Archived: Charter House

Since the appointment of the acting manager there has been some work done in relation to updating care plans to make them more centred on people's individual care and support. However this work has now stopped and when we visited we found that plans and risk assessments did not inform staff how to safely support people at all times. This lack of available information was impacting on people's safety within the home.

People living at Charter House were still seen to be vulnerable because staff and management did not know how to keep people safe. The acting manager was unaware of guidelines and processes to follow when an incident of abuse occurred at the home. They are also unable to offer effective staff support prior to, during and following incidents.

Although daytime staffing levels were largely being maintained, staff were working long hours in order to maintain these. Staff were not receiving effective support or leadership. The lack of training for staff could place people living at the home at risk of receiving unsafe or inappropriate care.

People did not know what the management arrangements at the home were. The provider had appointed a manager who does not have the skills and experience to manage the home and the management consultant employed to support them was now working from home and thus not providing the much needed support that the staff valued when it was initially organised.

Following our visit we contacted the local authority to share our concerns about the home. Social care professionals were already working with people living at Charter House to assess their care and support needs and the local authority team who investigate allegations of abuse are currently investigation four new allegations. Previous allegations relating to poor care and support were substantiated.

We found that not everyone gets on with each other at Charter House and disagreements and altercations are now having a negative impact on the quality of people's life. Staff shared concerns in relation to three people in particular.

Care plans and risk assessments did not inform staff how to safely support people at all times. One person had worked at the home for a month and had not read peoples' care files suggesting that they are not working documents.

People living at Charter House were still vulnerable to abuse because, although the home had implemented safeguards to keep people safe, they were not being followed at all times. For example the home was not always maintaining minimum staffing levels as agreed with the local authority. When staffing levels have been increased however staff told us that it had a positive impact on peoples' quality of life as there were more opportunities for one to one support. Staff also reported a reduction in the number of incidents that have occurred over recent weeks.

Since our visit in March 2011 there have been improvements made to the home which have made Charter House a nicer place to live. People living in the home identified some positive changes that have taken place recently. They told us that meals have improved. One person said that there are now lots of fruit and vegetables available, and they said, 'I love it'. We also saw a selection of hot and cold drinks freely available in the small kitchen area. People told us they were happy with the new decor and in particular the garden area. Safety concerns had also been addressed in relation to the environment.

During our August 2011 visits, we found that the lack of current robust management arrangements within the home was causing communication errors that were ultimately putting people at risk of harm. This was because care and support plans were not being updated to reflect increased and changing needs. Staffing levels were not being risk assessed to ensure there are sufficient staff on duty, with sufficient skills to meet the needs of people living at the home. Also the provider was unaware of the actions taken by named members of her staff.

Communication issues between the senior staff and the provider are leaving the home without clear direction. People living at the home, and the staff team were unclear about current management arrangements and the provider's assurances that she will ask people living at the home what they think of the service provided have not been actioned. As a result some people were still not confident that they will be safe at Charter House.

People said that they understood the care and support choices available to them and said that they had opportunities to express their views and make decisions in relation to their care. One person told us that their cultural beliefs are respected and supported by staff and that they value this. One person told us that staff respect their privacy by knocking before entering their room.

Four people living at Charter House told us that they are always asked to give consent in relation to how their care is provided and what medical support they receive. People also said that they are involved in updating care plans when these needs change. One person said that their social worker and GP tell them about their rights in relation to treatment and support and that they fully understand them.

People told us that it is 'ok' living at Charter House. One person was more positive and said,

'It's friendly and very caring'.

People living at the home are able to decide what they do and when they do it. People told us that they can come and go as they please.

People are involved in cleaning their rooms but all said that staff keep the house clean, do the cooking and the washing. Only one person has told the home that they would like to be more involved in the cooking. The manager said that this is happening and this was confirmed in conversations. People told us that they like the meals on offer at Charter House. Everyone we spoke with said that staff prepared and cooked meals within the home but said that they could have an alternative if they did not like what was on offer. We were told by a person living at the home that one person likes cooking and is able to make cakes. Another person regularly makes a curry for everyone.

Two people told us that they knew what medication they were prescribed and the reasons why they took it. Both said that staff support them to manage their medication and that they were happy with these arrangements. One person went on to say that they regularly see the GP who explains all about their medication.

Four people told us that staff are supportive and always listen to them. Three people felt that the management did not always listen and that this causes upset and frustration. On the day of our visit three of the four people we spoke with raised concerns or made allegations in relation to the home. These are currently being investigated and issues are being monitored by social care professionals to ensure the protection of the people living at the home.

Two people we spoke with said that Charter House is always clean and tidy. One person said that staff do a good job to keep the house clean and cleanliness was noted as being very important to this person. One person however raised a number of issues in relation to poor maintenance of the home and these were shared with the deputy manager on the day of our visit to resolve.

People who spoke with us said that they were happy with the support that they receive from the staff team. One person told us that staff knew how to meet their needs. Everyone said that staff were 'ok'.

One person wanted to commend the support that they received from their key worker and said,

'She's a good un'.

This person went on to say,

'She is always working and does everything you ask her'.

People told us that there are staff around whenever they need support or assistance.

Staff told us that they are very happy working at Charter House. One person said,

'I am really happy here. Great staff and manager is very supportive. It is a lovely place to work'.

Staff on duty at the time of our visit felt very well supported by the manager and by the senior staff member who carries out supervisions and appraisals. Staff demonstrated a good understanding of their roles during discussions and the positive comments made by people living at the home about the staff team reflected they were competent to do their job.

People told us that they have completed surveys that asked them what the home did well and what could be done better. The home arranges meeting for people to attend to share their views about the home but only one person out of the four who spoke with us found them useful. People told us that they know who to speak to if they have a complaint.

People told us that they knew what information was kept within their care files but no one wanted to access their files on a regular basis. People told us that their care plans are kept in the office.