Inspection on 02/01/09 for Mount Carmel

This inspection was carried out on 2nd January 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Mount Carmel 03/01/07

Mount Carmel 30/11/05

Mount Carmel 10/05/05

Mount Carmel 21/02/05

Mount Carmel 28/04/04

Similar services:

Rugby House Project

City Roads Crisis Intervention

Agar Grove & St Augustine`s Alcohol Treatment & Rehab

Herbert Street

Haven (The)

Charis

Hartley House

Brook Drive, 124

Extracts from inspection reports are licensed from CQC, this page was updated on 20/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Mount Carmel 12 Aldrington Road London SW16 1TH     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: Louise Phillips     Date: 0 2 0 1 2 0 0 9 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. that people have said are important to them: They reflect the things 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 28 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 28 Information about the care home Name of care home: Address: Mount Carmel 12 Aldrington Road London SW16 1TH 02087697674 02086960412 mountcarmeluk@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mount Carmel Hostel for Recovering Alcoholics Limited Name of registered manager (if applicable) Ms Ruth Elizabeth Allonby Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 past or present alcohol dependence past or present drug dependence Additional conditions: The maximum number of service users who can be accommodated is: 18 The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Past or present drug dependence - Code D Past or present alcohol dependence - Code A Date of last inspection Brief description of the care home Mount Carmel is a care home for clients who are recovering from alcohol addiction. The home provides treatment and therapy to clients who have followed a period of total abstinence. The stay at Mount Carmel is for approximately six months. During this time they are supported to begin a Twelve Step programme of recovery from their addiction. The service focuses on the first five steps of the programme with support through group therapy and one-to-one counselling. There is a large parking area to the front of the property and a well-maintained garden to the rear of the home. The home Care Homes for Adults (18-65 years) Page 4 of 28 care home 18 Over 65 0 0 18 18 Brief description of the care home is situated close to local shops and public transport links. At the time of inspection the fees for the service were #400 per week. The manager stated that the fee is currently under review. Care Homes for Adults (18-65 years) Page 5 of 28 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: This inspection took place over one day by a Regulation Manager. A tour of the premises was carried out and care records were inspected along with other relevant paperwork. Time was spent talking to the manager and staff. Feedback has also been gained from surveys received from two members of staff, seven people who use the service and two health/ social care professionals involved with the service. Information has also been gained from the Annual Quality Assurance Assessment (AQAA) that we asked the manager to complete about the service and developments to be made. Care Homes for Adults (18-65 years) Page 6 of 28 Care Homes for Adults (18-65 years) Page 7 of 28 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 28 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 28 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 Mount Carmel are appropriately assessed to ensure that the service can meet their needs. Evidence: Most people who use they service say that they had relevant information before they moved to the service. One said that they would have liked more information about the 12 step programme that the service is based on. Another person who uses the service said that their decision to move to Mount Carmel was because of the ..good reputation.. that they had heard about the service, going onto say ..moving here was the best decision I have made... The assessment of new people to Mount Carmel is carried out by staff who work at the home. The assessment process involves looking at the persons drinking behaviours, history of this, physical issues and their reasons for wanting to use the services of Mount Carmel. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: All people who use the service have a contract that outlines the services to be provided and details about what the fees cover. Care Homes for Adults (18-65 years) Page 11 of 28 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. People who use the service are fully involved in planning their care and identifying their support needs. Evidence: Mount Carmel provides a very specific service that is detailed in the Residents Information Booklet. People who use the service are expected to be fully involved in the programme, which involves them examining their behaviours and reasons for drinking as part of the first steps to their recovery. This process is carried out through the treatment programme, which involves one-to-one sessions with their counsellor and through group work. Each person has a keyworker who is available for support throughout the programme, and with whom they meet at least once a week. Feedback from professionals involved with the service is that they feel it works in the interests of the people who use the service, and that it meets the needs of people from different backgrounds. One Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: professional commented that Mount Carmel provides ..excellent support... The care plans are based around individual goals that they wish to achieve, and describe how they will be supported through the programme to address these issues. Risk assessments are also individualised, based around areas such as the person looking after their own medication and use of cleaning products. The management of the risks is incorporated into the care plans. Care Homes for Adults (18-65 years) Page 13 of 28 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 excellent 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 are supported with personal development to lead a more fulfilling life. They are fully involved in all aspects of their lifestyle choices and in planning and preparing meals at the service. Evidence: The service provided by Mount Carmel is specifically designed to support the people who use the service to develop, take on personal responsibility and lead an alcoholfree life. Support for this is provided through group sessions and one-to-one counselling therapy. The programme is structured all day from Monday to Friday with additional counselling support provided at weekends. Professionals involved with the service say that they feel the staff provide ..excellent support... One also said that the service caters for people from different cultural backgrounds. One person who uses the service said that the programme is ..very structured.., but that this ..is necessary Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: and beneficial... The group sessions include discussion about feelings, peer assessments, nutrition and drama. For the initial four weeks of their stay new people to the service are escorted by another person who uses the service any time they leave the premises. During this period contact with family and friends is limited to telephone conversations only. This is to enable the person to focus on their recovery during the initial stages of the programme. Intimate relationships between people using the service is discouraged to ensure that people remain focused on their recovery and the programme. The service benefits from the input of a nutritionist who holds weekly group sessions and one-to-one work with people who need support to lead a more healthy life. Meals provided at the service are planned and prepared by current and people who continue to use the service, but who have completed the in-house programme. People using the service plan the menu and are provided with money to purchase the food for the service. Care Homes for Adults (18-65 years) Page 15 of 28 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. The health and social care needs of people who use the service are well met and relevant support provided. Evidence: People who use the service attend to their own personal care needs. Support is provide to people who use the service, through keywork sessions, one-toone counselling and group-work. There are also two staff who are Registered Mental Health Nurses, and who can monitor the mental health needs of the people who use the service, and access appropriate support as necessary. Professionals who are involved with the service say that the staff team are good at liaising with them about the needs of the people who use the service, that they promote a safe environment and are good at reinforcing boundaries, to aid the recovery of the person. The medication at Mount Carmel is managed with the full involvement of the person Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: using the service, with appropriate support provided by the staff at the home. Care Homes for Adults (18-65 years) Page 17 of 28 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 have the opportunity to raise concerns with relevant people in the organisation. Risks to people are minimised through staff training. Evidence: Mount Carmel has a complaints policy that details how to make a complaint and how this will be dealt with. On admission, all people who use the service are given a verbal explanation of the complaints procedure, and written information is also provided. The majority of feedback received from people who use the service is that they know how to make a complaint, with one saying that they were not sure. Three times a year the management committee holds a management meeting, and prior to this members of the committee hold a surgery to enable people who are currently using the service to discuss any areas of concern, or any issues that can be taken to the meeting. The manager stated that most staff had received training in safeguarding of vulnerable adults, and that this is also covered in new staffs induction to the service. The service must ensure that the safeguarding training that people undertake includes the guidelines and procedures of the local authority, of the actions to take in the event of an allegation being made at the service. This is to ensure that all staff know exactly Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: who to contact in this event. Care Homes for Adults (18-65 years) Page 19 of 28 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. The environment is pleasant and homely for the people who use the service. Evidence: The environment at Mount Carmel is comfortable, welcoming and homely. Ongoing work is occuring at the service to upgrade aspects of the home, to promote a more modern environment for people during their stay. People who use the service have the task of maintaining the cleanliness of the home, and this is carried out on a rota basis, with people taking in turns to clean different areas of the home. One person who uses the service said that they feel there should be better management of this, as the cleaning can be a bit chaotic at times. Care Homes for Adults (18-65 years) Page 20 of 28 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. The staff team are appropriately trained for their work with people who use the service. the service could benefit from more robust recruitment checks to minimise risks to people who use the service. Evidence: New staff are interviewed by the manager and deputy manager, and once employed have an induction and six month period of probation. Feedback from staff working at the service is that they received a satisfactory induction to working at Mount Carmel. Two staff files were looked at during the inspection and found to contain relevant information. However, care must be taken by the service to ensure that robust recruitment checks are carried out, as the file for one person was seen to contain a reference that had not been signed or dated, and another staff did not have required copies of proof of identification. Feedback from professionals involved with the service is that there are trained and experienced staff working at the home. One member of staff who responded to the surveys that they feel they do not receive enough training for their role. Similarly, one person who uses the service said that Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: they feel that some of the staff could benefit from being more reflective in their work. However, the majority of responses from people who use the service is that they feel supported by appropriately trained staff. Care Homes for Adults (18-65 years) Page 22 of 28 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 service is well managed and run in the best interests of the people who use this. Appropriate health and safety checks are maintained to minimise risks to people staying at the home. Evidence: The manager continues to convey a very competent and professional approach to her work that is evidence through the management of the service and commitment of the staff team. Feedback from staff is that there is good communication at the service and that they feel they are able to contribute to the running of the home for the benefit of the people who use the service. Monthly reports are received by the CSCI from a member of the trustees which provides regular information about the service. Meetings with people who use the service occur daily, where feedback is used to adapt the service and make positive developments to the home. Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: There is evidence at the home to demonstrate that appropriate health and safety checks are carried out on gas safety, electrical equipment, water testing and fire systems. Care Homes for Adults (18-65 years) Page 24 of 28 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 25 of 28 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 1 23 13 The Registered Persons must ensure that all staff receive training in safeguarding that incorporates the guidelines and procedures of the local authority. This is so that staff know exactly who to contact in the event of an allegation of abuse occuring at the service 31/03/2009 2 34 19 The Registered Persons must ensure that robust recruitment practices are carried out at the service. This is to ensure that people who use the service are protected by the homes recruitment practices. 31/01/2009 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. Care Homes for Adults (18-65 years) Page 26 of 28 No. Refer to Standard Good Practice Recommendations 1 3 Consideration should be given to providing more information about the 12 step programme to potential users of the service. The service should review each staff recruitment file to ensure that all relevant, and robust information is held about each member of staff. The Registered Manager should obtain the NVQ Level 4 qualification in management 2 34 3 37 Care Homes for Adults (18-65 years) Page 27 of 28 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 28 of 28 - 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!