Inspection on 24/05/05 for 17a Linda Grove

This inspection was carried out on 24th May 2005.

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.

Other inspections for this house

17a Linda Grove 30/10/07

17a Linda Grove 12/12/05

17a Linda Grove 18/01/05

17a Linda Grove 06/07/04

17a Linda Grove 02/03/04

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

CARE HOME ADULTS 18-65 17a Linda Grove 17a Linda Grove Cowplain Hampshire PO8 8UX Lead Inspector Kathryn Kirk Unannounced 24/05/05 10:00 a.m. 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. 17a Linda Grove H54 S11715 Linda Grove v224249 240505.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 17a Linda Grove Address 17a Linda Grove Cowplain Hampshire PO8 8UX 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) 023 9226 2536 Community Integrated Care Mrs Pamela Joyce Wakelin CRH 4 Category(ies) of LD Learning Disability LD(E) Learning Disability registration, with number over 65 of places 17a Linda Grove H54 S11715 Linda Grove v224249 240505.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. All service users admitted from 11th June 2003 must be between 35 and 65 years of age. 2. Service users over 65 accommodated at the home on 11/06/03 may continue to be accommodated provided that the home can continue to meet their needs. Date of last inspection 18/01/2005 Brief Description of the Service: 17a Linda Grove is a purpose built bungalow. Knightstone Housing provide the accommodation. Community Integrated care manages the service. It is registered to provide residential care for up to four adults with a learning disability. Service users have their own bedroom and share the use of bathroom, toilet dining and lounge areas. There is an enclosed rear garden which is accessible to service users in wheelchairs. 17a Linda Grove H54 S11715 Linda Grove v224249 240505.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and is the first of two that will take place during the year March 2005-April 2006. The inspection took three hours. There are currently three service users in residence at Linda Grove. Two were at home during the inspection, their needs are such that they were unable to contribute verbally to the inspection process. The inspector spoke with the acting manager and with two other care staff. The premises were toured and some documents and records were also examined. Linda Grove has been inspected under the Standards that relate to Adults aged18-65. One of the current service users falls within this age category, the other two are older. The conditions of registration are such that any future service user to be admitted must be aged between 35 and 65 years of age. The inspection found that the quality of care provided at Linda grove is good. There are no requirements or recommendations made as a result of this visit. What the service does well: What has improved since the last inspection? A new system of care planning is in place which will provide greater clarity as to individual need, goals and aspirations. Some repair and maintenance has been carried out, for example the carpet in the hallway has been replaced. 17a Linda Grove H54 S11715 Linda Grove v224249 240505.doc Version 1.30 Page 6 There has been a full audit of the service, the results of which are not yet available. 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. 17a Linda Grove H54 S11715 Linda Grove v224249 240505.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection 17a Linda Grove H54 S11715 Linda Grove v224249 240505.doc Version 1.30 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 standard(s) 2 and 5 No service user would be admitted to the home before a full professional assessment has been completed and careful consideration has been given as to whether needs identified could be met. Contractual agreements are in place but need some clarification. EVIDENCE: All new admissions to the home are referred through care management arrangements. Staff confirmed that a care management assessment and care plan are completed before admission and a copies of these were seen on files viewed. There is also a pre-admission assessment, which is completed by staff at the home. This considers all aspects of health care, as well as the social, emotional and physical needs of any potential service user. Through discussion it was evident that compatibility with others in the home would be of prime consideration. Knightstone Housing Association has issued each service user with a licence agreement. Copies of these were seen. Staff said that they are in the process of contacting service users next of kin so that they can sign them on behalf of their relative, if in agreement. Written statements of terms and conditions were also seen on file. These have been issued by Communiity Integrated Care. (CIC) They had been signed by a representative of CIC and by a representative of each service user. It has previously been noted that these contracts do not contain accurate information about benefit entitlement, in 17a Linda Grove H54 S11715 Linda Grove v224249 240505.doc Version 1.30 Page 9 particular the Disability Living Allowance mobility component. The amounts payable by each service user towards costs are therefore unclear. 17a Linda Grove H54 S11715 Linda Grove v224249 240505.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 and 9 The care planning process helps to put the service user at the centre of service delivery by the care home. Systems are in place to help service users to take responsible risks. EVIDENCE: There was evidence on file that care management assessments have been reviewed and updated in October 2004. Care needs are also reviewed through a system of person centred planning. This system has recently been changed and staff intend to implement a slightly different system of person centred planning. A sample set of documents were seen which when complete will contain detailed information about preferred daily routines. Information about communication needs are also included. Staff said that it is the intention that these will be reviewed once a month with the service user in consultation with important people in their lives. The plan is devised in pictorial form and has simple printed English alongside. A number of risk assessments were seen on file. These identify particular risks and give staff guidance as to how these may be minimised. These have been reviewed at least once a year. Staff sign to confirm that they have read and understood them. It was discussed and agreed that an assessment would be 17a Linda Grove H54 S11715 Linda Grove v224249 240505.doc Version 1.30 Page 11 completed where a risk has been identified regarding staff helping a service user in a wheelchair over a gravel surface. 17a Linda Grove H54 S11715 Linda Grove v224249 240505.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) 12 14 15 and 16 Daytime activities offered are appropriate and meet individual needs. Family members are encouraged to visit and to be involved in the lives of their relatives. Service users rights are respected. EVIDENCE: One younger service user takes part in day services five days a week. This offers her activities tailored to meet her needs and is a continuation of the daytime activities she engaged in prior to entering the home. The two older service users are offered activities at a more gentle place. These include swimming, visiting shops and cafes and going to the theatre. Staff said that these had been identified as appropriate during the care planning process. There was evidence that staff evaluate how successful these have been to ascertain whether service users have benefited from these outings. Service user bedrooms contain tv and video equipment. Staff confirmed that service users have at least one holiday a year. This year one service user is going on an activity holiday to the Isle of Wight, one is going to the New Forest and one is going to a holiday park. 17a Linda Grove H54 S11715 Linda Grove v224249 240505.doc Version 1.30 Page 13 A notice on display at the home welcomes visitors on behalf of service users. Family and friends are encouraged to be involved in daily routines and life in the home. One relative for example has become involved in redesigning the garden area. Staff confirmed that service users can see visitors in private, if this is their wish. All bedroom doors are lockable and keys are available. Staff said that current service users are unable to use keys and staff also need to open and respond to and correspondence on their behalf. It was noted at a previous inspection that this is documented as part of the care planning process. It was observed that service users preferred form of address is used and that this is recorded on file. Staff were observed to talk to and interact with service users and not exclusively with each other.Service users have unrestricted access to all of the communal areas in the home. 17a Linda Grove H54 S11715 Linda Grove v224249 240505.doc Version 1.30 Page 14 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) 18 and 19 Staff are sensitive and considerate in offering personal support. Staff liaise with health care professionals to ensure that health care needs are addressed promptly. EVIDENCE: Service users were seen to have moving and handling assessments. Personal support is provided in private. Times for daily routines, for example, getting up were found to be flexible to suit individual preference. Technical aids and equipment to maximise independence were seen throughout the home, for example a parker bath, rails and raised toilet seats. Through discussion it was evident that service users receive additional specialist support and advice as needed, for example one service user has been provided with a specialist wheelchair. Staff said that they are waiting for an occupational therapist to advise on how the chair can be adjusted to ensure comfort. Records reflected that service users have access to relevant health care professionals. All service users are registered with a local GP practice. Staff describe health care support as excellent. Staff demonstrated that they are aware of any potential complications in service users health, for example in a change in drug regime, by ensuring that service users are promptly referred to health specialists who can offer advice and support. There was also evidence that staff consider any 17a Linda Grove H54 S11715 Linda Grove v224249 240505.doc Version 1.30 Page 15 information issued by the Medical Device Agency and take remedial action if necessary. 17a Linda Grove H54 S11715 Linda Grove v224249 240505.doc Version 1.30 Page 16 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 and 23 Procedures are in place to help to protect service users and to ensure that views about the home are listened and responded to. EVIDENCE: There is a complaints procedure. Staff agreed that this would be slightly amended so that it includes the information that any complaint would be responded to within twenty eight days. There have been no complaints received about this service either by staff at the home or by The Commission for Social Care Inspection. The home has an adult protection procedure including a whistle blowing procedure. Senior staff said that all staff are offered training in the protection of vulnerable adults and all but two current staff have attended this course. Staff are also going to be offered training in crisis prevention and intervention, which provides guidance on how to manage challenging behaviours. Staff confirmed that where Community Integrated Care acts as appointee on behalf of a service user, individual financial statements are produced. These detail any interest accrued. These records have been seen during previous inspections. 17a Linda Grove H54 S11715 Linda Grove v224249 240505.doc Version 1.30 Page 17 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 and 30 The home provides a very comfortable clean and suitable environment for current service users. EVIDENCE: The home meets individual and communal spatial requirements. It is safe, comfortable bright and airy and was clean throughout on the day of inspection. Furnishings and fittings were observed to be of good quality and there is evidence that repair and maintenance is carried out, for example the carpet in the hallway has been replaced and a new dining set has been purchased since the last inspection. Laundry facilities are sited separate to areas where food is prepared. The laundry flooring is impermeable and the walls are readily cleanable. The home has a washing machine with a sluice facility. Cleaning materials are stored securely and COSHH procedures are in place and are regularly updated. Handwashing facilities are prominently sited and staff confirmed that they have access to gloves and aprons to prevent the spread of infection. 17a Linda Grove H54 S11715 Linda Grove v224249 240505.doc Version 1.30 Page 18 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 and 35 Staff are competent and qualified to care for current service users. Staffing ratios meet need. Recruitment procedures are thorough. EVIDENCE: It was observed that staff on duty at the time of the visit were approachable and that they were comfortable with service users. Through discussion they demonstrated that they were interested in their jobs and that they were motivated to provide a good service. There are two staff members who are studying for their NVQ level 3 in care and two staff who have already achieved this. Two others are studying for their NVQ level2. The rota was examined. It showed that a minimum of two staff are on duty at any time during the day and that there is an additional staff member on duty in the middle of the day. There is no significant difference in staffing rations at the weekend. There is one waking night staff on duty each night and one staff member sleeps in. Staff said that Linda Grove is fully staffed and there is no need to use agency staff. Staff confirmed that staff meetings are held. Staff described morale as good. One staff file was viewed. This contained an application form, two written references, evidence of identity and evidence that a satisfactory CRB check 17a Linda Grove H54 S11715 Linda Grove v224249 240505.doc Version 1.30 Page 19 had been undertaken. Staff asked confirmed that they had received a statement of terms and conditions of employment. Staff describe training opportunities as excellent and said that they were offered appropriate training to enable them to carry out their job effectively. Records of training showed that all staff are offered training in first aid, basic food hygiene, fire safety,and moving and handling. As discussed in other sections all staff are also given training in adult protection issues and in Crisis prevention and Intervention (CPI) Records and discussions indicated that new staff receive a structured induction programme. 17a Linda Grove H54 S11715 Linda Grove v224249 240505.doc Version 1.30 Page 20 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 and 39 The home is well run and quality of the care provided is regularly reviewed. EVIDENCE: There is an acting manager in post who demonstrated during the inspection that she has a good understanding of her role and responsibilities. The registered manager is due to return to work within the next two weeks. Staff said that CIC have very recently completed an audit of the service. Staff at Linda Grove have not yet received written feedback of the findings. Staff discussed how they envisage that the new system of person centred planning would help to inform future planning. The service is visited once a month by a senior manager who performs an internal audit. One such visit was to take place on the day of inspection. 17a Linda Grove H54 S11715 Linda Grove v224249 240505.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x 2 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 x 3 3 3 x Standard No 31 32 33 34 35 36 Score x 3 3 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 17a Linda Grove Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x x x H54 S11715 Linda Grove v224249 240505.doc Version 1.30 Page 22 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 17a Linda Grove H54 S11715 Linda Grove v224249 240505.doc Version 1.30 Page 23 Commission for Social Care Inspection 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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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