CARE HOME ADULTS 18-65
Lawrence Road (1) 1 Lawrence Road Basildon Essex SS13 2NB Lead Inspector
Nicola Dowling Unannounced Inspection 11th January 2006 10:00 Lawrence Road (1) DS0000018055.V276649.R01.S.doc Version 5.1 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 Lawrence Road (1) DS0000018055.V276649.R01.S.doc Version 5.1 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. Lawrence Road (1) DS0000018055.V276649.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Lawrence Road (1) Address 1 Lawrence Road Basildon Essex SS13 2NB 01268 590678 01268 590678 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) Estuary Housing Association Limited Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Lawrence Road (1) DS0000018055.V276649.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 1st August 2005 Brief Description of the Service: Lawrence Road provides twenty-four hour care for two adults with a learning disability. The home is a purpose built bungalow situated in a semi-rural area between Southend and Pitsea. Transport links to the area are not very good. The home consists of a large lounge, small dining room, two bedrooms, one toilet/bathroom for residents, staff and visitors and a kitchen and office. The home has a large garden/patio area to the rear of the property. There is limited parking to the front of the property. Lawrence Road (1) DS0000018055.V276649.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over a four hour period on one day. The inspection consisted of a brief tour of the home, reading documents, talking with staff and observing the care given to the two residents’. The staff on duty were spoken to and there were no visitors to the home that could give their views of the service. Currently the home does not have a registered manager and a member of staff is undertaking this role until a new manager is recruited. What the service does well: What has improved since the last inspection? What they could do better:
Some information around the home is out of date. There is a high use of agency workers in this home. The agency workers are regular and familiar with the residents. However there has not been a good balance of skills between the agency workers’ and Estuary Housing Association employees. This has meant that a resident has not had all her needs met in terms of attending her activities. Lawrence Road (1) DS0000018055.V276649.R01.S.doc Version 5.1 Page 6 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. Lawrence Road (1) DS0000018055.V276649.R01.S.doc Version 5.1 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 Lawrence Road (1) DS0000018055.V276649.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 5 Residents have their own contract that is in picture format EVIDENCE: Residents have a contract on their care file. This contract has been read to them and the document signed or marked by them. Both residents have communication difficulties despite this the home have made efforts to discuss the contract with them. Lawrence Road (1) DS0000018055.V276649.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 Staff support residents with decision making. EVIDENCE: Residents can take small decisions for themselves such as, how they spend their time in the home or what to wear. However, mostly decisions are taken for them. For example, the residents are unaware of the value of money. Therefore the staff follow Estuary Housing Association policy on safe guarding and managing the residents money. There are a number of checks and balances that are carried out to ensure this is undertaken properly. Lawrence Road (1) DS0000018055.V276649.R01.S.doc Version 5.1 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 17 The residents have a relaxed lifestyle with good food EVIDENCE: There are some restrictions in place around the house and this is for the resident’s safety. For example there are baffle handles on the kitchen door. Residents can only go into the kitchen with a staff member but not on their own, this is because there are too many dangers that the resident would be unaware of. The residents can get up and go to bed and spend the time of day how they choose. One resident likes to spend time listening to music in her room and chooses to spend that time on her own. Staff eat with the residents and meals are eaten at the table in the dining room. Boundaries are set for good and bad behaviour at the table so that meal times can be enjoyed. Lawrence Road (1) DS0000018055.V276649.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 20 Personal support is offered in private by staff of the same gender. Medication policy and administration are generally good EVIDENCE: Residents’ personal care was carried out in the bathroom and their own room on the day of inspection. Residents were properly dressed and clean in appearance. No moving and handling equipment is used in the home and staff coped well with residents on a one–one basis. Medication administration records were checked. No omissions were found in the medication charts and there were protocols in place for staff to follow. One out of date non-prescription medication was found in the medication cupboard otherwise all medication was accounted for. Lawrence Road (1) DS0000018055.V276649.R01.S.doc Version 5.1 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were inspected at the last inspection and were not inspected at this inspection. The Commission has received no complaints and there have not been any adult protection incidents reported. Lawrence Road (1) DS0000018055.V276649.R01.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Standards 24 and 30 were inspected at the last inspection and were not inspected at this inspection. Lawrence Road (1) DS0000018055.V276649.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 33 The skill mix of staff does not regularly meet the residents’ needs for activities. EVIDENCE: On the day of inspection there were two agency workers on shift. Both these agency workers demonstrated caring attitudes to the residents. However they were unable to meet one of the resident’s weekly activities as neither of them could drive the residents vehicle to take her to it. After checking back it was found that this has happened on four occasions since December. The home has a high number of agency workers that cover the duty rota. For example over a one week period there are two staff every day on the early shift which makes a total of 14 early shifts a week. Over this one-week period agency workers covered 9 of the 14 early shifts. From the duty rota one Estuary Housing Association employee covers one shift a day, leaving the rest of the day covered by agency workers. Lawrence Road (1) DS0000018055.V276649.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 42 The home is run with the safety of the residents in mind despite no manager in post. EVIDENCE: The home have recently lost an acting manager and a member of staff is acting up in the manager’s role until a replacement is found. Information about the home still has the previous acting managers picture and name on it. This information is now out of date. A selection of safety certificates was inspected. This included fire, gas and electric. All these were up to date and showed the equipment was safe for use. Lawrence Road (1) DS0000018055.V276649.R01.S.doc Version 5.1 Page 16 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 x 3 x 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 x ENVIRONMENT Standard No Score 24 x 25 x 26 x 27 x 28 x 29 x 30 x STAFFING Standard No Score 31 x 32 3 33 2 34 x 35 x 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score x 3 x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 x 3 x 2 x x x x 3 x Lawrence Road (1) DS0000018055.V276649.R01.S.doc Version 5.1 Page 17 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. 1 Standard YA33 Regulation 18(1)(b) Requirement The Registered Person must ensure that staff in the home have the skills to meet the residents needs The Registered Person must recruit a manager for the home Timescale for action 20/03/06 2 YA37 9 20/03/06 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 Refer to Standard YA20 Good Practice Recommendations The home should remove out of date stock from the medicine cupboard. Lawrence Road (1) DS0000018055.V276649.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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