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Inspection on 01/02/06 for 151 Valley Road - Leonard Cheshire Disability

Also see our care home review for 151 Valley Road - Leonard Cheshire Disability for more information

This inspection was carried out on 1st February 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

151 Valley Road continues to provide a good standard of care, which meets the assessed needs and preferences of the residents. Records seen were easily accessible, very detailed and easy to cross-reference. There was clear evidence that the records are routinely reviewed and updated. The overall management of medication was good with no excess medication stored in the home. Robust systems are in place, which help to check any changes in medication from the previous visit. As on previous inspections the home was spotlessly clean with no excess clutter of unpleasant odours.

What has improved since the last inspection?

Development work is underway to improve the home`s quality assurance and quality monitoring systems. For example, the home is pro-active in seeking feedback via communication books, evaluation forms and reviews. The home has a rolling redecoration programme. Since the previous inspection the lounge has been redecorated and new furniture has been ordered. The large airy conservatory has also been reorganised and is now more of an activities room. The variety of musical instruments makes a visually stimulating display for the residents.

What the care home could do better:

It is pleasing to note that no requirements arose from this inspection.

CARE HOME ADULTS 18-65 151 Valley Road 151 Valley Road Lillington Leamington Spa Warwickshire CV32 7RX Lead Inspector Maggie Arnold Unannounced Inspection 1st February 2006 3:00pm 151 Valley Road DS0000004221.V281782.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 151 Valley Road DS0000004221.V281782.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. 151 Valley Road DS0000004221.V281782.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 151 Valley Road Address 151 Valley Road Lillington Leamington Spa Warwickshire CV32 7RX 01926 881612 01926 881612 sarah.hyde@lc-uk.org 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) Leonard Cheshire Mrs Sarah Jane Hyde Care Home 4 Category(ies) of Learning disability (4), Physical disability (4) registration, with number of places 151 Valley Road DS0000004221.V281782.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th July 2005 Brief Description of the Service: 151 Valley Road is a purpose-built four-bedroom bungalow that is operated by the Leonard Cheshire Foundation. The property and all beds are purchased and funded through Social Services. The home provides respite care (and day care) for adults with profound and multiple disabilities. It is situated approximately two miles from Leamington Spa town centre and is within easy walking distance of local shops, pubs, library, church and health and community centres. There are four single bedrooms, two have en-suite facilities. The large flat garden area is mainly lawned and includes a sensory area complete with mobiles and touch sensitive items. There is ample parking space to the front of the property. 151 Valley Road DS0000004221.V281782.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on a weekday between the hours of 3.00pm and 5.20pm. The manager and three members of staff were on duty. Two residents arrived at the home from day care at approximately 4.00pm. The main focus of this inspection was referral information, risk assessments, personal support and how the home in What the service does well: What has improved since the last inspection? 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. 151 Valley Road DS0000004221.V281782.R01.S.doc Version 5.1 Page 6 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 151 Valley Road DS0000004221.V281782.R01.S.doc Version 5.1 Page 7 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 All new residents have a full assessment prior to admission. This helps to ensure that the home can meet the individual resident’s aspirations and needs. EVIDENCE: Two care plans and accompanying records were selected for scrutiny. There was evidence on one file to demonstrate that the placing agency had provided the home with a detailed referral. The potential resident’s school had provided additional information. The referrals help to form the basis of the resident’s plan of care. The inspector was advised that the second resident had been receiving care from Leonard Cheshire Homes for a significant number of years and it was probable that the initial referral had been archived. The manager confirmed that potential residents are offered every opportunity to visit the home for short visits or overnight stays before committing themselves to regular respite stays. The short visits help the home to build up a fuller picture of the resident’s needs and preferences. 151 Valley Road DS0000004221.V281782.R01.S.doc Version 5.1 Page 8 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&9 Residents’ assessed and changing needs are reflected in their care plans. This ensures that the residents receive a safe and personalised package of care. EVIDENCE: Both care plans and accompanying records were up to date and easy to crossreference. One care plan clearly reflected the resident’s initial referral. There was also evidence that the care plans was developed as the home got to know more about the needs and preferences of the residents. For example, an initial referral had highlighted specific eating and drinking care requirements. The requirements were clearly recorded on the resident’s care plan. A risk assessment was also completed regarding potential difficulties associated with the resident’s eating and drinking needs. Care plans and accompanying risk assessments covered a wide range of needs and preferences. These included likes, dislikes, medication, routines, religion, culture and any particular behavioural issues. 151 Valley Road DS0000004221.V281782.R01.S.doc Version 5.1 Page 9 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): 13, 15 &17. Residents enjoy varied leisure activities. This works towards a feeling of well being and good quality of life. Residents enjoy meals that are varied and wholesome. EVIDENCE: Standards 12,15, 16 &17 were assessed at the time of the last inspection. All met with the National Minimum Standards. Seven relatives completed pre-inspection comment cards. All All of the residents live at home with their family or guardians and only stay at 151 Valley Road for one or two weeks at a time. The inspector was advised that recent activities have included a meal at a Chinese restaurant, visits to a pantomime, theatre and theme park. In the last twelve months, some short stay residents also had the opportunity to visit Disney Land. 151 Valley Road DS0000004221.V281782.R01.S.doc Version 5.1 Page 10 Activities within the home include time spent in the sensory room and sensory garden, enjoying a foot spa or Jacuzzi as well as playing musical instruments, painting and drawing. Wherever possible, the residents continue to attend their usual day care centres. A brief check of the kitchen found that there were good stocks of varied fresh, frozen and tinned foodstuffs. Records are retained of both sample menus and actual meals taken by the residents. It was also noted that systems are in place to remind the staff of any particular dietary or care needs of the residents. Food, freezer and refrigerator temperature are routinely recorded. 151 Valley Road DS0000004221.V281782.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 & 20. Residents benefit from the discrete, individually based care and support that is provided in a sensitive manner by the home. Residents are protected by the home’s medication policies and procedures. EVIDENCE: Standards 20 and 21 met the national standards at the time of the last inspection. The home has good records and risk assessments that detail residents’ preferences regarding the type of support they require. For example, one care plan and accompanying risk assessment detailed how a particular resident liked to be assisted when going to bed. The accompanying risk assessment was very explicit regarding the degree and type of staff support required when moving and handling. It was particularly pleasing to note that the care plans and risk assessment were based on maximising the resident’s independence. A scrutiny of the medication cabinet and records confirmed that the home administers and deals with residents’ medication in a safe and accountable manner. For example, systems are in place to monitor the quantity of, and use by dates, of medication. The inspector observed how the home checked medication brought in by one resident. 151 Valley Road DS0000004221.V281782.R01.S.doc Version 5.1 Page 12 The home followed the safe practice of checking with the resident’s GP regarding hand written changes to medication instructions. The home does not hold excessive or unnecessary amounts of medication. 151 Valley Road DS0000004221.V281782.R01.S.doc Version 5.1 Page 13 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): These standards were met in full at the last inspection. EVIDENCE: Not assessed on this occasion. 151 Valley Road DS0000004221.V281782.R01.S.doc Version 5.1 Page 14 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): These standards were met in full at the last inspection EVIDENCE: Not assessed on this occasion. A brief inspection of the home found that it continued to be a homely, safe and comfortable environment. Since the previous inspection the staff have redecorated the lounge. The home was awaiting the delivery of new curtains, sofas and lighting fitments. The large conservatory, which leads directly off the sitting room, has recently been reorganised and is now more defined as an activities room. For example, various musical instruments and games are left out. As on the previous inspection, the home was clean, hygienic and free from unpleasant odours. 151 Valley Road DS0000004221.V281782.R01.S.doc Version 5.1 Page 15 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): Not assessed on this inspection. EVIDENCE: Standards 32, 34 and 35 were assessed and found to meet the National Minimum Standards at the time of the last inspection, which took place in July 2005. In addition to the manager the home has seventeen care staff and one ancillary staff member. Eight of the care staff have achieved a National Vocational Qualification Level 2 and sixteen staff members hold a current First Aid certificate. All of the staff have undertaken training in the safe administration and management of medication. The number of staff on duty will vary according to the number and needs of the short stay residents. Training courses in the last twelve months have included First Aid, Basic Food Hygiene, Health and Safety and communication. Some staff have also undertaken Protection of Vulnerable Adults Awareness training. 151 Valley Road DS0000004221.V281782.R01.S.doc Version 5.1 Page 16 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): 39 The views of residents and their families underpin the reviews and development plans of the home. This ensures that the service is managed and developed in a way that meets the needs and preferences of the residents. EVIDENCE: The home has a number of systems in place, which ensures that the residents and their advocates’ views are taken into account. For example, all of the residents have their own two-way communication book that always goes home and comes in with the resident. The home is also proactive in ensuring that every opportunity is offered to relatives and advocates to attend resident reviews. For example, relatives choose when and where the review annual review is to take place. If it is preferred, there is an option for the review to take place over the telephone. Although the response rate is poor, a Leonard Cheshire services evaluation form is also sent to relatives following their son or daughters respite stay at 151 Valley Road. 151 Valley Road DS0000004221.V281782.R01.S.doc Version 5.1 Page 17 The home is also required to complete a corporate annual self-assessment report that must include the views of residents, staff, relatives, other professionals and volunteers. 151 Valley Road DS0000004221.V281782.R01.S.doc Version 5.1 Page 18 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 x 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 x 33 x 34 x 35 x 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 x x 3 x LIFESTYLES Standard No Score 11 x 12 x 13 3 14 x 15 x 16 x 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 x 3 x x x 3 x x x x 151 Valley Road DS0000004221.V281782.R01.S.doc Version 5.1 Page 19 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. Standard Regulation Requirement Timescale for action 151 Valley Road DS0000004221.V281782.R01.S.doc Version 5.1 Page 20 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 151 Valley Road DS0000004221.V281782.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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. Extracts may not be used or reproduced without the express permission of CSCI 151 Valley Road DS0000004221.V281782.R01.S.doc Version 5.1 Page 22 - 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!