complaints procedure. The complaints procedure needs further review so that there is consistency in the number of days for investigation to be made and a decision given. The Senior Manager and Chair of the Committee have both left the organisation and the procedure needs to be amended to take account of the changed names for ease of access and guidance for service users and staff. Of the service users spoken to, they all confirmed aware and knowledge of whom they should approach if they had a complaint. Each service user has a copy of the complaint procedure in their rooms. It should be noted that the comment from a relative is that though they have not had to make a complaint, that they are unaware of the complaints procedure. A draft policy relative to vulnerable adults is available but this now needs to take into effect Camden’s Adult Protection protocol when revising the draft document. Examination of staff files showed that staff receive training in regard to adult protection. Mary Wollstonecraft House DS0000010325.V287977.R01.S.doc Version 5.2 Page 16 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 and 30 The quality outcome in this area is good; this judgment is made using the evidence available, including a visit made to the home. The home provides a pleasant and comfortable place for service users to live. Maintaining a safe environment is paramount, and is a continuous challenge for staff. The home was clean and hygienic on the day of the visit. EVIDENCE: The home was toured, which included a visit to a service user’s room with their consent. The room was in an organised state and decorated with input from the service user, who expressed satisfaction with the services on offer. Problems identified previously relating to the bath replacement on the 1st floor and replacement of various floor coverings are being addressed on a gradual scale. Artificial ventilation by way of an extractor need to be installed in the staff toilets on the ground floor as no natural ventilation exists in this room. Staff report that they have had to install a camera for surveillance purposes because of attempts being made to break in to the home. It should be noted however, that the camera is ineffective as staff are unable to see visitors to the home. Repositioning of the camera or installation of a cctv would benefit the home in allowing staff to view visitors outside the home. Mary Wollstonecraft House DS0000010325.V287977.R01.S.doc Version 5.2 Page 17 The home is clean and hygienic and staff were observed carrying out their duty attentively. Mary Wollstonecraft House DS0000010325.V287977.R01.S.doc Version 5.2 Page 18 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): 32, 34 and 35 The quality in this outcome area is excellent. The judgment is made using evidence available, including this visit to the home. Service users are supported by staff that are competent, qualified and vetted by the home’s recruitment policies and practices; service users individual and joint needs are met by trained staff. EVIDENCE: At the time of this inspection four out of six support workers had qualified for the NVQ level 3. Two other support workers are due to complete the same course by September of this year. The manager is RMN qualified and is an NVQ Assessor; she also possesses other relevant management qualifications. The files examined during the inspection conformed to the required standards. Two references and CRB and POVA checks are taken up for all staff and the PIN numbers of qualified nurses are appropriately monitored and verified. Staff photographs are placed on each file. A rolling development and training programme is in place and supervision and appraisals occur. Mary Wollstonecraft House DS0000010325.V287977.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 The quality of this outcome area is excellent; this judgment is made using available information including this inspection visit. The home is well managed and in a consistent way; Service users are canvassed for their views and their health, security and welfare are protected. EVIDENCE: The home is managed and led by a manager who is competent, qualified and experienced to run the home. Service users are canvassed for their views about the service; the majority of the comprehensively written policies and procedures under the care practice in the home. There is also an opportunity for other people involved with the service to make their views known about improvement to the services on offer via the annual surveys conducted. The records observed and operational practice seen ensures that service users and staff health, safety and welfare are promoted and protected. It should be said that the last monitoring monthly report in the home was dated 5th April 2006, the responsible individual must ensure that the monthly visits and reports continues to occur. Mary Wollstonecraft House DS0000010325.V287977.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 4 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 4 STAFFING Standard No Score 31 x 32 4 33 x 34 4 35 4 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 x 4 x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 x 4 x 4 x x 3 x Mary Wollstonecraft House DS0000010325.V287977.R01.S.doc Version 5.2 Page 21 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 YA1 /2 Regulation 4/5 Requirement Timescale for action 30/09/06 2 YA22 22 3 YA24 23 4 YA42 24 The registered person must ensure that the statement of purpose and service user guide are revised The registered person must 30/09/06 ensure that the complaints policy and procedure is reviewed to take account of names changed in the process for information and guidance to service users. The registered person must 30/01/07 continue with the repairs and improvements outlined in the list kept in the home and including the installation of an extractor in the staff toilets. The registered person must 30/09/06 ensure that the monthly visits and recorded reports continues 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 Mary Wollstonecraft House DS0000010325.V287977.R01.S.doc Version 5.2 Page 22 1 YA23 The registered person should give serious consideration to formalising the draft adult protection protocol for information and guidance to staff. Mary Wollstonecraft House DS0000010325.V287977.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Camden Local Office Centro 4 20-23 Mandela Street London NW1 0DU 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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