Inspection on 07/11/06 for 1 Larch Road

This inspection was carried out on 7th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

1 Larch Road 09/03/09

1 Larch Road 16/01/06

1 Larch Road 17/08/05

1 Larch Road 06/01/05

1 Larch Road 21/10/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Larch Road (1) Eckington Sheffield Derbyshire S31 9ED Lead Inspector Judith Beckett Key Unannounced Inspection 7th November 2006 10:30a. Larch Road (1) DS0000020034.V316599.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 Larch Road (1) DS0000020034.V316599.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. Larch Road (1) DS0000020034.V316599.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Larch Road (1) Address Eckington Sheffield Derbyshire S31 9ED (01246) 431158 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) Enable Care & Home Support Limited Mrs Simone Crossley Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (8) of places Larch Road (1) DS0000020034.V316599.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 Larch Road Care Home is registered to provide accommodation and personal care to service users whose primary care needs fall within the following categories:Learning Disabilities (LD) 8 2. Learning Disabilities LD(E) 8 The maximum number of persons to be accommodated at 1 Larch Road Care Home is 8 16th January 2006 Date of last inspection Brief Description of the Service: 1 Larch Road is a purpose-built home for eight service users with learning disabilities. The home consists of two adjoining bungalows no 1 and no 3 with separate entrances. It is situated in Eckington, approximately 6 miles from Chesterfield. The home provides personal care and accommodation for 8 residents. The home is spacious and accessible, providing ground floor accommodation with single bedrooms and a pleasant garden. The home is near to local shops, pubs and public transport. Two mini buses are unavailable for service users. Larch Road (1) DS0000020034.V316599.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection. In September 2006 no 1 and no 3 became one registration. The existing manager of no 1 is now responsible for both bungalows. For ease of identification in this report the units will be referred to as 1 and 3. Prior to the inspection a pre-inspection questionnaire had been received from the manager as well as four resident questionnaires. The inspection took place over two and a half hours. On arrival at the home the manager, one carer and three residents were present but five residents were out attending day centres. A tour of number 1 & 3 took place. The inspection covered all the key standards. Discussions took place with the area manager, manager, residents and staff, records were inspected. One residents care plan was looked at. What the service does well: What has improved since the last inspection? The home had met some of the requirements made at the last inspection. A policy relating to receipt, handling, storage, administration and disposal of medicines is now in place. The recommendation that the terms and conditions for the residents are in an appropriate form had also been rectified. A suitable system of quality assurance monitoring has been introduced. New worktops had been provided for both kitchens. The external door has been varnished in number 3. The external doors are in the process of being alarmed. Larch Road (1) DS0000020034.V316599.R01.S.doc Version 5.2 Page 6 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. Larch Road (1) DS0000020034.V316599.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 Larch Road (1) DS0000020034.V316599.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users were provided with information about the home and its services. EVIDENCE: A new statement of purpose and service user guide had been produced for the new registration; this was well written and easy to read. One resident was eager to show me a copy of this, which she keeps in her room. One resident was case tracked and had a comprehensive needs assessment in their files. Prior to admission residents receive a full needs assessment. Prospective residents are given the opportunity to spend time in the home. Observations of interaction between staff and residents indicated that the home was able to meet the assessed needs of its residents. Each resident had a contract and statement of terms and conditions, detailing the fees covered. These related to Derbyshire Care and Home Support Ltd.and now requires changing since the change of company name. Larch Road (1) DS0000020034.V316599.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): 6,7,8,9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported to enable them to achieve an independent lifestyle as possible. EVIDENCE: The individual written care plan of one resident was examined and their care was discussed with the manager. Care plans were formulated within a framework of risk management and in accordance with their assessed needs. They were up to date and regularly reviewed with residents. A key worker system is in place. The manager informed me that the care plans in no.3 are in the process of being updated to come in line with those in no. 1. All the residents have lived at Larch Road for some time. It is evident that staff know them well. Residents were supported to access local learning disability services. All attend day centres according to their needs and Larch Road (1) DS0000020034.V316599.R01.S.doc Version 5.2 Page 10 abilities. All are treated as individuals and have different hobbies and pastimes. None of the residents in no 3 attend evening classes. The home manager is to look into the possibilities of this with the individual residents. Residents are encouraged to use any independent living skills they have and are encouraged to make independent choices according to both ability and need. Some are able to carry out small tasks in the home including laying the table, cleaning, shopping, washing up and helping to prepare meals. One resident laid the table and helped serve lunch during the inspection. Residents are encouraged to do their own ironing with staff supervision where appropriate. Larch Road (1) DS0000020034.V316599.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): 12,13,14,15,16,17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ individual rights, independence, wishes and lifestyle preferences were well promoted in accordance with their risk-assessed needs EVIDENCE: All of the residents had been on holiday recently. Two had been to Spain with two carers. The remaining residents had been to the seaside in England. Individual choice is taken into account when booking holidays. Residents are able to enjoy a full and stimulating lifestyle with a variety of options to choose from. The home seeks views of the residents and considers their varied interests when planning holidays and routines of daily living. Residents are taken shopping with their key workers to choose personal items and furnishings to their bedrooms. Residents participate in domestic tasks according to their assessed abilities. This is recorded in their care plan. All eight residents have access to day centre services during the week. These are reviewed regularly. They attend activities outside the home as they wish, accompanied by staff from the home. Larch Road is integrated into the local Larch Road (1) DS0000020034.V316599.R01.S.doc Version 5.2 Page 12 community and staff were fully aware of the facilities local to the home. Residents are enabled to access local facilities. The home focuses on involving residents in all areas of their life and actively promotes the rights of individuals to make informed choices this includes maintaining family and personal relationships. One resident returns to his family home for alternate weekends. Choices are available for meals. Residents in no 1 were actively encouraged to engage in meal planning, shopping and preparation in accordance with their abilities and wishes and food provided was a nutritious and balanced diet. The home manager to is to look into the possibility of involving residents in no 3 when planning menus and shopping. Larch Road (1) DS0000020034.V316599.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service There were suitable systems and arrangements in place to ensure that residents are well supported in terms of their personal and health care needs EVIDENCE: The personal support needs of the resident case tracked were documented by way of their individual assessments and care plans including their preferences. Records were kept in respect of residents’ health care needs and interventions. Individual records were kept of service users access to outside health-care professionals. Medication in the home was securely stored and there were well kept records of the receipt, administration and disposal of medicines. The manager indicated that all staff had undergone appropriate training in the safe handling of medication. Annual medication assessments are completed by all staff that administers medication. A policy / procedure was now available which was Larch Road (1) DS0000020034.V316599.R01.S.doc Version 5.2 Page 14 specifically about the safe handling and administration of medication at the home. Larch Road (1) DS0000020034.V316599.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is suitable information provided for residents and their representatives to enable them to raise concerns and to complain. Residents were protected by staff awareness of adult protection issues. EVIDENCE: The home has a clear complaints procedure. There is a copy for each service user in their service user guide and this is displayed in the hallway. A record of all complaints or issues in the home are recorded. No complaints had been received about the home since the last inspection. The manager stated she is always available to discuss concerns with relatives, residents, health care professionals and staff. Staff have a good knowledge and understanding of Adult protection issues, which protects service users from abuse. Larch Road (1) DS0000020034.V316599.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): 24,25,26,27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment within the home is good providing service users with an attractive and homely place to live. EVIDENCE: A tour around both bungalows took place. The homes were clean, well ventilated and well lit. Both bungalows have a fitted kitchen with a range of up-to-date appliances. Each bungalow has its own spacious dining area and lounge. Both lounges have a television and music centre Resident’s rooms were personalised and well decorated. The residents had all chosen their own colour schemes and bedding, all have an armchair and a set of drawers as well as a TV. Each bungalow has a large bathroom, one has a hoist and the other a rise and fall chair, both are well equipped with handrails, one also has a walk-in shower and the other a separate shower room. Larch Road (1) DS0000020034.V316599.R01.S.doc Version 5.2 Page 17 Residents see it as their own home; it is very well maintained and attractive, clean and free from any odours. Residents are fully involved in decisions about the decor or any changes in accommodation. Fixtures and fittings are of a high quality, well maintained and adapted to meet the wishes of the residents. Residents personalise their own rooms and bring in their own furniture if they wish. Larch Road (1) DS0000020034.V316599.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are well supported by a stable staff team and the manager constantly seeks to facilitate staff development in accordance with the needs of the service user group accommodated. EVIDENCE: A total of nineteen staff work in the bungalows. Each bungalow is staffed independently. Discussions were held with the manager about the arrangements for staffing in the home. Three members of staff have transferred since the last inspection and three new members have been appointed from other homes within the group. Two members of staff have achieved NVQ 2 and one member (the manager) NVQ 4. Three members are reaching retirement age and therefore reluctant to undertake any further training. This leaves the home with below the 50 level of staff that will have achieved NVQ 2.Efforts should be made to correct this. All staff records do not have photographs but indicate that completed Criminal Records Bureau disclosures have been carried out. Larch Road (1) DS0000020034.V316599.R01.S.doc Version 5.2 Page 19 Monthly visits by the home managers line manager are recorded. Discussions were also held with the manager and staff about training and development of staff, including training undertaken in the previous 12 months and that planned. New training records had been issued from headquarters to monitor all training received. All had completed their moving and handling training, fire training, first aid and safe handling of medicines and had undertaken a drug assessment. One still required to attend Food Hygiene training. Larch Road (1) DS0000020034.V316599.R01.S.doc Version 5.2 Page 20 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. Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service The home is well managed and service users rights and interests are promoted within the framework of effective communication and management systems. EVIDENCE: The manager has completed her N.V.Q 4.in management. Quality of service questionnaires had been completed recently. Discussions around this issue took place with the manager. Reports of regular visits to the home by the registered provider were made. There were satisfactory arrangements for the annual maintenance of equipment in the home. There were suitable systems in place for the reporting and recording of accidents and untoward occurrences. Larch Road (1) DS0000020034.V316599.R01.S.doc Version 5.2 Page 21 A range of policies and procedures were in place and developed by the organisation. The manager has recently taken over the day-to-day running of no 3. She is aware of the work that needs to be done to bring this in line with no 1. This is likely to take some time to create one staff team. The providers should ensure the manager has sufficient time to fulfill managerial duties and responsibilities in order for this to happen. Larch Road (1) DS0000020034.V316599.R01.S.doc Version 5.2 Page 22 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 3 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 4 25 4 26 3 27 3 28 3 29 3 30 4 STAFFING Standard No Score 31 X 32 2 33 X 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 2 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 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 Larch Road (1) DS0000020034.V316599.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15(1) Requirement All residents must have a completed plan of care that identifies how the resident’s needs in respect of their health and welfare are met. Original timescale 01/02/05. Staff records must include all the items in Schedule 2. Original timescale 31/03/06. Timescale for action 31/12/06 2. YA34 Schedule 2. 31/12/06 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. 3. Refer to Standard YA8 YA32 YA33 Good Practice Recommendations Residents in no 3 are consulted on menus and evening activities. At least 50 of care staff should be working towards NVQ Level 2 in care by the end of 2005 The providers should ensure that the manager has sufficient supernumerary time to fulfil managerial duties and responsibilities. Larch Road (1) DS0000020034.V316599.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Larch Road (1) DS0000020034.V316599.R01.S.doc Version 5.2 Page 25 - 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!