Care Home: Chelsea House

Similar services:

• Ashlong House
• Norbury Crescent (30)
• Edenvale
• Wadham Avenue
• Chatsworth Care - Dawson House
• Cowden Road, 52 - 54
• Chatsworth Care - Tudor Lodge
• Foxley Lane (121a)

What the care home does well Chelsea House provides a small but homely environment, with demonstrable care and support for the people living there. The home has had very positive feedback from placing authorities who are pleased with the improvements that living in the home has bought to people`s lives. The improved management arrangements, including the senior management support, are clearly beneficial to the home and the people who live there. What has improved since the last inspection? The home has now recruited and appointed a permanent manager, who has applied for registration with the Commission for Social Care Inspection. Formal one to one supervision and staff meeting arrangements have improved and there are more regular staff meetings. This has supported a better flow of communication across the team. Each person`s staff record now includes a recent photograph. There have also been improvements in response to recommendations made: a better system of providing people with medication when they go away over night is now in place. Staff have had better opportunities to familiarise themselves with the policies and procedures. CARE HOME ADULTS 18-65 Chelsea House 4 Winchelsea Road London N17 6XH Lead Inspector Margaret Flaws Unannounced Inspection 20th August 2008 12:30 Chelsea House DS0000010823.V366223.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 Chelsea House DS0000010823.V366223.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. Chelsea House DS0000010823.V366223.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chelsea House Address 4 Winchelsea Road London N17 6XH 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 8885 1898 Mr Wilhelm Dale Lewis Mr Wilhelm Dale Lewis Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Chelsea House DS0000010823.V366223.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th May 2007 Brief Description of the Service: Chelsea House is a small care home registered to provide accommodation and personal care for a maximum of three adults with learning disabilities. Mr Dale Lewis owns the home and is registered as the manager. Mr Lewis also provides a separate specialist outreach service for people with learning disabilities, under the umbrella name of Pashun Care Services. The home is a terraced house with three bedrooms. On the ground floor, there is a lounge, bedroom, toilet, kitchen and a separate dining room. On the first floor there is a bathroom with a toilet, two bedrooms and a small office. There is a small paved area at the front of the house and a back garden, which is accessible to people living in the homes. The house is located near the busy Philip Lane and close to a sports centre. There is easy access to shops, restaurants and transport facilities located along the high street at Seven Sisters. The stated aim of the home is to provide a holistic and high quality of care to people with learning disabilities. The home also aims to provide practical help for people and maximise their individual potential while adhering to the core values of showing respect for people, encouraging local community participation and promoting independence. Placements at the home costs between £3430 - £1099 for each person per week. People living in the homes are expected to pay separately for some items and activities, such as eating out. Following Inspecting for Better Lives the provider must make information available about the service, including inspection reports, to people living in the homes and other stakeholders. Chelsea House DS0000010823.V366223.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day. During the inspection, we spoke at length to the home manager, one staff member, one resident and spent time observing the interactions of people who live in the home. Because of the nature of their disabilities, it is difficult to gain their opinions in detail but they appeared relaxed and pursuing their own interests. We also spoke to one relative and one placing social worker. The inspection also comprised a review of policies and procedures, care and staff records. The manager provided CSCI with a good Annual Quality Assurance (AQAA) document, which contributed information to this inspection. The quality rating for this service is 2 stars. This means that the people who use this service experience good quality outcomes. What the service does well: What has improved since the last inspection? What they could do better: Some core staff training needs updating and it is recommended that a training review take place. Chelsea House DS0000010823.V366223.R01.S.doc Version 5.2 Page 6 It is recommended that Chelsea House document the procedure for providing medication to people going home over night in the medication policy. 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. Chelsea House DS0000010823.V366223.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 Chelsea House DS0000010823.V366223.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 People who use the 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 living in the home have had their individual aspirations and needs fully assessed. Prospective residents can be confident that they would be given all the information they need to make a decision about living in the home. EVIDENCE: There have been no new admissions since the last inspection. The home has a sound policy for the assessment and admission of new residents. It clearly sets out the arrangements for visits, trial periods and case reviews. There is good information available for prospective residents. The manager said that in the future the home may expand by moving to a larger premises but at the moment, the current placement of residents is stable. In the records for the two residents we checked, there was very good assessment information on file. These included thorough initial assessments of each person’s holistic needs, regularly reassessments, placement reviews and good risk assessments. Chelsea House DS0000010823.V366223.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 and 9 People who use the 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 living in the home are involved in decision making about the life of the home and about their own lives. People have individualised, accessible care plans that set out their needs and these are regularly reviewed, in consultation with them. Good written risk assessments are in place, risks are appropriately assessed and managed, to help people develop and to protect them from harm. EVIDENCE: We saw evidence of good process for identifying and supporting people’s choices and needs in the two resident’s file we checked. Each person’s plan set out their needs and goals, and outlined the tasks involved in meeting these goals. There is also clear guidance about how to work with each person to support them and help them achieve their goals. Individual risks are reviewed and reassessed on an ongoing basis. One person, who has in the past Chelsea House DS0000010823.V366223.R01.S.doc Version 5.2 Page 10 experienced and presented considerable challenges, has continued to improve both in behaviour and wellbeing. Regular reviews have been completed. For example, one person’s review with the placing authority took place the day before the inspection. The home had prepared detailed information for the review, including a full care plan reviews, pictorial activities information, new risk assessments and an outline of health care needs. It was evident that significant work had been done to prepare for the review. We spoke to this resident and he showed us a copy of review notes. He was positive about his involvement in the process and his interaction with staff and the social worker. We also spoke to his social worker by telephone. She said that she was very pleased with his progress living in the home; that his wellbeing and behaviour had stablised considerably and that he was very happy living there. The two other residents are due for their placement reviews later in the year. Regular internal reviews take place and changes are made in line with the wishes and needs of the residents. These are clearly documented. One person preferred to lock his room when he went out. On this return from the day centre, he showed his room and said that he was very happy with the way he was able to keep it. He said he enjoyed watching freeview TV. The diversity issues of the residents have been addressed through support of their cultural needs in diet, entertainment and beliefs. Staff have received some equality and diversity training. Chelsea House DS0000010823.V366223.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 and 17 People who use the 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 living in the home have the opportunity to develop as people and maintain important personal and family relationships. Individual rights and choices are supported by the home and its ethos. Food provided suits people’s choices and cultural needs. EVIDENCE: People living in the home are supported to participate in a range of activities, both within the home and in the local community. Staffing levels and support are well planned and sufficient for staff to accompany residents into the community as needed. The registered person also provides a separate specialist day service and all residents usually attend on a daily basis. However, one resident often prefers going out and about, so staff accompany him on individual outings. Chelsea House DS0000010823.V366223.R01.S.doc Version 5.2 Page 12 On weekdays, residents undertake a range of activities, for example, bowling, swimming, ice skating and horse riding, as part of their day centre involvement. In the home, staff described some of the in-house activities, such as listening to classical music, watching TV, playing board games and doing puzzles. The Manager explained how family support is maintained. All residents have strong family involvement and two have very regular family visits to the home. One person also goes to stay with his family. We spoke to one family member who was positive about the way in which the home provides support and care. The menu is simple and to a large extent dictated by the residents. People’s cultural wishes in relation to food are well supported. For example, one person said he prefers West Indian food, which he eats regularly. Staff said that it is easy to buy the ingredients in the Tottenham area. Two other residents’ cultural preferences are well supported (both come from South Asian backgrounds). The manager said that the residents generally eat a large lunch at the day centre and have a lighter meal in the evenings. Chelsea House DS0000010823.V366223.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 and 20 People who use the 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 living in the home have their physical and emotional healthcare needs met through good quality planning and supportive intervention. Staff encourage people to be independent and to take responsibility for their own personal care needs. Medication policy and procedures are sound and protect people living in the home. EVIDENCE: People’s needs, including the need for support with personal care, are outlined in their files. These give good guidance to staff about the best approach to take in working with each person. The home has a proactive approach to regular healthcare checks of physical and mental health and these were all clearly documented and timetable. It was easy from reading each person’s file to get a clear picture of their health needs and how they were being met. We discussed an incident with one resident who had a serious injury at the day centre and we also reviewed the documentation in relation to this event. It was clear that the resident was very well protected by the staff accompanying him Chelsea House DS0000010823.V366223.R01.S.doc Version 5.2 Page 14 on that occasion and that this recovery (to a severely injured wrist) was going well, with good follow-up support by the home. We reviewed the policy and procedure regarding the administration of medication. As part of an ongoing policy and procedures review, the medication policy has been updated (May 2008). This policy is simple and clear for staff to follow. At the previous two inspections, recommendations were made to ensure that the home avoids secondary dispensing when providing medication to people going home for the weekend. We discussed this with the manager. He described how he had consulted with the local pharmacy and agreed that the medication blister pack can be cut with the medication intact and given to the person to take home. He also demonstrated how this is done. This addresses the recommendation previously made. However, as matter of good practice, it is recommended that the home document this procedure in the medication policy. The Medication Administration Records were in order, with no gaps or issues identified. Staff said that the home has a good relationship with a local pharmacy. One person who experienced challenging behaviour has had his medication significantly reduced since living at the home, as his wellbeing has improved. One person does not take any medication. There was evidence that most staff had received training in the administration of medication and the manager checks the competency of staff to in this area. Chelsea House DS0000010823.V366223.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 and 23 People who use the 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 has an open culture that supports people living there to express their views and concerns in a safe and understanding environment. People are enabled to express their views and concerns. People living in the home are protected by the home’s safeguarding adults policies and procedures. EVIDENCE: Staff have generally received training in the protection of vulnerable adults and there have been no adult protection issues since the last inspection. There is a clear complaints procedure in place and no complaints had been received in the home since the previous inspection. Chelsea House DS0000010823.V366223.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 and 30 People who use the 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 a comfortable, homely and well-maintained environment suitable for the residents’ needs. EVIDENCE: The home is on the scale of an ordinary family home and is generally well maintained, clean and homely. Each person has their own bedroom, and these are comfortable and reflect their personalities and interests. There is a small kitchen space downstairs and a narrow garden area. The lounge is a nicely furnished and set out with recreational items. No maintenance issues were identified at this inspection. The laundry is located outside, along with the COSHH cupboard. It was appropriately locked at the time of this inspection. Kitchen and food temperatures are taken daily and recorded. Chelsea House DS0000010823.V366223.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 and 36 People who use the 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 living in the home are supported by sufficient numbers of properly recruited, trained and supported staff. EVIDENCE: The rota reflects that the home is well staffed, providing one to one support to the people who live there the majority of the time. One person is funded for two to one support. The recruitment procedure is sound. One new staff member had been appointed since the last inspection. When interviewed, he described a clear induction process and demonstrated a good understanding of his role. In the three staff files we checked, staff had all had correct pre-employment checks completed prior to starting work. All staff now have a recent photograph on their file, meeting a requirement from the last inspection. We checked the supervision records. Supervision was documented and dates recorded. A previous requirement to ensure that staff receive formal supervision six times a year has been met. The Manager explained that the team is now stable and well grounded, with each team member able to act Chelsea House DS0000010823.V366223.R01.S.doc Version 5.2 Page 18 responsibly and responsively in their roles. He said that, as they were small team working so closely together on a daily basis, it was easy to change and innovate in response to the residents’ needs and to communicate well. Team building had been informal but productive, with social occasions celebrated alongside formal meetings (now recorded and held monthly). The Manager explained some ways in which internal training is provided, for example, by the use of role plays to get across new information or to check competency. Staff are progressing through NVQ achievement and two staff members are training to be healthcare professionals. Staff have been trained in health and safety, food hygiene, restraint, medications, first aid, fire safety, infection control and manual handling. Some core staff training needed updating and it is recommended that a training review take place. Chelsea House DS0000010823.V366223.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People who use the 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 planned and well focused on the needs of people living in the home. People’s views are formally and informally assessed and their health and safety needs protected. EVIDENCE: In the past, the home had an unstable period in management but now the current manager has been formally appointed to this role. He is in the process of applying to the CSCI for registration. This meets a requirement made at the last inspection. He said that he has had excellent support and mentoring from the registered person and senior management team and that this has helped him to develop in the role. He is currently studying for the NVQ4 in Care and will enrol in the Registered Managers’ Award after this is completed. Chelsea House DS0000010823.V366223.R01.S.doc Version 5.2 Page 20 The staff, relative and care professional spoken to during the inspection were very positive about the management of the home, the approachability of the manager and the way in which support and care was managed. The records, including care and staff documentation, were very systematic and orderly. Staff meetings are now held more than six times a year, meeting a previous requirement. The policy and procedures review is now complete and staff have signed off the new policies to say that they have read them (this was recommended at the last inspection). There are good quality assurance procedures in place with formal surveys in place. The manager said that, because the residents’ families are closely involved with them, he has very regular contact with them and is able to address issues as they arise. We randomly checked the health and safety certificates and records. These were up to date and reflected the information supplied in the Annual Quality Assurance Assessment. Staff have received appropriate health and safety training. Incident and accident records were inspected. The only incident was the previously described injury to resident at day centre. Fire records were good. Equipment has been regularly checked, fire drills recorded as taking place monthly and alarms and call point tested weekly. Chelsea House DS0000010823.V366223.R01.S.doc Version 5.2 Page 21 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 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 3 X 3 X 3 X X 3 X Chelsea House DS0000010823.V366223.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA32 YA20 Good Practice Recommendations A training review should take place to ensure that all staff training is kept up to date. The home should document in the medication policy the agreed procedure for giving medication to residents when they go home overnight. Chelsea House DS0000010823.V366223.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Chelsea House DS0000010823.V366223.R01.S.doc Version 5.2 Page 24 - 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!