Inspection on 29/01/09 for 130 Long Lane

This inspection was carried out on 29th January 2009.

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

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

Other inspections for this house

130 Long Lane 23/03/07

130 Long Lane 20/02/06

130 Long Lane 15/08/05

130 Long Lane 22/02/05

130 Long Lane 14/12/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 130 Long Lane 130 Long Lane Grays Essex RM16 2PR two star good service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alan Thompson Date: 2 6 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: 130 Long Lane 130 Long Lane Grays Essex RM16 2PR 01375394649 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): South Essex Special Needs Housing Association Ltd Name of registered manager (if applicable) Mrs Joan Sylvia Day Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 2 0 care home 2 learning disability Additional conditions: Date of last inspection 2 3 0 3 2 0 0 7 A bit about the care home 130 Long Lane provides care and accommodation for two adults with a learning disability. The home is owned and managed by South Essex Special Needs Housing Association (SESNHA). The home is a three bedroomed detached house situated in a residential area of Grays, approximately one mile from the main centre. Local shops and public transport links are close by. The house has a large enclosed rear garden. The home offers 24 hour care, and aims to achieve a small family like environment. Both service users attend a variety of day care placements and community activities. SESNHA have another small home nearby which also accommodates two service users. The two homes have the same registered manager, share some staff and maintain close links. The range of fees charged to individual service users is according to assessed needs and the agreed care package provided. CSCI inspection reports can be obtained from the home, or via the CSCI internet website, www.csci.org.uk Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home We started this inspection on Thursday 29th January 2009 with a second visit on 26th February 2009 to complete the process. This report reflects our findings on the days of the inspection along with information provided by the manager and feedback by service users and staff. The manager was at the home on the both days of the inspection, but could not be available all day at the first visit as other arrangements had already been made. Because of this we returned when the manager and service users would be in. The manager had completed and returned the Annual Quality Assurance Assessment AQAA to us before the inspection. This document gives homes the opportunity of recording what they do well, what they could do better, what has improved in the time since our last inspection as well as their future plans for improving the service. Some of the information and detail provided within the AQAA has been included in this report. During our visit we spoke with service users, the manager and staff on duty. We also asked for surveys to be completed by service users and staff. We received five completed surveys back and reference to what was said in these has also been made in this report. We looked at some records and policies and procedures and were were shown around parts of the home and grounds. What the care home does well This home had a relaxed, friendly and homely atmosphere. Staff on duty were knowledgeable about peoples care needs and the staff team worked together well and were enthusiastic about their work. People who live in the home are involved in the day to day planning of their own care and in the way the home is managed on a daily basis. The staff team makes sure that service users are able to enjoy a wide variety of leisure and social activities, both close to the home are further away. The home is well managed by an experienced manager who manages in a positive and enthusiastic way. What has got better from the last inspection People have new beds in their rooms. There is also a new washing machine, a new dining table with chairs and new carpets throughout the home. The manager also said that the hall, stairs, kitchen and both service user bedrooms had been re-decorated. Large trees had been removed from the front garden allowing more light into the front of the house. What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Alan Thompson CQC CPC1 Capital Park Fulbourn Cambridge CB21 5XE 01223 771300 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People considering moving into the home could be confident that the admission processes used will ensure that their needs can be met. Evidence: The homes Statement of Purpose and Service Users Guide were seen, and included the information needed to help new services users make an informed choice when considering moving into 130 Long Lane. Information was easy to read and includes pictures. The current service users were placed and funded by local authorities and both have lived in the home for over 10 years. Records confirmed that these organisations had provided an assessment of needs to the home before admission. The manager said that should any new people be referred in the future then she would carry out a written assessment of needs for all prospective service users prior to admission. Documentation relating to new admissions was seen and included an initial assessment form that had headings of mobility, self care, medication, health and communication needs. Service user files had copies of assessments in them that covered the areas needed to ensure that peoples needs could be met. The manager confirmed that any people interested in moving to the home in future would be invited to visit and to stay for a trial to see if they liked it. Service users said that they were asked if they wanted to move into the home and that they liked living in 130 Long Lane. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The information in the homes care plans ensured that people’s needs could be met in the way they wished. Evidence: At the time of this inspection there were two service users living at 130 Long Lane. Their support/care plan files were inspected. These had comprehensive risk assessments that showed the perceived hazard, the level of risk and guidelines for staff on methods to minimise this. Risks had been reviewed regularly and staff spoken with said they had been trained in the assessment of risks. Care plans were person centred and service users had been fully involved in their completion. Daily assessed needs were listed under individual headings with each area of need showing details of the area of need/problem and a daily plan of actions for staff to follow to meet these. Personal preferences were recorded along with details of people’s likes and dislikes around routines, activities and food. All care plans had been regularly reviewed with daily records completed by staff. Care reviews included recorded notes of the service users views and those spoken with said they were included in the care planning process. Healthcare issues were seen recorded on service users files including visits to medical professionals, social workers, hospital visits, GP consultations, dentists, opticians and chiropodists. Also seen recorded were notes of any reviews of placement undertaken with the placing authority and the service user. The manager confirmed that service user meetings take place to ensure their views Evidence: and opinions about the service are listed too. Minutes of meetings that took place in October 2008 and January 2009 included evidence of discussion on activities, food, routines and family contact. Service users comments were included. Service users spoken with confirmed that they thought they are fully included in day to day decision making within the home, with staff offering daily choices around routines and events. This was evident throughout both days of our inspection with staff and service users observed making joint decisions about meals and activities. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Service users are able to participate in a range of social and leisure opportunities that meet their expectations. Meals and mealtimes are flexible and suite the lifestyle of service users living at the home. Evidence: The manager confirmed that none of the service users living in 130 Long Lane is in any form of paid or voluntary employment, however one has worked in the past and staff support service users rights to look for employment if they wished. College courses are attended by both service users and 1 to 1 staff support is provided for this where needed. Staff also support service users to access community interests and activities, public transport and staff cars are used to get out and about. Records had been kept of activities and service users had a weekly activity schedule showing the options they had chosen for that week. Regular activities enjoyed by service users included local theatres, cinemas, restaurants, shopping, pubs, bingo, trips to London and regular short breaks and holidays to places such as Brixham, Hastings, Folkestone and Turkey. Service users also attend church and clubs. Service users spoken with confirmed that they enjoy the things they do and told us about the trips and holidays they went on with staff in the UK and abroad. Service users are supported by staff in seeing their relatives and friends, with staff willing to take people to relatives homes for visits. Records had been kept of family contact. The Evidence: manager confirmed that staff respect peoples privacy and would not go into bedrooms if service users asked them to stay out, except if the welfare of the person was in doubt. Service users do not have keys to their rooms but could if they wished, according to assessed risks. Bedroom doors are lockable from the inside and can be opened from the outside in an emergency. Throughout this inspection staff were observed to interact appropriately with service users and appeared to always use the individuals preferred form of address. Discussions between service users and staff about routines and choices were taking place throughout the inspection and the atmosphere in the home was very relaxed, supportive and friendly. Service users were confident about making their views and opinions known to staff. Nutrition records were inspected and evidenced a varied and balanced diet. The manager said that service users usually eat the main meal in the dining room but could eat in their own rooms if they wish. Breakfast and lunch were seen to be taken at times according to service users choices and their daily routines, and the main meal of the day is either lunch or dinner according to daily routines and peoples choices for that day. Menus are based on a four week rotation but are very flexible. Service users accompany staff on a weekly shopping trip at a local supermarket and some also take part in the preparation and cooking of meals. Service user meetings include discussion on the food and the manager confirmed that service users food preferences and likes/dislikes form the basis of menu planning. People living in the home told us they liked the food and enjoyed eating out with staff. Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living at the home can expect to receive support in an appropriate and dignified way that meets their needs. Evidence: Care records and discussion with service users and staff confirm that service users are fully supported in making their own choices around clothing styles, hairstyles and general appearance. Assessment records included preferences around daily routines, and details of the levels of personal care support required were also seen documented. Service users spoken with also confirmed that they liked the staff and were satisfied with the care provided them in the home. The current service user group are offered staff support and guidance in recognition of their individual healthcare needs and to access community healthcare facilities. Their healthcare needs were seen recorded within individual care plans and updated in the daily care notes, along with records of any visits and/or consultations. All service users needed full staff support with their medication needs. Service user files seen included a signed form consenting to staff providing this support. People living in the home did not appear to have a full understanding or awareness of the medical reasons for medication regimes prescribed to them. The manager confirmed that if service users refused medication then advice and encouragement is offered to them to understand the reason for the prescribed dosage. If they continue to refuse their prescribed medication the GP is contacted for advice. The homes written medication procedure/policy was seen and clarified policies on homely remedies, side effects of the medicines prescribed, the storage of medicines Evidence: and of administering prescribed dosages. Records were seen relating to the re-ordering and returns of unused medication. Service users go with staff to collect their own prescriptions and medication from their GP and pharmacist. A random sample of medication administration records and stocks of current medication were inspected. No errors were noted. Training records seen had evidence that staff had been given training relating to the medication practices and procedures used in the home. In addition the manager and deputy manager had both passed an advanced care of medicines training course. Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Practices in the home safeguard service users and ensure that concerns are listened to and addressed. Evidence: The manager had a complaints procedure in place, which clarified the complaints process and the timescales that the manager should respond to the complainant. The complaints procedures also included pictorial guidance for service users on how to make a complaint. This clearly indicates to service users that they have a right to feel sad or feel unhappy and that they should tell somebody. Comments made by service users verbally and in service user surveys confirmed that if they were unhappy they would speak with staff or the manager. Both service users have active involvement with their respective families and had regular contact with external health/social care professionals. The home has links with the local advocacy service and was able to demonstrate that this service is used as appropriate to ensure that service users wellbeing is paramount to any given situation. There was a set template form for recording complaints and a complaints record book. There had not been any formal complaints recorded since the last inspection. In the home was a copy of the safeguarding adults policy and procedure produced by the registered provider, and a copy of the local authority safeguarding forms to be used if an alert needed to be raised. The guidance seen included information for staff on the adult protection procedures and on types of abuse that may occur. Staff had been trained on safeguarding vulnerable adults from abuse. Confirmation of this was gathered from looking at training records and speaking with staff. Staff spoken with also understood what was meant by ‘safeguarding adults from harm’ and said that if they suspected an issue then they would contact the manager. Also in place was a whistleblowing policy which clarified staffs responsibility to report any suspected abuse. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Service users live in a comfortable, clean and homely environment. Evidence: During the inspection a partial tour of the home was made accompanied by the manager. The home was seen to be clean and well maintained, very homely and service users bedrooms were personalised. Service users spoken to were very happy with the standards in the home, they also said they liked their rooms and that staff helped them keep their rooms clean and decorated. Both private rooms are singles and are on the first floor. Private rooms seen had wardrobes, adequate storage facilities and various items of personal possessions according to individual choices. There was one bathroom with wc on the first floor. Communal sitting areas comprised of a lounge at the rear and a dining room at the front. The lounge was comfortable and the dining room had sufficient space and furniture for eating in. There is has a good size back garden which could be accessed from a rear door, and there is also a front garden. The gardens are maintained by staff and were acceptably maintained when looked at on our second visit. The home does not have off road car parking but visitors and staff can park on the road at the front. 130 Long lane does not have a pay phone but one person had there own mobile phone, and staff said that both service users use the homes telephone to keep in touch with family and friends. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Service users are supported by an experienced staff team who are trained for their roles. The recruitment procedure in the home provides the safeguards to ensure that appropriate staff are employed. Evidence: A clear organised staff rota was available for inspection. On the day of the inspection two service users were living at the home. Daytime staffing was a minimum of one staff on duty. At night there is one person sleeping in on call. Daytime staffing levels may be more if there are planned activities arranged. The manager, and staff spoken with confirmed that staff meetings take place to ensure that all are kept informed of relevant issues and are able to take part in planning and decision making in the home. The home has a stable staff team and only one person had been employed since our last inspection. Recruitment records looked at showed that proper checks had been carried out with an application form completed, interview records kept, proof of ID obtained, a CRB check carried out, two references seen and a contract of employment issued. New staff are subject to in-house induction training during their first week of employment with new staff being shadowed by experienced staff for their first two weeks. After completing the in-house induction then staff move on to the Skills for Care modules for social care staff. Areas covered included the principles of care, the role of the care worker, safeguarding vulnerable adults guidance and first aid, food hygiene and moving and handling training. Comments in staff surveys returned to us confirmed that they thought their recruitment was done thoroughly, and that their induction covered what they needed to know when starting their jobs. Staff training records had been kept and certificates seen showed that staff had been trained in safeguarding, outcomes for care workers, person centred care, mental Evidence: capacity act, deprivation of liberty, infection control, personal care, medication, food hygiene, health and safety, COSHH, fire awareness, people handling, risk assessment, care planning, dementia awareness, first aid, inclusive living, NVQ, communication skills, diabetes and handling bereavement. Staff spoken with confirmed they were supported by the manager. They also said that they had been offered good training opportunities appropriate to their roles. Staff seen were open, friendly and demonstrated sound care values. All had a good understanding of work practices and routines and the observed rapport between staff and service users was very relaxed and friendly. Regular staff supervision meetings had been given to staff six times a year to ensure that they are supported in their roles. Records were seen of the agenda discussions and actions. Areas included had been work-load, impact of work, support and guidance, organisation and personal issues. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People live in a home that is well managed and run in their best interests. Evidence: The manager has over twenty years experience of working in the field of social care. This includes twelve years as manager of 130 Long Lane since the home was opened. The managers qualifications include the registered managers award and the NVQ level 4. There is a deputy manager in post who also holds these awards. Comments made during discussion with staff and in surveys returned to us about management of the home confirmed that staff thought they were properly supported by the manager. The registered provider commissions an annual quality monitoring audit of the service by an independent body. A report is generated from this which was seen and confirmed that good standards had been met. It is recognised by us that day to day practice in the home includes staff listening to and acting upon service users views and opinions, and that service users views are asked for at the registered provider monthly visits. However the annual audit report seen focused on the business aspects of the service and did not sufficiently evidence that service users and stakeholders views had been sought Random samples of records required to be kept by regulation were inspected. These included regulation 26 reports (monthly registered person report), staff rota, visitor book, nutrition records, assessments, care plans, staff recruitment, medication records and fire drills. All seen were in order. Records seen showed that staff had received training in first aid, fire safety, health and safety and food safety. Evidence: Service records were also looked at and showed that the homes fire equipment, gas equipment, electrical installation supply and portable electrical appliances had all been tested/serviced within recommended timescales. The manager confirmed that hot water supply is delivered at or near 43 degrees celcuis, and that weekly checks on this take place. Records of this were seen Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 39 Quality assurance mechanisms should seek the views of all stakeholders, and inform the annual quality check of the home. Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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