CARE HOME ADULTS 18-65
Lumley Road (16) 16 Lumley Road Horley Surrey RH6 7JL Lead Inspector
Graham Cheney Announced 21 June 2005 14:30 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 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 Stationary 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. Lumley Road (16) H58_s13453_16 Lumley Road_v226224_210605_stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Lumley Road (16) Address 16 Lumley Road, Horley, Surrey, RH6 7JL Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01293 782238 Royal Mencap Society Mr S Chandramurthi CRH Care Home 6 Category(ies) of LD Learning Disability, 5 registration, with number LD(E) Learning Disability - Over 65, 1 of places Lumley Road (16) H58_s13453_16 Lumley Road_v226224_210605_stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The age range of the persons to be accommodated will be: 18 - 65 years, except one over the age of 65. Date of last inspection 18 January 2005 Brief Description of the Service: 16 Lumley Road is a detached house developed to provide accommodation for up to eight adults with learning disabilities, one of whom may be over the age of 65. The home is set in a residential area within walking distance from Horley town centre. All bedrooms are single occupancy and are decorated to a good standard. There is a pleasant garden to the rear of the property for the service users to enjoy. The home has some off road parking. Lumley Road (16) H58_s13453_16 Lumley Road_v226224_210605_stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This visit was the home’s first inspection for the CSCI year 2005/2006. It was an announced visit, which meant that staff and residents were aware that it was due to happen. The inspector arrived at 2.30 pm knowing that some of the residents would be at home, while others would be returning from day activities during the afternoon. Residents were keen to show the inspector around the home and in particular their bedroom. This gave the opportunity to talk on a one to one basis about life in Lumley Road. Later on the inspector joined all the residents and staff to talk about their recent holiday and other interests. The inspector also spent time talking with the manager and staff about how the home was operating. The middle part of the inspection was used to look at the homes documentation, records, care plans, staffing arrangements and medication. All of the residents seemed very happy living at Lumley Road and keen to tell the inspector about their lives and what they had been doing recently. Comment cards returned by residents, relatives and visitors to the home were all very positive about the care and support provided. What the service does well:
The relationship between residents and staff was observed to be relaxed and friendly, creating a warm and homely feel. This was best shown as residents chatted with the manager, staff and inspector during the inspection, the main topic being their recent holiday to Florida. They also talked about their day and plans for a BBQ the next day. Residents meetings were held on a regular basis and the minutes provided evidence that residents were very involved and active in the way the home was run. Residents were encouraged and supported to be as independent as they were able and they all appeared to lead busy and interesting lives, which included attending clubs, day centre, work placement, leisure activities, shopping and home time for life skills development. Some of the residents were able to access the local community independently. The home also has its own transport. The manager explained how the system for recording and checking residents’ personal finances worked and the safeguards that were in place to ensure that all of the residents’ monies were protected. The overall process as described by
Lumley Road (16) H58_s13453_16 Lumley Road_v226224_210605_stage 4.doc Version 1.30 Page 6 the manager seemed sound encouraging independence, but also protecting each person’s monies. The home used to have double rooms but these were now being used as large single rooms to the benefit of the particular residents. Some of the other rooms were comparatively small, but the residents said they were very happy them and felt at home. The garden was well presented a credit to the work of the residents and staff. Staffing levels were being maintained with two on duty throughout the waking day and a third on either 10.00 to 6.00 or 8.00 to 4.00 at the weekend. A carer sleeping in provided night cover. The home does not use agency staff, which means that care, and support is consistently provided by staff that residents know and trust. Evidence gathered from staff files and discussion with the manager and staff on duty indicated that recruitment processes were being properly carried out, with references and checks all being completed. What has improved since the last inspection?
Care plans have been developed and provide evidence, through daily notes and regular reviews, that care needs were being consistently met. The day to day care plans provided a good level of information about each person, based upon person centred planning, identifying their needs and wishes and gave staff a clear guide as to what support and help was needed. The manager was able to demonstrate how personal care programmes had worked to improve the quality of life for individuals. It was particularly noted that person centred plans included peoples’ dreams and how these may become possible, as had been the case for recent trip to America, and provided evidence that this was being followed. They also included a relationship circle, which identified who was important in their lives. The manager explained that maintaining contact with families, as they and the residents were getting older was becoming more difficult but this was seen as very important with every effort being made to support residents. The improvement to the reviewing of care planning was commended, as was the trip to America, which had clearly taken a lot of planning and organisation and, from residents comments, had been greatly enjoyed by all. The training and development of staff continues to improve. One of the staff had completed NVQ level II, two others were nearing completion and all had completed the induction training with the newest member of staff undertaking the foundation level, before going onto start NVQ. Supervision was being undertaken by the manager on a regular basis. The manager has achieved the registered managers award (RMA) and was commended on this achievement.
Lumley Road (16) H58_s13453_16 Lumley Road_v226224_210605_stage 4.doc Version 1.30 Page 7 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. Lumley Road (16) H58_s13453_16 Lumley Road_v226224_210605_stage 4.doc Version 1.30 Page 8 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 Standards Statutory Requirements Identified During the Inspection Lumley Road (16) H58_s13453_16 Lumley Road_v226224_210605_stage 4.doc Version 1.30 Page 9 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 standard(s) 1, 2, 3 The home’s statement of purpose and service user guide provided a good level of information to help prospective residents to make an informed choice as to whether the home could meet their needs. The service was commended for recognising individual’s aspirations and in planning and supporting them to achieve these. EVIDENCE: It was particularly noted that person centred plans included peoples’ dreams and how these may become possible, as had been the case for recent trip to America, and provided evidence that this was being followed. They also included a relationship circle, which identified who was important in person’s lives. The manager explained that maintaining contact with families, as they and the residents were getting older was becoming more difficult but this was seen as very important with every effort being made to support residents. Lumley Road (16) H58_s13453_16 Lumley Road_v226224_210605_stage 4.doc Version 1.30 Page 10 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 standard(s) 6, 7, 8, 10 Evidence gathered from this inspection indicated that this was a real strength in the home with each of the standards was being met effectively and aspects were commended. This gives confidence that each individual’s needs and aspirations were being recognised and met with appropriate support and care. EVIDENCE: Care plans have been developed and provide evidence, through daily notes and regular reviews, that care needs were being consistently met. The day to day care plans provided a good level of information about each person, based upon person centred planning, identifying their needs and wishes and gave staff a clear guide as to what support and help was needed. The manager was able to demonstrate how personal care programmes had worked to improve the quality of life for individuals. Lumley Road (16) H58_s13453_16 Lumley Road_v226224_210605_stage 4.doc Version 1.30 Page 11 It was particularly noted that person centred plans included peoples’ dreams and how these may become possible, as had been the case for recent trip to America, and provided evidence that this was being followed. They also included a relationship circle, which identified who was important in their lives. The manager explained that maintaining contact with families, as they and the residents were getting older was becoming more difficult but this was seen as very important with every effort being made to support residents. The improvement to the reviewing of care planning was commended, as was the trip to America, which had clearly taken a lot of planning and organisation and, from residents comments, had been greatly enjoyed by all. Residents meetings were held on a regular basis and the minutes provided evidence that residents were very involved and active in the way the home was run. The manager explained how the system for recording and checking residents’ personal finances worked and the safeguards that were in place to ensure that all of the residents’ monies were protected. The overall process as described by the manager seemed sound encouraging independence, but also protecting each person’s monies. Lumley Road (16) H58_s13453_16 Lumley Road_v226224_210605_stage 4.doc Version 1.30 Page 12 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 standard(s) 11, 12, 13, 14, 15, 16 This was another strength of the home with evidence gathered during this inspection confirming that the home meets each of the assessed standards. This meant that the home was able to demonstrate that residents were encouraged and supported to lead as independent and fulfilling life as they were able. EVIDENCE: Residents were encouraged and supported to be as independent as they were able and they all appeared to lead busy and interesting lives, which included attending clubs, day centre, work placement, leisure activities, shopping, boot sales and home time for life skills development. Some of the residents were able to access the local community independently. The home also has its own transport. Lumley Road (16) H58_s13453_16 Lumley Road_v226224_210605_stage 4.doc Version 1.30 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 standard(s) 20 Evidence gathered during this inspection confirmed that the home meets standard 20. This meant that the home was able to demonstrate that residents’ health and personal care needs with regard to medication were being appropriately met. EVIDENCE: Evidence gathered indicated that the home’s practice, policies and procedures with regard to the administration and recording of medication were all assessed as sound, i.e. medication administered records were accurately completed and medication was properly stored. Lumley Road (16) H58_s13453_16 Lumley Road_v226224_210605_stage 4.doc Version 1.30 Page 14 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 standard(s) 22 Evidence gathered during this inspection confirmed that the home meets the assessed standard. This meant that the home was able to demonstrate that residents were being appropriately protected and that residents’ views were important and acted upon. EVIDENCE: Residents meetings were held on a regular basis and the minutes provided evidence that residents were very involved and active in the way the home was run. The relationship between residents and staff was observed to be relaxed and friendly, creating a warm and homely feel. This was best shown as residents chatted with the manager, staff and inspector during the inspection, the main topic being their recent holiday to Florida. They also talked about their day and plans for a BBQ the next day. This indicated that residents trusted staff and therefore could tell them if they had any problems or concerns. Lumley Road (16) H58_s13453_16 Lumley Road_v226224_210605_stage 4.doc Version 1.30 Page 15 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 standard(s) 24, 25, 26 Evidence gathered during this inspection confirmed that, the home meets each of the assessed standards and provides a reasonable level of accommodation appropriate to the needs of the current residents. EVIDENCE: The home used to have double rooms but these were now being used as large single rooms to the benefit of the particular residents. Some of the other rooms were comparatively small, but the residents said they were very happy with them and felt at home. The garden was well presented a credit to the work of the residents and staff. Lumley Road (16) H58_s13453_16 Lumley Road_v226224_210605_stage 4.doc Version 1.30 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35, 36 Evidence gathered during this inspection confirmed that the home meets each of the assessed standards. Staff appeared to be enthusiastic and committed to supporting residents, with training and development given a high priority. EVIDENCE: The relationship between residents and staff was observed to be relaxed and friendly, creating a warm and homely feel. This was best shown as residents chatted with the manager, staff and inspector during the inspection, the main topic being their recent holiday to Florida. They also talked about their day and plans for a BBQ the next day. Evidence gathered from staff files and discussion with the manager and staff on duty indicated that recruitment processes were being properly carried out, with references and checks all being completed. Staffing levels were being maintained with two on duty throughout the waking day and a third on either 10.00 to 6.00 or 8.00 to 4.00 at the weekend. A carer sleeping in provided night cover. The home does not use agency staff, which means that care, and support is consistently provided by staff that residents know and trust.
Lumley Road (16) H58_s13453_16 Lumley Road_v226224_210605_stage 4.doc Version 1.30 Page 17 The training and development of staff continues to improve. One of the staff had completed NVQ level II, two others were nearing completion and all had completed the induction training with the newest member of staff undertaking the foundation level, before going onto start NVQ. Supervision was being undertaken by the manager on a regular basis. Lumley Road (16) H58_s13453_16 Lumley Road_v226224_210605_stage 4.doc Version 1.30 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 43 Evidence gathered during this inspection confirmed that the home meets each of the assessed standards and was seen to be well run with sound and accountable management support. EVIDENCE: All of the residents seemed very happy living at Lumley Road and keen to tell the inspector about their lives and what they had been doing recently. Comment cards returned by residents, relatives and visitors to the home were all very positive about the care and support provided. The manager has achieved the registered managers award (RMA) and was commended on this achievement. The procedures for monitoring and supporting residents with their personal finances was sound.
Lumley Road (16) H58_s13453_16 Lumley Road_v226224_210605_stage 4.doc Version 1.30 Page 19 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 4 3 x x Standard No 22 23
ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 4 3 3 x 3
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 x x x x Standard No 11 12 13 14 15 16 17 3 3 3 4 4 3 x Standard No 31 32 33 34 35 36 Score x 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Lumley Road (16) Score x x 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x x 3 H58_s13453_16 Lumley Road_v226224_210605_stage 4.doc Version 1.30 Page 20 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 Regulation Requirement Timescale for action 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 Good Practice Recommendations Lumley Road (16) H58_s13453_16 Lumley Road_v226224_210605_stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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