Inspection on 25/06/08 for Lynwood

This is the latest available inspection report for this service, carried out on 25th June 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lynwood 02/07/07

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)

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 Lynwood 14 Beccles Drive Barking Essex IG11 9HX Lead Inspector Harbinder Ghir Unannounced Inspection 25th June 2008 10:00 Lynwood DS0000068972.V365789.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 Lynwood DS0000068972.V365789.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. Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lynwood Address 14 Beccles Drive Barking Essex IG11 9HX 020 8594 6786 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) Dharshivi Ltd Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home only - Code 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 - Code LD The maximum number of service users who can be accommodated is 7 Date of last inspection 21st November 2007 Brief Description of the Service: Lynwood Care Home is a semi-detached property situated in a residential area of Barking. The home provides care to seven adults with learning disabilities. The home is situated close to local shops and facilities. The property has seven bedrooms, a communal lounge, kitchen, conservatory, visitors’ room, office, laundry room, bathroom and two showers. A service users guide is available for prospective residents and the current fees range from £800.00 to £1300.00 per week. Additional charges are made for personal items such as toiletries, newspapers, hairdressing, holidays and some activities. Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use the service experience good quality outcomes. This was an unannounced inspection undertaken by Regulation Inspector Harbinder Ghir on the 25th June 2008. The first day of the inspection was unannounced and started at 10.00 am. It took place over 6 hours The registered proprietor of the home was available throughout the day of the inspection and feedback was provided to her at the end of the inspection. During the inspection the inspector was able to talk to five of the residents who were at home during the inspection. Staff on duty during the day were also spoken to and were also observed carrying out their duties. A second day was spent contacting relatives and professionals by telephone for further feedback; their feedback has been included in the report. The London Borough of Barking and Dagenham who is the host authority for the service was contacted, inviting their comments on the service they are commissioning. They did not provide any feedback to be included at this inspection. The Commission for Social Care Inspection received a completed Annual Quality Assurance Assessment prior to the inspection. The inspector would like to thank everyone involved in the inspection process. What the service does well: What has improved since the last inspection? Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 Page 6 At the last inspection 10 requirements were made in relation to updating the statement of purpose; the recording of complaints; health and safety; safeguarding adults guidance to be updated,; quality assurance system; staff rota and the service to employ a manager. All of these requirements have been complied with at this inspection, which demonstrates the service’s commitment to improving their service delivery. What they could do better: 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. Lynwood DS0000068972.V365789.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 Lynwood DS0000068972.V365789.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): 1, 2, 3, 4, 5 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The statement of purpose provides prospective individuals with the information they need to make an informed choice about where to live. However, the complaints procedure within the document needs to be reviewed to ensure it complies with the Care Homes Regulations. The service completes comprehensive pre-admission assessments, to ensure they can fully meet the needs of prospective residents. Trial visits are offered to all prospective residents, to ensure residents have information on the services and facilities provided at the home. Each resident has an individual written contract of the statement of terms, to ensure they agree to the services provided at the home. EVIDENCE: The home provides a statement of purpose that is specific to the individual home and the resident group they care for. It clearly sets out the objectives and philosophy of the services supported by a service user’s guide. The Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 Page 9 statement of purpose has been reviewed since the last inspection complying with the requirement made at the inspection. It now has included information on the staffing structure at the home and is supported by a service user guide, which is in picture format. However, the complaints procedure within the document does not refer to the Commission for Social Care Inspection as contactable at any time or stage of a complaint being made. It is Recommendation 1 that this is reviewed and amended. The service user guide is very easy to read and understand and is very suitable to the communication needs of people living at the home. It was not possible to examine up to date pre-admission assessments, as the service does not have any recently admitted residents. However, the service has a comprehensive pre-admission policy and procedure in place and admissions would not be made to the home until a full needs assessment has been undertaken. The policies and procedures highlighted that admissions to the home would only take place if the service is confident that staff have the skills, ability and qualifications to meet the assessed needs of prospective residents. New prospective residents would be able to visit the home as many times as they like and have an opportunity to stay overnight. Relatives and family would also be invited to visit the home. All residents were provided with a statement of terms and conditions. This set out simply and clearly and in detail about what is included in the fee, the role and responsibility of the provider, and the rights and obligations of the individual. Contracts were signed by those living at the home or their representatives. Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There is a comprehensive care planning system in place, which provides staff with the information needed, to meet the needs of residents. The right for residents to exercise choice and control is promoted by the service and they are actively consulted on, and participate in, all aspects of life in the home. Risk assessments are undertaken routinely, to ensure residents are supported to take risks as part of an independent lifestyle, and are always updated according to residents’ changing needs. Service users’ financial interests are safeguarded, and systems are in place that ensures that the records of residents’ outgoings and incomings of money are recorded correctly. Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 Page 11 EVIDENCE: Four care plans were closely examined. Care plans seen evidenced that the service involves individuals in the planning of care that affects their lifestyle and quality of life. Care plans were comprehensive; person centred and clearly set out residents’ health, personal and social care needs. Information was found specific to the religious, cultural and social care needs of residents and how the service was to meet these needs. The information provided in care plans was very detailed and individualised, and clearly recorded and described how residents wanted their needs met. For example one resident’s care plan informed how they would like their personal care attended to. The care plan stated, “I like to have a shower and hair washed before going to bed, staff need to give me full support in this. I tend to have this early in the evening after having my evening meal.” Another care plan informed, “When I go to the barbers I do not like to have my hair washed, or the clippers used on me as I do not like the sound of electrical appliances.” The documents also included information in picture formats and included information on residents’ likes, dislikes, how they communicate and what they are able to do independently and tasks they require assistance with. A key worker system also allows staff to work on a one-to-one basis and contribute to the care plan for the individual. A relative of resident spoken to commented very positively about the staff at the home and their loved one’s key worker. They said, “The staff at the home are very friendly. D’s key worker is lovely. I can’t fault the home.” Care plans were working documents and are reviewed on a six monthly basis or as and when required. Evidence was seen of reviews taking place with care managers also involving the resident and their representatives. Reviews focused on asking what has worked for the individual, where progress is being made, achievements, and concerns and identified action points. Relatives spoken to also informed that they are always invited to attend review meetings at the home and spoke very positively about the care provided at Lynwood. “I think the home is really, really, good. They take X out a lot and do a lot with her, they’ve also managed to get X a job. We think they care for all the residents really well. When we have visited all of them looked well cared for and we have been really pleased with what we have seen. We are very happy with the home and are happy that she is there,” informed a relative of a resident. Each care plan included very comprehensive and detailed risk assessments, which are reviewed regularly. The management of risk is positive in addressing safety issues while aiming for outcomes for people. Where there are limitations, the decisions have been made with the agreement of the person or their representatives and are accurately recorded. For example one resident was afraid of attending healthcare appointments which was highlighted in the Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 Page 12 individuals care plan and also recorded that the individual must be encouraged positively by care staff to attend these appointments but must not be forced if they continuously refuse and for the appointments to be rearranged. This was also evident during the inspection as residents were going for routine healthcare checks. Staff were observed talking and explaining to residents why they were going and were supported positively. Daily case recording notes were examined which are linked to the care plan and focus on the specific needs of residents rather than recording information in a general manner. Each resident has a personalised case recording book, which provided specific information about each resident which is used to monitor their care needs or their behaviour on a on-going basis. Residents were involved in the daily running of the home as far as their abilities allowed and provided a very homely atmosphere. On arriving at the home at 10.00 am some residents were seen to be getting up and getting ready for the day, whilst other residents decided to get up a short while later at their own preference, which were respected by staff. Residents were seen participating in cleaning after themselves, making cups of tea and laying the table. Residents’ rights to make choices were actively promoted; by them being supported to choose what to wear, to eat and being consulted about which activities they wanted to participate in. The financial records of residents were viewed and the inspector tracked the amount of money the service held for three individuals. All amounts were accounted correctly and were in order. There were clear systems to record outgoings and incomings of money, which were audited regularly by the registered proprietor. Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 Page 13 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): 11, 12, 13, 14, 15, 16, 17 People using the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are provided with support to maintain their independence and in areas of personal development according to their needs and wishes. Residents are engaged in community life, promoting their opportunities to be part of the local community. Residents are offered meals that promote their choices and respect their individual preferences. Residents are supported to maintain family links and relationships inside and outside the home. EVIDENCE: Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 Page 14 Central to the home’s aims and objectives is the promotion of the individual’s right to live an ordinary and meaningful life, appropriate to their peer group, in both the home and the community, and to enjoy all the rights and responsibilities of citizenship. The home understands the importance of enabling younger adults to achieve their goals, follow their interests and be integrated into community life and leisure activities in a way that is directed by the person using the service. One resident was away on holiday at Bognor Regis, supported by a member of staff. The service has supported two residents to gain part time employment at local charity shops. One resident spoken to said “I love going to work, I cut labels and really enjoy it.” The resident was very excited when speaking about their employment and it was very evident that they were enjoying their experiences of working. During the inspection residents were seen going out throughout the day with the support of staff to the local supermarket and to eat out as it was a hot sunny day. Residents choose the activities they want to participate in. Two residents attend Karate clubs twice a week; another resident has a fitness instructor coming to them at home, which is their choice. Residents also attend local colleges, go swimming, attend day centres and evening clubs where they socialise with other individuals of from their age group. Some residents have partners, which they are supported to see on a regular basis. One resident showed the inspector pictures of her boyfriend in her room and spoke of how she visits him and sees him during the evenings. Outcomes for people living at the home were very positive, and there was evidence that they are enjoying the life opportunities that they experience. The home provides meals, which are varied and nutritious and meet the dietary needs of residents. There was plenty of fresh fruit and vegetables at the home. Residents choose their own meals and inform staff every evening what they would like to eat the next day. Residents can also refuse their choice of meal on the menu on the day and staff prepared alternative meals specified by the resident. Residents’ choices of meals for the day was displayed in the dining room and all residents had chosen something different to eat, reflecting choice and variety in the meals provided at the home. Residents were also seen going out to do the food shopping with the support of staff. Evidence was also seen of residents going out to local restaurants and being provided with take away meals of their choice. This information was also included in each resident’s individual care plan. One resident liked to go to German restaurants while another resident stated they liked Chinese cuisine, which was provided by the home and by the residents being supported to attend restaurants of their choice. People who use the service have the opportunity to develop and maintain important personal and family relationships. Residents are supported to contact family by telephone and visit them. Evidence was seen of the home looking into buying a mobile telephone for a resident so they could contact their family as they wished. Relatives spoken to spoke very highly of the home. A relative informed, “We’ve always thought the home was a very nice Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 Page 15 place, we have been very impressed, it is the best we have seen. Y has got their own room, and they are very happy there. Y is a quiet person and the home allows Y to have their own privacy, which they really respect. We have had no concerns about the home.” Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 Page 16 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, 21 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents receive personal support and care in the way they prefer and require. Medication practices ensure the safety of residents. The ageing, illness and death of service users are handled with respect and as the individual would wish. EVIDENCE: Residents at the home receive personal care and healthcare support using a person centred approach with support provided based upon the rights of dignity, equality, fairness, autonomy and respect. Each resident has a devised health plan which identifies the healthcare needs of residents including specialist health, nursing and dietary requirements, which are clearly recorded Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 Page 17 and act as an indicator of change in health requirements. The plan also identified residents’ daily routines including the type of support they need in relation to personal hygiene and according to their level of care needs. All residents have a designated key worker to promote their privacy and dignity, and all personal care is provided in private. Attention is paid to personal preferences in relation to the provision of personal care, for example whether one prefers a shower or a bath. Personal support takes account of individual preferences and residents’ choice of dress and appearance is respected. Residents were well dressed and groomed. Residents are supported by staff to attend appointments with healthcare professionals and their health is closely monitored and prompt referrals are made. There was evidence of staff taking female residents to well women checks and the involvement of multli-disciplinary healthcare professionals where required were made to dentists, chiropodists, GP’s and community psychiatric nurses. As part of the inspection the Learning Disabilities Nurse was spoken to. She informed, “Staff follow our instructions according to guidelines and they have sustained the challenging behaviour of one resident, whose behaviour has stabilised within the home. The home is ok and there are no concerns from my part.” Steps have been taken to find out the wishes of residents in the event of their death, including contacting relatives or representatives where the resident is unable to express their views. There are policies and procedures for staff to follow in the event of a death; to ensure the death of a resident is handled with respect and as the individual would wish. Medication administration records (MAR) were closely examined. Medication records were fully completed, contained required entries, and were signed by two members of staff. The medication file contained photographs of each individual and a medication pen picture. There were also records of signatures by family receiving medication and staff accepting medication when residents were away for overnight stays with family, complying with the requirement made at the last inspection. However, the service must produce a written policy on any medication leaving the home that includes the procedures to be followed and the precautions to be taken, in compliance with Care Homes Regulations 2001 and The Administration & Control of Medicine Guidance. This will be stated as Requirement 1. Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 Page 18 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 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured their views are listened to and acted on. The service records all complaints and concerns to ensure any dissatisfactions with the service regardless of source are actioned. All staff have received up to date training in Safeguarding Adults, which ensures the protection of residents. EVIDENCE: People who use the service are supplied with a complaints procedure, which is in picture format and is clear, concise and easy to follow and was displayed around the home. As discussed under standard 1 the procedure needs to ensure that it states that the Commission for Social Care Inspection can be contacted at any time or stage of complaint being made. A complaints logbook is kept by the home, which was viewed. One recent formal written complaint was logged. This was reported as a safeguarding alert to the relevant authorities and to the Commission for Social Care Inspection through a Regulation 37 notification and was investigated by the service satisfactorily, who clearly recorded details of the investigation and any actions taken. The host authority following a strategy meeting has now closed the safeguarding investigation. Evidence was also seen of verbal complaints and concerns recorded by the service and what actions they took to resolve the concerns. Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 Page 19 All staff had attended Safeguarding Adults training which is also covered in the induction programme. The service has Safeguarding Adults procedures and protocols in place and include guidance on how to report incidents of abuse if the manager in post was a suspect. The service has obtained Safeguarding Adult procedures devised by The London Borough of Barking and Dagenham, which is the host authority for the service and the London Borough of Newham who fund the placements of all seven residents residing at the home. At the last inspection it was recommended that staff have guidance on how to record incidents of abuse, using body charts, preserving evidence and provide residents with a picture guide to identify the types of abuse. The London Borough of Barking and Dagenham have also recommended that the home used body charts when recording incidents at the home where physical injuries have been obtained, following the last strategy meeting held regarding the above incident. This has not yet been done by the home and therefore the recommendation will be repeated at this inspection as Recommendation 2. Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 Page 20 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, 25, 26, 27, 28, 29, 30 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable and homely living environment, enhancing residents’ comfort. But further maintenance would improve the environment of the home for people who live there. EVIDENCE: The home provides a physical environment that is appropriate to the specific needs of the people who live there. The environment provides specialist aids and equipment to meet their needs. The home is a very pleasant and a safe place to live and the bedrooms and communal rooms meets the National Minimum Standards or are larger. All seven bedrooms have en-suite facilities. Each resident had personalised and decorated their room according to their own individual preferences with soft furnishings, pictures, posters, photographs and personal memorabilia. Three residents informed that they liked their rooms and had personalised it themselves. A relative spoken to also informed that “D has a lovely room” and that she wouldn’t mind staying there herself. Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 Page 21 The home provided a very homely atmosphere and residents were seen sitting together, watching television or relaxing in their rooms. Furnishings were of a good standard and the house was airy and free from offensive odours. During a tour of the building it was identified that some residents bedrooms and bathrooms were not clean. The carpet in one resident’s bedroom needed hoovering and two residents bathrooms required a deep clean as mould mildew was very prevalent. The home has a good-sized rear garden, which provided adequate garden furniture. However the rear garden and lawns at the front of the property were over grown and needed attention. The property also looked a bit tired and in need of re-decoration to ensure its maintenance. All parts of the home to which residents have access to must be must be kept clean and maintained, to ensure residents live in a safe and comfortable environment. This will be stated as Requirement 2. Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 Page 22 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, 33, 34, 35, 36 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Recruitment practices are robust and ensure residents are in safe hands at all times. Adequate staff training is provided to all care staff, to ensure they are equipped with the skills and are competent to do their jobs. The service has a good skill mix of staff, ensuring adequate numbers of staff are on duty to meet the needs of residents. People who use the service do not benefit from a formally supervised staff team. EVIDENCE: Three staff files were closely examined, which were for newly recruited members of staff, which were all in good order. References and Criminals Records Bureau checks had been obtained for all three members of staff. Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 Page 23 The service has made a commitment to staff training that is focused on delivering improved outcome for people who use the service. Staff have received training in safeguarding adults, communication and interpersonal skills, challenging behaviour, administration of medication, person centred care, moving and handling, food hygiene, health and safety and risk assessments. Staff qualifications evidenced that the service has a ratio of 50 of NVQ qualified staff. Staff spoken to during the inspection spoke very positively about the support they have received from the registered proprietor since the last inspection. One member of staff commented that “Selvi (registered proprietor) has been brilliant, I really enjoy working here, and things have been really good.” Another member of staff said “Yes, things have been good, it’s been good working at the home, we are really supported.” The staff rota included all the members of staff on duty and was an accurate reflection of the members of staff on duty, ensuring the protection of residents, complying with the requirement made at the last inspection. The staff rota evidenced that there are enough staff available to meet the needs of people using the service, with more staff being available at peak times of activity. The staffing structure is based around delivering outcomes for residents and is not led by staff requirements. There are now four members of staff on duty from 8 am to 3 pm, three to four members of staff on from 3 pm to 10 pm and one waking and one sleep in on duty at night. The latest supervision records were viewed for all staff. A supervision programme is in place but staff files evidenced that staff members are not supervised formally on a regular basis (at least six times a year). It is Requirement 3 that staff are supervised regularly, to ensure staff are provided with the skills, training and knowledge to perform the tasks required by their employment role. Relatives spoken to spoke very positively about the staff team. “When we have visited the home, the staff are very supportive and now they have even got X a job. We are really happy that she is there,” said a relative. “We’ve got to know a few regular carers, they have always been very nice. We have no concerns and have no problems with the home,” informed another relative. “I have got to know a few regular carers. They are really nice and caring and I can have a laugh with them” said another relative. Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 Page 24 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, 42 People using the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. A new manager has been recruited to ensure people who use the service benefit from a well run home. The systems for service user consultation are in place, which also include views from stakeholders, ensuring the home is run in the best interests of residents. The welfare of staff and residents is promoted by the home’s policies and procedures. EVIDENCE: Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 Page 25 A manager was recruited in March 2008 but unfortunately recently left the home. A new manager has been recruited whose recruitment file was viewed which was in good working order. The new manager is to commence employment with the service within the next few weeks. Since the departure of the last manager the registered proprietor and a senior member of staff have been over looking the running of the home. Staff spoken to informed that this has not had any serious impact on the running of the home and that things have greatly improved since the last inspection. The evidence from this inspection also reflects that the service has improved its service delivery and has complied with all the requirements made at the last inspection. New quality assurance systems have been developed and surveys for people who use the service, relatives, care managers and other professionals were seen which are in the process of being given out to complete. Surveys included open-ended questions on all aspects of the care provided at the home. Residents also have their own meetings on a regular basis to discuss the any issues they have regarding the running of the home. The home works to clear health and safety policy. Health and Safety records were inspected. All documentation was in order and appropriately completed. Certificates viewed included certificates verifying up to date portable appliance testing, electrical installation, gas safety, employers liability insurance and a recent fire risk assessment, where all fire extinguishers in the building had been replaced. Fire drills were also completed regularly. A completed Annual Quality Assurance Assessment was received before the inspection and was supported by a wide range of evidence. It informed of the changes the service has made and where they still need to make improvements. Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 Page 26 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 2 2 3 3 3 4 3 5 3 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 2 25 3 26 3 27 3 28 3 29 3 30 2 STAFFING Standard No Score 31 x 32 3 33 3 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x LIFESTYLES Standard No Score 11 3 12 4 13 4 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 x 3 x x 3 x Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 Page 27 N0 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 YA20 Regulation 13(2) Requirement Timescale for action 30/09/08 2 YA30 YA24 13 (4) (a) 3 YA36 18 (2) (a) The Registered Persons must ensure that the service produces a written policy on any medication leaving the home that includes the procedures to be followed and the precautions to be taken, in compliance with Care Homes Regulations 2001 and The Administration & Control of Medicine Guidance. The Registered Persons must 30/09/08 ensure that all parts of the home to which residents have access to must be must be kept clean and maintained to ensure residents live in a safe and comfortable environment. The Registered Persons must 31/10/08 ensure that staff are supervised regularly, to ensure staff are provided with the skills, training and knowledge to perform the tasks required by their employment role. Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 Page 28 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 Refer to Standard YA1 Good Practice Recommendations It is recommended that the complaints procedure within the Statement of Purpose refer to the Commission for Social Care Inspection as contactable at any time or stage of a complaint being made. It is recommended that that there is additional guidance for staff on how to record incidents of abuse, using body charts, preserving evidence, and provide residents with a picture guide to identify the types of abuse. Repeated Recommendation. 2 YA23 Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 Page 29 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 Lynwood DS0000068972.V365789.R01.S.doc Version 5.2 Page 30 - 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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