Inspection on 29/09/09 for Lucerne House

This is the latest available inspection report for this service, carried out on 29th September 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Lucerne House 23/06/08

Lucerne House 05/09/07

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Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report CARE HOME ADULTS 18-65 Lucerne House 12 Mitten Road Bexhill-on-Sea East Sussex TN40 1QL Lead Inspector Alexis Reilly Unannounced Inspection 29th September 2009 09:30 Lucerne House DS0000069865.V378034.R01.S.doc Version 5.3 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Lucerne House DS0000069865.V378034.R01.S.doc Version 5.3 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Lucerne House DS0000069865.V378034.R01.S.doc Version 5.3 Page 3 SERVICE INFORMATION Name of service Lucerne House Address 12 Mitten Road Bexhill-on-Sea East Sussex TN40 1QL 01424 224181 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) lucernehouse@fsmail.net Care Pro (South East) Ltd Ms Diane Rachel Saadya Care Home 10 Category(ies) of Learning disability (0) registration, with number of places Lucerne House DS0000069865.V378034.R01.S.doc Version 5.3 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning disability (LD). The maximum number of service users to be accommodated is 10. Date of last inspection 22nd December 2008 Brief Description of the Service: Lucerne House is a detached property located in a quiet residential area of Bexhill within easy walking distance of the town centre shops. There is a large garden for use by residents. At the rear of the house, a chalet-type summerhouse. The home is currently registered for eight adults with learning disabilities. Residents private and communal accommodation is provided on three floors and maintained to a high standard. Since the last inspection an extension has been completed to the side of the main house. This has provided three additional bedrooms, an office and a new laundry facility. The home has a mini-bus type vehicle. The current fees charged ranges from approximately £400 to around £850 per week. The service currently has nine residents. Eight of these have lived in the home for several years. The latest inspection report is sent out to any enquirer who expresses an interest in the home. A copy of the report is kept on display in the home with a copy obtainable via the manager. Lucerne House DS0000069865.V378034.R01.S.doc Version 5.3 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The inspection began at 9.30 and lasted for four hours and 15 minutes. The inspector spent time with three residents independently and two residents in company seeing others in the home. The inspector looked at the care that three residents receive in the home, examining the care plans and the associated documents such as risk assessments and activity plans for these individuals. Other documents examined were copies of notifications, accidents and appointments, evidence of external reviews, the record of complaints and the complaints procedure. Staff recruitment files and staff induction training sheets were also examined. The inspector viewed all the communal areas and visited two of the three bedrooms of the residents involved in the case tracking. The inspector spent time with the Registered Manager and spoke with one staff member. What the service does well: What has improved since the last inspection? Resident’s contracts are more detailed particularly in regard to the costs of facilities and services not covered by the fees. Resident’s monies are managed in a transparent way and in their best interests. Activities undertaken by residents are properly risk assessed and documented on their care records. Lucerne House DS0000069865.V378034.R01.S.doc Version 5.3 Page 6 Staff receive mandatory training in key areas and regular formal supervision is in place. The Registered Manager is in the process of creating and implementing a new medication policy and good progress has been made on the procedures within the home. Evidence was also supporting to confirm service users have access to free NHS chiropody, and that the home continue to support advocacy arrangements and include advocates and other professional and none professional representatives when making best interest decisions for service users. The Registered Manager has a process in place to assess the quality of the services provided at the care home including monthly regulation 26 visits. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Lucerne House DS0000069865.V378034.R01.S.doc Version 5.3 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 Lucerne House DS0000069865.V378034.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 2 People using 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 has had one new admission. Evidence was supporting to suggest that the Registered Manager has obtained assessment documents such as learning disability assessments from the community and also CPA documentation prior to offering the prospective resident a place in the home, thus ensuring these persons needs can be met within the home. EVIDENCE: As part of the inspection the inspector looked at the care that three particular residents receive in the home spending time with them during the inspection. To help make a judgement on the care these people receive the inspector examined the person centred care plans and the associated documents such as risk assessments and activity plans for these individuals, also evidenced were the external reviews from the community learning disability team to ascertain if the needs identified in the assessment are used as a basis for a comprehensive care plan. Lucerne House DS0000069865.V378034.R01.S.doc Version 5.3 Page 9 The home has had one new admission since the last inspection. Evidence throughout the inspection confirmed the appropriate assessment documents and background information was collated prior to offering this person a placement in the service, and this information was used to develop the care plan, and that the individual had felt welcomed into the home and had settled well. Lucerne House DS0000069865.V378034.R01.S.doc Version 5.3 Page 10 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 People using 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. Residents have care plans in place which are person centred and are clear documents to work from. Resident’s have been involved in the development of their care plan. Risk assessments are detailed and clear. Residents are able to make their own choices and decisions, and are treated as individuals. Contact with advocacy services is promoted. EVIDENCE: As part of the inspection the inspector looked at the care that three particular residents receive in the home. To help make a judgement on the care these people receive the inspector examined the person centred care plans and the associated documents such as risk assessments and activity plans for these Lucerne House DS0000069865.V378034.R01.S.doc Version 5.3 Page 11 individuals, also evidenced were the external reviews from the community learning disability team to ascertain if the needs identified in the assessment are used as a basis for a comprehensive care plan. Other documents examined were copies of notifications, and accidents and appointments. The inspector spent time with the Registered Manager, one care team member and the three residents who were part of the case tracking, other residents were seen in the home. Care plans were found to be person centred with detailed information, the Registered Manager is in the process of reformatting the plans slightly and having them typed up, these will then be an easy to access booklet style format and contain clear, relevant information. Risk assessments were comprehensive and detailed, with guidance included specifically for dealing with individual’s behaviour. It was evident that the staff used the care plan as a working document. Contact with advocacy services is promoted. Lucerne House DS0000069865.V378034.R01.S.doc Version 5.3 Page 12 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): This is what people staying in this care home experience: 12,13,15,16 & 17 People using 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. Residents do benefit from regular and planned activities. Residents benefit from freedoms and flexible routines, and generally enjoy the food. Residents are consulted and listened to regarding the choice of daily activity. This ensures they have a varied and interesting life in the home. EVIDENCE: As part of the inspection the inspector looked at the care that three particular residents receive in the home spending time with them during the inspection. To help make a judgement on the care these people receive the inspector examined the person centred care plans and the associated documents such as Lucerne House DS0000069865.V378034.R01.S.doc Version 5.3 Page 13 risk assessments and activity plans for these individuals, also evidenced were the external reviews from the community learning disability team to ascertain if the needs identified in the assessment are used as a basis for a comprehensive care plan. Other documents examined were copies of notifications, and accidents and appointments. The inspector spent time with the Registered Manager, one care team member and the three residents who were part of the case tracking, other residents were seen in the home. Evidence was supporting from discussions with staff, service users, care plans and activities schedules to confirm that resident are involved in valued activities and these are both recreational and structured. Residents choose the activities that happen in the home, and have weekly planned activities which include the use of the community resources. Some residents are involved in voluntary work in the local community. The home has a practice were each week the residents meet to plan the menu for the following week ahead. Residents are more involved in preparation of meals in the home. Personal relationships and family relationships are encouraged if these are helpful and appropriate. Menus in the home are varied. Lucerne House DS0000069865.V378034.R01.S.doc Version 5.3 Page 14 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 People using 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. Residents benefit from a comprehensive plan of care and input from the community learning disability team. The Registered Manager has a good relationship with the general practice and resident’s health care needs are reviewed and referrals made were appropriate. The procedure for administering medication was found to be in good order. This ensures residents have good general health. EVIDENCE: As part of the inspection the inspector looked at the care that three particular residents receive in the home spending time with them during the inspection. To help make a judgement on the care these people receive the inspector examined the person centred care plans and the associated documents such as risk assessments and activity plans for these individuals, also evidenced were the external reviews from the community learning disability team to ascertain Lucerne House DS0000069865.V378034.R01.S.doc Version 5.3 Page 15 if the needs identified in the assessment are used as a basis for a comprehensive care plan. Other documents examined were copies of notifications, and accidents and appointments, the record of complaints and the complaints procedure. The inspector spent time with the Registered Manager, care team member and the three residents who were part of the case tracking, other residents were seen in the home. The medication system in the service has been changed and the Registered Manager is half way through the creation of a new policy. The main change is that the new witness procedure in place requires two staff to carry out the medication procedure one to carry out the procedure and one to sign to confirm this has been done correctly. Residents who are entitled to free chiropody care now receive it. The inspector saw good examples of practice in relation to sensitive and appropriate delivery of information to service users with regard to sexual health. The inspector examined a sample of MAR sheets and can confirm there is a sample list of staff signatures to reference with the MAR sheets. Medication records were found to be in good order, and these sheets had a photograph of each resident on them. The Registered Manager has a productive relationship with the CLDT. Lucerne House DS0000069865.V378034.R01.S.doc Version 5.3 Page 16 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People using 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 deals with complaints and issues of safeguarding effectively, the Registered Manager has notified the CQC and social services of all significant incidents in the home. Residents are protected by the homes recruitment procedures. EVIDENCE: As part of the inspection the inspector examined copies of notifications, and accidents and the record of complaints and the complaints procedure. The inspector spent time with the Registered Manager. The Registered Manager has notified the CQC of any significant incidents which have occurred in the home, and has produced evidence to show these had also been forwarded to the relevant member of the CLDT. Evidence was available to confirm that the home deals with safeguarding vulnerable adult alerts quickly and effectively working well with the CLDT to resolve the issue and safeguard the service user effectively. Lucerne House DS0000069865.V378034.R01.S.doc Version 5.3 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 People using 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. Residents live in a bright and clean home with an accessible garden. The Registered Manager has ensured appropriate risk assessments are in place and information from the AQAA confirms the required certification is up to date. EVIDENCE: During the inspection the inspector visited all communal areas of the home, the lounge, conservatory/dining area, and kitchen. The inspector also visited two of the three rooms of the residents case tracked. The home is well maintained, and resident’s bedrooms are personalised. On the day of the inspection there was an issue with a water leak in the upstairs room. This was dealt with quickly and effectively by the Registered Manager and has Lucerne House DS0000069865.V378034.R01.S.doc Version 5.3 Page 18 resulted in one of the residents going home for a weekend break whilst the ceiling repair is undertaken. Lucerne House DS0000069865.V378034.R01.S.doc Version 5.3 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 & 35 People using 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. Staff interact well with residents and have an understanding of their needs through, training, supervision and knowledge passed to them by the Registered Manager. The service is currently in the process of recruiting three seniors to the staff team. Residents benefit from staff that have achieved NVQ level 2, and can met the needs of the residents placed within the home. EVIDENCE: As part of the inspection the inspector examined three recruitment files of staff recruited to the service since the last inspection, these were found in general to be in good order. However out of the three files viewed, one had two references in but these were not dated, out of the remaining two files one had only one reference and the last file had one reference on file and the second was found before the site visit concluded. The service is in the process of starting the skills for care induction booklets for the new staff recruited and Lucerne House DS0000069865.V378034.R01.S.doc Version 5.3 Page 20 these will be issued at the next team meeting. Staff receive training, supervision and attend regular team meetings. Existing staff have already achieved NVQ level 2 in care. The service is in the process of recruiting three seniors and they will be allocated the task of supervisions of care staff. Residents are now on the second interview panel for staff. Members of staff were seen on the day of the inspection interacting positively with residents in an encouraging manner. The Registered Manager must however ensure that two written references are called for and kept on file so they are available to view during an inspection. The inspector has not given a requirement for this at this time; however the Registered Manager must ensure that this practice improves. Lucerne House DS0000069865.V378034.R01.S.doc Version 5.3 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 & 42 People using 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 Registered Manager is effective and ensures the home is run in the best interests of the service users. They have moved the service forward since the last inspection and the home is a well managed place to live which ensures service users are at the centre of the provision. EVIDENCE: As part of the inspection the inspector assessed the care that three particular service users received in the home. The inspector met with these three service users individually and saw other residents in the home spending time briefly with them. The inspector spoke with the Registered Manager who has Lucerne House DS0000069865.V378034.R01.S.doc Version 5.3 Page 22 been appointed since the last inspection and with one care team member. A variety of documents were inspected such as care plans, risk assessments, activity schedules, team meeting and resident meeting minutes, notifications, staff training and recruitment documents and quality assurance documents. The inspector spoke in detail with the Registered Manager about safeguarding alerts received by the CQC and the inspector can conclude that the Registered Manager has dealt effectively with these issues and manages the service well. The Registered Manager has worked hard to address the issue raised at the last inspection they have developed care plans and brought in a person centred approach to the delivery of care, they appear to work well with the registered provider and have instigated staff recruitment, the service is now in the process of recruiting three senior staff to work in the home. Staff receive training and supervision and the home works well with the CLDT. Lucerne House DS0000069865.V378034.R01.S.doc Version 5.3 Page 23 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 3 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 Version 5.3 Page 24 Lucerne House DS0000069865.V378034.R01.S.doc 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. Refer to Standard Good Practice Recommendations Lucerne House DS0000069865.V378034.R01.S.doc Version 5.3 Page 25 Care Quality Commission Care Quality Commission Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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. 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