Inspection on 30/10/07 for 17a Linda Grove

This inspection was carried out on 30th October 2007.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

17a Linda Grove 12/12/05

17a Linda Grove 24/05/05

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 Cowplain Hampshire PO8 8UX Lead Inspector Ian Craig Unannounced Inspection 30th October 2007 2:15pm 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 17a Linda Grove Address Cowplain Hampshire PO8 8UX 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) 023 9226 2356 www.c-i-c.co.uk. Community Integrated Care Mrs Pamela Joyce Wakelin Care Home 4 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (4) of places 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. All service users admitted from 11th June 2003 must be between 35 and 65 years of age. 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. 1st December 2006 Date of last inspection Brief Description of the Service: 17a Linda Grove is a purpose built bungalow. Knightstone Housing provides the accommodation. Community Integrated Care manage 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 a bathroom, toilet, dining and lounge areas. There is an enclosed rear garden which is accessible to service users in wheelchairs. The home’s weekly fees are £1,116.08. 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection consisted of a tour of the premises, examination of records, documents and policies and procedures. This included residents’ care records. Discussions took place with the manager. Staff were observed with the residents. Survey forms were sent to social services’ care managers, residents, residents’ relatives and to the home’s staff. Eleven survey forms were returned and information contained in these has been used for this report. The home also completed and returned an Annual Quality Assurance Assessment, which has also been used for this report. What the service does well: Staff confirmed that there is an induction programme for newly appointed staff and that there are a variety of training courses for staff to attend. This includes training in dealing with challenging behaviour and adult protection procedures. Each staff member is subject to recruitment checks prior to commencing work. This ensures the service protects residents during the staff recruitment stage. Staff describe the home’s management as supportive and approachable. A care manager made the following comments about the home: • The staff are well trained and are able to give correct information when asked. • The staff team support the service users and their families over and above expectations. • The service offers a consistent staff team. The staff team communicate well together so that there is a good and clear understanding of information. • I cannot suggest any areas where improvements can be made as I feel that this service meets the needs of the service users as a person centred approach is used. Future admissions to the home are carefully planed to ensure that any new resident’s needs can be met. 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 6 Care plans are generally comprehensive although it was noted that a review was not accurately completed. Care records show that each resident has a choice in how they spend their time. There is evidence that each resident attends a variety of social, leisure and occupational activities. The home has its own vehicle with a tail lift for residents with mobility needs. The environment was found to be clean, homely and well maintained with the exception of signs of wear and tear on kitchen units. The building is single storey with ramped access for those with mobility needs. Measures are taken to safeguard staff and residents’ health and safety. What has improved since the last inspection? What they could do better: Greater attention is needed when reviewing each person’s needs especially medication care plans. In one instance the service user’s medication had been changed but the care plan had not been updated even though a record had been entered to show it had been reviewed. The home needs to ensure that there are sufficient numbers of staff on duty at weekends so that residents can go out. The service is already addressing this. 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 7 Arrangements need to be made so that resident’s finances held by the organisation in bank accounts accrue interest to the individual person. The service is also addressing this. 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. The summary of this inspection report can be made available in other formats on request. 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Potential resident’s needs are thoroughly assessed before an agreement is reached whether the home can meet the person’s needs. This involves liaison with social services and opportunities for any service user to visit the home. EVIDENCE: Records and discussion with the manager show that when a service user is referred to the home for possible admission that a thorough assessment takes place before agreement is reached that the person’s needs can be met by the home. The home’s own pre admission assessment consists of a member of staff meeting the person and completing an a comprehensive pro forma which includes the following: • What is the client like? • Likes/dislikes • Challenging behaviour • Day time activities • Medication 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 10 • • • • • • • • • • • Free time Self help Sleeping habits Health Hearing Dexterity Continence Mobility Communication Sight Transport Potential residents and their relatives have an opportunity to come and look around the home and to spend time there. The home also attends multi agency planning meetings regarding potential resident’s needs. Residents are provided with information about the service, which is contained in each person’s personal file. 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans and risk assessments are generally of a good standard although procedures for dealing with emergency medication had not been accurately updated to reflect current needs. Residents are able to exercise choice in their daily lives and are involved in decision making in the home. EVIDENCE: Care plans were examined for each of the residents accommodated at the home. These are completed in detail and include guidance for staff to follow in delivering personal care and in supporting with social and leisure needs. 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 12 Resident’s choice and individuality are reflected in the care plans. Assessments and care plans are subdivided into the following needs: • Medical history • Personal hygiene, including nail care, hair care, teeth care, shaving and other hygiene areas • Going to the toilet • Dressing • Eating • Health • Posture and movement • Maintaining safety in the home, including road safety • Working and recreation • Social relationships • Sexuality • Sleeping • Independent travel • Education skills • Basic skills • Cooking • Community facilities Risk assessments are carried out and recorded for various activities for individuals such as road safety and use of equipment. The previous report required that resident’s individual care plans are reviewed. Records show that this has taken place but it was noted that a change in a resident’s medication meaning that staff no longer had to follow specific recorded guidelines had not been updated, even though a record had been made to say the medication needs had been reviewed. The home is introducing a person centred planning approach to recording care plans, which includes the use of pictorial diagrams. These show that residents attend activities of their choice. A social services care manager commented on how the home follows a person centred approach. Residents involve themselves in daily household activities. One resident was observed helping a member of staff wash the home’s mini bus. Each person’s likes and dislikes are recorded. Records show that residents are able to choose the food they like to eat. When redecoration takes place the residents are involved in choosing the colour schemes and the furniture. A staff member commented that residents have a choice in the activities they attend, where they like to go out in the community and when they go to bed. 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from being able to develop independent living skills and having access to a variety of social, leisure and occupational activities. EVIDENCE: Daily running records are maintained for each resident. These are detailed and show that each person has a varied and full lifestyle. For one person, records for the calendar month of October 2007 showed participation in daily activities both outside and inside the home. These include regular attendance at a day centre, pub lunches, shopping trips, visits to the hairdresser, meetings with family members, walks, drives, golf and household routines. Staff confirmed that residents have a “fulfilling life.” A relative states that there are outings in the evening and at weekends and that residents attend day services. 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 14 On 3 days, however, a record had been made to say that there are “no activities 2 staff on.” This was discussed with the manager. Three staff are needed on duty at a given time so that residents can go out at weekends. The rota for October 2007 showed that for 16 staff shifts at weekends that on only 2 occasions 3 staff had been on duty. One survey form from a resident stated that there are not enough staff to go out. The problem has been addressed for the month of November with 3 staff at weekends so that residents can be taken out. This will be monitored at a future inspection. None of the residents has had a holiday this year and the manager identified that this is an area that needs to be improved. A record of the food consumed by each resident for each meal is maintained, demonstrating that residents have an individual choice in what they eat. Residents also contribute to the menu planning. Fresh fruit is provided. 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 18 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health and personal care needs are met. EVIDENCE: Daily running records show residents having appointments with general practitioners, dentists and other health care professionals. Contact with health care professionals are also recorded in care plans to show that these needs are monitored. Care plans and daily running records also show that each resident’s personal care needs are met. Guidelines are in place for staff to follow for providing and supporting individuals with personal hygiene, dressing and hair care. Procedures for administering medication were looked at. Medication administration recording sheets show that staff record a signature each time 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 16 they administer medication to a resident. The home carries out regular audits of medication stocks for safety reasons. Staff receive training in medication procedures from the organisation. The Individual Needs and Choices section of this report refers to the care plan for medication ‘as required’ not being revised. 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home acts upon any complaints made and listens to the views of the residents. Steps are taken to protect residents from any possible abuse. EVIDENCE: The home has a complaints procedure, which the home intends to make available in a pictorial format for easier understanding. Two complaints have been made in the last 12 months, both of which have been resolved according to the manager. A record of the complaints and the outcome of the home’s investigation are not maintained at the home but held at the organisation’s head office. The recommendation in the last report for a record of complaints to be held at the home is repeated. Staff receive training in adult protection procedures. The home has copies of adult protection procedures as well as guidance for staff on Mental Capacity Act legislation regarding decisions being made on behalf of residents. Training is also provided for staff in dealing with challenging behaviour. 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 18 Residents’ monies are held by the organisation’s head office. No record is available of these amounts for each person. It is uncertain if residents receive any interest payments on the amounts they have deposited. The home completes a request form for money to be sent to the home from the head office for individual residents. Records of these amounts and of any money spent are maintained. It was understood that the home is looking at opening local bank accounts in the name of individual residents. This will allow residents to receive any interest payable on their savings or deposit accounts. 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well-maintained, clean and homely environment that has been adapted to meet their needs. EVIDENCE: The home is a single storey building with ramps for those with mobility needs. Adaptations have also been made to other parts of the home such as the installation of a hoist and specialist bathing facilities. There is a garden with a patio area, which includes tables and chairs for residents to use. 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 20 Bedrooms are well maintained and have been personalised by the residents with televisions, ornaments, pictures, music listening equipment and other items related to hobbies and interests. Communal areas are comfortable. Residents were observed using the lounge and kitchen. It was noted that the kitchen units are showing signs of wear and tear and will need to be renewed in the near future. The home was found to be clean and there is a purpose built laundry for residents’ clothing. 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Opportunities for leisure activities have been limited at weekends due to staff shortages. Residents are supported by a well-trained staff team work and are protected by the home’s recruitment procedures. EVIDENCE: Comment was received from one staff member that the home has been short staffed which has led to a restriction in opportunities for residents to go out. This was confirmed from discussion with the manager and examination of the staff rota. The home needs 3 staff to be able to provide both care and outings for the residents. For 16 staff shifts on weekends in October 2007 this had been achieved on only three occasions. This shortcoming, however, has been addressed by the recruitment of additional staff and the rota for the month of 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 22 November shows 3 staff on duty at weekend. As this has been addressed a requirement has not been made. Night time staffing consists of one ‘waking’ and one ‘sleep in’ staff members. Staff confirmed that they have an induction programme when they commence work, which includes training in first aid, food hygiene, financial procedures, autism, epilepsy, health and safety and fire safety. Two staff referred to the induction being “clear” and “good.” Copies of the individual staff induction programmes were not readily available as they are completed by staff ‘on line.’ Staff also described how they are supported by the management team and that there are good systems for communication within the home. The organisation has a training programme. Four of the nine care staff are trained to NVQ level 2 or above and one person is studying the qualification. Staff confirmed that they have regular supervision, which is also supported by records. A care manager described the staff team as well trained, consistent, knowledgeable, caring and sensitive. Records and feedback from staff show that newly appointed staff undergo a process of interview and checks including criminal record bureau checks and references before they start work. 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed in the best interests of the residents. Residents and staff are protected by the home’s health and safety procedures. EVIDENCE: The manager is qualified at NVQ level 4 and has attained the Registered Manager’s Award. During the inspection the manager showed a commitment to improving the lives of the residents and to running the home effectively. Staff describe the manager as supportive, helpful and approachable. 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 24 The home carries out satisfaction surveys to obtain the views of residents and their relatives about the home. A representative from the organisation completes a monthly audit and a report. The home is still developing its quality assurance system. Progress on the completion of this will be checked at the next inspection. Staff are trained in first aid, moving and handling, food hygiene, and infection control. The home’s management monitor the date that this training takes place so that staff attend ‘refresher’ courses. The home’s appliances and equipment are tested and serviced by suitable qualified persons with the exception of a lack of clarity as to when the electrical circuits were last tested which should be completed every 5 years according to health and safety guidance. Fire safety equipment is tested and serviced in accordance with fire safety regulations. 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 25 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 3 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 26 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15.2(c,d) Requirement The registered manager must ensure care plans describe the support needs for service users and are reviewed regularly with the individual. This is a partial repeat from the inspection of 01/12/06. Timescale for action 30/11/07 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 YA22 Good Practice Recommendations It is recommended the home devise a way of ensuring there is an easy audit trail for the home to monitor complaints. 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 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 © 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 17a Linda Grove DS0000011715.V347567.R01.S.doc Version 5.2 Page 28 - 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!