Inspection on 20/06/06 for 13 Longmeadow Road

This inspection was carried out on 20th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

13 Longmeadow Road 08/11/07

13 Longmeadow Road 17/01/06

13 Longmeadow Road 20/07/05

13 Longmeadow Road 19/01/05

13 Longmeadow Road 24/06/04

13 Longmeadow Road 04/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Longmeadow Road (13) 13 Longmeadow Road Saltash Cornwall PL12 6DW Lead Inspector Alan Pitts Key unannounced Inspection 20th June 2006 10:00 Longmeadow Road (13) DS0000008977.V297904.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 Longmeadow Road (13) DS0000008977.V297904.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. Longmeadow Road (13) DS0000008977.V297904.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Longmeadow Road (13) Address 13 Longmeadow Road Saltash Cornwall PL12 6DW 01752 841680 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) Michael Batt Foundation (Valued Life Projects) Mr Brian Colin Roy Stokes Care Home 1 Category(ies) of Learning disability (1) registration, with number of places Longmeadow Road (13) DS0000008977.V297904.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 1 adult with a learning disability (LD) Total number of service users not to exceed a maximum of 1 Date of last inspection 17th January 2006 Brief Description of the Service: 13 Longmeadow Road is part of the Michael Batt Foundation, which aims to provide care and accommodation for people within the spectrum of learning disability. Its emphasis is to empower the service user to enable him to take responsibility for his decisions and actions within a guided framework. Staffing levels are on a one:one level. The home, which is rented on behalf of the service user, was set up to meet agreed stipulations. It is near the centre of Saltash and within easy each of Plymouth by private or public transport. The emphasis is on the service user directing the staff but where choices are obviously unwise or unsafe, these would be discussed. Guidelines regarding restrictions are in place, these have been discussed with the service user and relavant professionals in advance. The foundation provides a full support network for the staff and service user. Longmeadow Road (13) DS0000008977.V297904.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was organised to review the standards of care provided at the home. The inspection took place on 20th June 2006 over a period of approximately 2.5 hours. During the inspection the inspector met the member of staff on duty. The service user chose to decline the opportunity to meet with the inspector. The inspector was assisted in reviewing records kept, a tour of the premises and in discussing daily routines and procedures occurring at the home. The body of this report contains less information than might normally be expected in a report in order to protect the anonymity of the service user. What the service does well: What has improved since the last inspection? What they could do better: Longmeadow Road (13) DS0000008977.V297904.R01.S.doc Version 5.2 Page 6 The registered provider must do more to demonstrate compliance with requirements identified in this, and previous reports. The registered provider must make records required by regulation available for inspection on the premises. The registered provider must write to the Commission for Social Care Inspection detailing how they will meet these requirements. 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. Longmeadow Road (13) DS0000008977.V297904.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 Longmeadow Road (13) DS0000008977.V297904.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 5, The service user has lived at the home for some time, and the service is geared to the service user’s needs and capabilities. EVIDENCE: Fees are all dealt with centrally at the Foundation’s offices. The present service user has lived in the property for approximately 5 years, which was established specifically for him. Regular reviews of care are organised involving the consultant psychiatrist, community psychiatric nurse, and service user. The minutes and risk assessments are available at the home. The need for a contract and/or Statement of Terms and Conditions was identified at the last inspection. The member of staff on duty was not aware of such a document, and it was not evident in the service user’s care records. The registered provider must provide the service user with a contract and/or Statement of Terms and Conditions. Longmeadow Road (13) DS0000008977.V297904.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 The home is assisting the service user to be involved in decisions affecting him and recording these in individual plans. The service user is supported to take risks, and this is an inherent part of the service user’s care plan. Records are stored securely. EVIDENCE: The care plan, diary, evaluation and incident records were inspected. The service user’s care plan is detailed and includes agreed goals with the service user. These are agreed between the professional advisors, the Foundation staff, and the service user and are reviewed at a 3 monthly frequency. The member of staff was observed to encourage the service user to be proactive in making decisions regarding daily activity within the home. The service user is encouraged to participate in all aspects of the home and this is part of the service user plan. The service user plan is very detailed about the level of participation that the service user is able to maintain in the local community. The risk assessments identify escorted and non-escorted activity and restrictions. The service user is made aware of the need for, and consulted about, any restrictions. The service user has transport and goes to work five days a week. The service user has the freedom to make decisions and choices, though the staff are available to provide support to inform those decisions and Longmeadow Road (13) DS0000008977.V297904.R01.S.doc Version 5.2 Page 10 choices. Staff are available round the clock for the service user. The service user is aware of the information and records held. Longmeadow Road (13) DS0000008977.V297904.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 The home continues to encourage the service user to participate in all aspects of life and the community as fully as possible, within prescribed safety/risk parameters. The staff work to provide the service user with consistent positive advice with which to make decisions. The service user is actively involved in determining the weekly menu. EVIDENCE: The service user is involved in a work experience opportunity and staff try to advise and encourage the service user regarding personal relationships in conjunction with guidelines and the plan of care. Staff offer the service user opportunities to develop different living and social skills. The plan of care identifies appropriate responses to various situations and behaviours that should be reinforced through a consistent approach from staff. The service user is encouraged to take an active role in food preparation and also enjoys takeaway meals. Contact with family and relationships with others are supported, and the service user is free to decide the level of contact with significant others. The staff demonstrated a good understanding of the service user’s rights and responsibilities. Longmeadow Road (13) DS0000008977.V297904.R01.S.doc Version 5.2 Page 12 On the day of the inspection, the service user had returned from an early shift at work and chose to decline to meet the inspector. The inspector spoke at length with the service user at the last inspection. Longmeadow Road (13) DS0000008977.V297904.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 The health needs of the service user are met with evidence of multi disciplinary working taking place. Discussions with the staff member, and the care documentation, showed that there is a comprehensive consideration and subsequent reviews of the service user’s physical and emotional health needs to ensure that they are met as far as is possible. EVIDENCE: Personal support is provided on a 24-hour basis for the service user. The main aim of the support is to promote independent living for the service user and maximise his control over his life. The service user has access to all agencies as required and is registered at a local Health Centre. The service user’s care needs and progress are reviewed at 3-monthly case reviews, which are attended by a multi-disciplinary team, including a psychologist and Community Psychiatric Nurse. The home maintains a record of attendance at medical appointments. The service user orders repeat prescriptions for medication, though staff monitors this, and these are picked up from the local chemist. The medication chart showed some alterations to the hand-written prescriptions, the alterations obliterating the previous entry so it cannot be read. The correlation between the medication chart and the separate administration record is not obvious, particularly with the aforementioned alterations. Medications are Longmeadow Road (13) DS0000008977.V297904.R01.S.doc Version 5.2 Page 14 stored securely. There is a medication policy, but there is not a medication procedure. Where prescriptions are hand-written the registered manager should ensure that two initials are entered to indicate the entry has been checked and is correct. The registered manager should consider revising the medication records so that the prescribed medication, dose, and time is on the same sheet as the record of administration. Alterations should be made with a single line through the relevant entry. The registered manager must implement a medication procedure, which provides plain-english instruction to staff in relation to the receipt, ordering, storage, administration and return of medication. Longmeadow Road (13) DS0000008977.V297904.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 The service user has the relevant skills to communicate any concerns to staff or other agencies. The home has a generic Protection Of Vulnerable Adults policy provided by the parent organisation. EVIDENCE: A complaints policy is in use, which references relevant regulations, but does not provide a plain-english explanation of the process, including time-scales and relevant contact information (e.g. local Adult Social Care office). The registered manager must implement a complaints procedure, which provides a plain-english explanation of the process, including time-scales and relevant contact information (e.g. local Adult Social Care office). A generic Protection Of Vulnerable Adults policy is in operation. The registered manager must implement a plain-english Protection Of Vulnerable Adults procedure with clear step-by-step instruction for staff as to what to do in the event of an allegation of abuse (including relevant contact information). The staff member on duty was aware of ‘No Secrets’ guidance, and the need for the involvement of Adult Social Care professionals in any allegation of abuse. Longmeadow Road (13) DS0000008977.V297904.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Longmeadow is a residential property that affords comfortable accommodation in keeping with this type of property. The registered provider has developed a programme of redecoration. EVIDENCE: The home is a normal domestic dwelling in a location that suits the needs of the service user. A bathroom and separate toilet are provided on the first floor. The service user has some responsibility for domestic duties and these are linked to goals and planning for independence that are stated in the care plan. The service user’s care needs do not warrant specialist equipment. The home was clean at the time of the inspection and a programme of redecoration is now in operation. New windows have been fitted since the last inspection. The main lounge has been redecorated and the rear garden has been tidied, though this could be further improved. The second lounge has been tidied, but needs redecorating. The hall and dining area carpets are unsightly and need replacing. Improvements are evident since the last inspection though and the inspector is currently confident that the home’s redecoration programme will attend to these areas. Longmeadow Road (13) DS0000008977.V297904.R01.S.doc Version 5.2 Page 17 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): 34, 35 The staff member met at the home was organised and competent. Various records regarding recruitment, supervision and training schedules are required to demonstrate this competency and these must be kept at the home and available for inspection. The inspector had insufficient evidence to determine the level of training provided, nor the level of protection afforded service users by the home’s recruitment procedure. EVIDENCE: The home provides 1:1 staffing levels at all times. The inspector does have confidence in the staff’s understanding of the service user’s care needs and their ability to meet those needs, based on discussions which took place during the course of the inspection. The staff member displayed appropriate skills, organisation and attitudes. The service user has 24-hour support because of the complexity of needs rather than high dependency. Only male staff currently work shifts on a 1:1 staffing level by day and at night. The support staff have an identified network of managers that they can call if a problem arises and they need extra help or advice. Whilst it is acknowledged that it would be unreasonable to expect sensitive records to be available to all staff, and the registered manager was not present at this inspection, the staff member confirmed that the records set out below are not kept at the home: • Staff training records Longmeadow Road (13) DS0000008977.V297904.R01.S.doc Version 5.2 Page 18 • Staff employment records The record of staff qualifications and experience that was available was incomplete, the entry for the staff member on duty, and others, being blank. This record would be useful if current, complete, and supported by an entry of evidence of qualification being seen with the registered manager’s initial. The staff member on duty was aware of the General Social Care Council, but was unsure whether he had received a General Social Care Council handbook. This matter was raised at the previous inspection: • “The registered manager must provide an action plan to demonstrate that staff training will be provided that is appropriate to the work they are to perform, including first aid, food hygiene and NVQ training.” • “The registered manager must maintain various records regarding recruitment, supervision and training schedules. These are required to demonstrate staff competency and must be kept at the home and available for inspection.” The registered provider must ensure the records specified in Schedules 1, 2, & 3 are kept securely at the care home, and are available for inspection. The registered provider must provide the Commission for Social Care Inspection with a written action plan as to how it intends to meet these requirements. Longmeadow Road (13) DS0000008977.V297904.R01.S.doc Version 5.2 Page 19 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, 39, 42 This is a small home with a registered manager. There is a clear managerial hierarchy. The manager is supported by the registered provider in delivering appropriate services and staff demonstrated an awareness of their roles and responsibilities. EVIDENCE: The registered manager is currently undertaking the NVQ Level 4 qualification in care, and plans to subsequently undertake the Registered Managers Award. The registered manager anticipates the completion of the NVQ Level 4 later this year. In addition to this home, the Commission for Social Care Inspection has agreed that the registered manager also has responsibility for another of the registered provider’s care homes in Plymouth. The staff member on duty was seen to interact in a relaxed, yet professional manner with the service user. The staff member was unaware of any quality assurance programme in use at the home. The registered manager must implement a quality assurance programme, which seeks the views of the service user and others in respect of Longmeadow Road (13) DS0000008977.V297904.R01.S.doc Version 5.2 Page 20 the service provided, and arrange for the findings to be made available to the service user and to the Commission for Social Care Inspection. The home’s maintenance and safety documentation was inspected and seen to be in order: • Fire Training • Fire Equipment • Gas Safety Certificate • Employers Liability Insurance • Accident/Incident Records The registered provider must forward details of when the home’s electrical system was last certified as safe (this is a 5-yearly requirement). Longmeadow Road (13) DS0000008977.V297904.R01.S.doc Version 5.2 Page 21 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 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 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 X 33 X 34 1 35 1 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 2 X 3 X 1 X X 3 X Longmeadow Road (13) DS0000008977.V297904.R01.S.doc Version 5.2 Page 22 Yes 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 YA5 Regulation 5(a)(b) Requirement The registered provider must provide the service user with a contract and/or Statement of Terms and Conditions. This is carried over from the last inspection. 2. YA20 13 The registered manager must implement a medication procedure, which provides plainenglish instruction to staff in relation to the receipt, ordering, storage, administration and return of medication. The registered manager must implement a complaints procedure, which provides a plain-english explanation of the process, including time-scales and relevant contact information (e.g. local Adult Social Care office). The registered manager must implement a plain-english Protection Of Vulnerable Adults procedure with clear step-bystep instruction for staff as to what to do in the event of an DS0000008977.V297904.R01.S.doc Timescale for action 01/07/06 01/08/06 3. YA22 22 01/08/06 4. YA23 13 01/08/06 Longmeadow Road (13) Version 5.2 Page 23 5. YA34 17 allegation of abuse (including relevant contact information). The registered provider must ensure the records specified in Schedules 1, 2, & 3 are kept securely at the care home, and are available for inspection. This is carried over from the last inspection. The registered provider must provide the Commission for Social Care Inspection with a written action plan as to how it intends to meet this requirement. The registered provider must ensure the records specified in Schedules 1, 2, & 3 are kept securely at the care home, and are available for inspection. This is carried over from the last inspection. 01/09/06 6. YA35 17 01/09/06 7. YA39 35 8. YA42 13, 23 The registered provider must provide the Commission for Social Care Inspection with a written action plan as to how it intends to meet this requirement. The registered manager must 01/09/06 implement a quality assurance programme, which seeks the views of the service user and others in respect of the service provided, and arrange for the findings to be made available to the service user and to the Commission for Social Care Inspection. The registered provider must 01/09/06 forward details of when the home’s electrical system was last certified as safe (this is a 5yearly requirement). Longmeadow Road (13) DS0000008977.V297904.R01.S.doc Version 5.2 Page 24 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 Where prescriptions are hand-written the registered manager should ensure that two initials are entered to indicate the entry has been checked and is correct. The registered manager should consider revising the medication records so that the prescribed medication, dose, and time is on the same sheet as the record of administration. Alterations should be made with a single line through the relevant entry. Longmeadow Road (13) DS0000008977.V297904.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 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. 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