Inspection on 08/06/07 for Saltram Crescent, 91 & 99

This inspection was carried out on 8th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Saltram Crescent, 91 & 99 07/06/06

Saltram Crescent, 91 & 99 13/03/06

Saltram Crescent, 91 & 99 21/06/05

Saltram Crescent, 91 & 99 06/01/05

Saltram Crescent, 91 & 99 02/08/04

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

CARE HOME ADULTS 18-65 Saltram Crescent, 91 & 99 91 & 99 Saltram Crescent London W9 3JS Lead Inspector Wynne Price-Rees Key Unannounced Inspection 8th June 2007 10:30 Saltram Crescent, 91 & 99 DS0000010872.V333836.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 Saltram Crescent, 91 & 99 DS0000010872.V333836.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. Saltram Crescent, 91 & 99 DS0000010872.V333836.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Saltram Crescent, 91 & 99 Address 91 & 99 Saltram Crescent London W9 3JS 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 8964 8154 020 8968 1983 Lookahead Housing & Care William Berkye Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (36) of places Saltram Crescent, 91 & 99 DS0000010872.V333836.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th January 2007 Brief Description of the Service: Saltram Crescent is a Registered Care Home that operates in two, three storey houses (No 91 and No 99). The service is registered to provide accommodation for 12 residents who have a mental disorder. Each home accommodates six residents and both houses are managed from number 91. The care is provided by Look Ahead Housing and Care Ltd. The homes are situated in the Queens Park area with good access to public transport and local services. Each service user has a single bedroom and both houses have a kitchen/diner, lounge, adequate bathroom space and attractive patio garden area to the back of the two houses. Currently No 99, has only male service users. There are male and female service users at No 91. A prospective service user would need to be made aware of the high level of smoking in communal areas. In each house the bedrooms are on the first and second floors making the service unsuitable for anyone with a physical disability. The current scale of charge for the service as obtained from the pre-inspection information is £635.20 per week. Magazines, papers and toiletries are payable by the service users themselves. Saltram Crescent, 91 & 99 DS0000010872.V333836.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over seven hours on two days. Eight have your say questionnaires were returned by residents prior to the inspection. Residents and staff were spoken to during the course of the inspection as well as the manager. A tour of the premises took place; six residents care plans were case tracked, three from each house and records checked. No pre-inspection questionnaire was received before the inspection. What the service does well: What has improved since the last inspection? What they could do better: The home must complete the review and update of the care plan system so that all care plans are up to date. Saltram Crescent, 91 & 99 DS0000010872.V333836.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Saltram Crescent, 91 & 99 DS0000010872.V333836.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 Saltram Crescent, 91 & 99 DS0000010872.V333836.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a comprehensive written pre-admission assessment policy and procedure in place. One new client has moved in since the last key inspection and there were records of a referral from the Joint Homelessness Team at Westminster City Council. Adult Mental Health assessment that included the resident’s views and care plan from the Mental Health Trust. This information was forwarded prior to a decision being made if the client’s needs could be met by the home. There was also communication with the client’s previous home to enhance the available written information and help make the right decision. The client was able to visit the home to decide if they wished to live there. Saltram Crescent, 91 & 99 DS0000010872.V333836.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A sample of six care plans were case tracked, three from each house. The quality of the information varied depending on progress made towards reviewing how the care plans are recorded. Those that were completed were of good quality and demonstrated a level of client input and consultation that they decide on and included them signing the plans off. There were clearly identified priorities from which goals were set with how they were to be achieved, by whom and within a timescale. These were focused on the home’s objective of preparing client’s to return semi-independent and independent living by developing required life-skills. The skills that required development were identified during key-work sessions and progress made recorded in daily logs that fed reviews. The care plans were underpinned by individual risk assessments. The incomplete care plans contained some out of date objectives Saltram Crescent, 91 & 99 DS0000010872.V333836.R01.S.doc Version 5.2 Page 10 and information that required work to get them up to the standard of the others and the Care Manager said that staff are working towards this. As well as being involved in care plan development, clients also hold monthly house meetings that they minute were all aspects of living at the home are discussed and any complaints or grievances discussed. Those spoken with confirmed they are empowered to make their own decisions on a daily basis. This was further evidenced by the home’s daily routine that is fitted to the needs and wishes of the clients rather than the other way around. Clients were observed coming and going and carrying out activities as they pleased. Saltram Crescent, 91 & 99 DS0000010872.V333836.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: None of the clients are currently working although three attend a cookery course at Westminster Adult Education College, one goes to a day centre three days per week where they do some gardening and help with tea and coffee whilst socializing. Another client makes good use of the library where he is a frequent visitor and attends a Hindu temple. The clients’ are supported by staff to choose and attend courses. Many activities are focused on developing life-skills so that residents’ may live unsupported in the future. These include one to one cookery, art therapy and a cooking group. Two clients also visit another Look Ahead project where they do art classes. A resident often visits Borough Market and also enjoys canal walks. There is an emphasis on key-working sessions taking place off the premises and the clients make good use of local amenities such as restaurants, wine Saltram Crescent, 91 & 99 DS0000010872.V333836.R01.S.doc Version 5.2 Page 12 bars and picnics in the park. There are involvement plans that highlight activities that individual clients would like to do and these are sometimes filled in with key-workers over lunch. Although encouraged to go out, one resident is not very keen on doing so and many of his activities are home based. These include carrying out home security checks with staff. Clients have been on visits to museums and the London Aquarium. Family links are encouraged where possible and telephone calls and visits take place. The house rules are based on health and safety and respect for others and their property. There is a meal preparation rota and clients assist the cook, take turns food shopping and prepare their own breakfasts. The main meal of the day takes place in the evening and is regarded as a social event. Saltram Crescent, 91 & 99 DS0000010872.V333836.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home does not provided personal care. Staff prompt clients’ regarding personal hygiene, attending surgery appointments and picking up prescriptions where necessary. One client came to the office to pick up his medication during the inspection. The district nurses visit as required. Health needs are included in the individual care plans and health checks take place a minimum annually. All the clients’ are registered with GPs at various surgeries and have full access to community based health care services. There is a written medication administration policy and procedure that staff are aware of and follow. Two clients are self-medicating, whilst another who was self-medicating, when they moved in, is no longer as monitoring showed they were not taking the medication. Their medication will be administered until they feel able to self-medicate. The home keeps no controlled drugs. The medication administration records were checked for all clients and found to be up to date and appropriately kept. Medication was also suitably stored and disposed of if not required. Saltram Crescent, 91 & 99 DS0000010872.V333836.R01.S.doc Version 5.2 Page 14 Saltram Crescent, 91 & 99 DS0000010872.V333836.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a complaints policy and procedure that clients’ are aware of and know how to implement. A complaints record is kept with incidents also detailed. The complaints are responded to and investigated appropriately with outcomes stated. There was one complaint since the last key inspection. Required notifications are forwarded to the local CSCI office. Adult protection is part of induction training and staff have also received two day POVA training. The training has enabled them to identify what constitutes abuse and procedure to follow if encountered. They have also received training in how to deal with aggressive behaviour as part of the rolling training programme. Each Look Ahead project identifies its own training needs within the context of the organisation. Any money held on behalf of clients is fully documented including transactions that are signed by clients’ and staff. These are audited by the organisation. The clients either look after their own financial affairs as part of life-skill development or are under appointeeship with Westminster City Council. Saltram Crescent, 91 & 99 DS0000010872.V333836.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The premises are fit for the stated purpose and décor is adequate to meet clients’ needs, as there seems to be quite a lot of wear and tear. There was a suite of furniture in the lounge of 91 that looked quite worn on first inspection. A client said that it had only been purchased the previous year. The communal areas of 99 smell strongly of cigarette smoke due to the heavy smoking of the clients. The home has done its best to combat this and the Care manager said that it would change when the no smoking ban comes into force on 1st July 2007. Generally the home is clean, tidy and well maintained. Saltram Crescent, 91 & 99 DS0000010872.V333836.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Currently there are seven support workers, two who are currently on secondment elsewhere. Their posts are being covered by internally by Look Ahead staff from other projects although sometimes it is necessary to use agency staff. If agency staff are used the home checks with the agency that those supplied have been fully vetted. There are also occasional supernumerary student placements. The rota demonstrated that there are sufficient numbers of staff on duty at all times to meet clients’ needs. The staff team exceed to required 50 NVQ level 2 qualified requirements. They all have training and development plans that feed the annual development review in conjunction with monthly supervision sessions. Staff have access to a rolling training programme as well as receiving core induction training when they join the organisation. There is a comprehensive written recruitment procedure that is based on equal opportunities and includes CRB and POVA disclosures. Saltram Crescent, 91 & 99 DS0000010872.V333836.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 40. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Care Manager has attained an NVQ level 4 management award and has been in post for four years. They were very knowledgeable about what constitutes good care practice and the client group they provide a service for. There is a comprehensive quality assurance system with performance indicators and trigger levels that is reviewed annually and regularly monitored. The development plan is tailored to the individual project and then incorporated within the organizational business plan. One to one surgeries also take place with individual clients as part of the new diversity client plans. The fire fighting equipment is checked and serviced annually and safe-working practices followed. Weekly fire alarm tests take place and quarterly fire drills including one at night within a year. The fire brigade recently visited to give Saltram Crescent, 91 & 99 DS0000010872.V333836.R01.S.doc Version 5.2 Page 19 clients fire safety information. Full up to date building risk assessments were in place. Any accidents and incidents are fully recorded. Fridge and freezer temperatures are checked and recorded daily. The care manager recently attended a risk mapping training session. Health and safety, food hygiene, first aid and infection control are all included as part of core induction training with refresher courses available as required. The required policies and procedures were in place. Saltram Crescent, 91 & 99 DS0000010872.V333836.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 X 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Saltram Crescent, 91 & 99 DS0000010872.V333836.R01.S.doc Version 5.2 Page 21 NO 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 YA6 Regulation 15 (1) Requirement All care plans must be updated. Timescale for action 15/08/07 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 Saltram Crescent, 91 & 99 DS0000010872.V333836.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE National Enquiry Line: 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 © 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 Saltram Crescent, 91 & 99 DS0000010872.V333836.R01.S.doc Version 5.2 Page 23 - 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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