Inspection on 12/02/09 for 2 Lloyd Road

This inspection was carried out on 12th February 2009.

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

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

Other inspections for this house

2 Lloyd Road 16/01/07

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 2 Lloyd Road 2 Lloyd Road Taverham Norwich Norfolk NR8 6LB The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lella Hudson Date: 1 2 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 32 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: 2 Lloyd Road 2 Lloyd Road Taverham Norwich Norfolk NR8 6LB 01603869469 01603869713 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): New Boundaries Community Services Ltd Name of registered manager (if applicable) Ms Sally Cumbers Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 3 0 care home 3 learning disability Additional conditions: The registered person may provide the following category/ies of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD The maximum number of service users who can be accommodated is: 3 Date of last inspection A bit about the care home 2 Lloyd Road is a three bedroomed bungalow in Taverham providing care to three people with learning disabilities. Care Homes for Adults (18-65 years) Page 4 of 32 The Home is located approximately five miles outside the city of Norwich. It is situated in a quiet residential area not far from the main road providing access to the city. There is access to local facilities including shops and pubs. The Home has a garden at the rear and parking to the front of the Home. Each of the bedrooms is single and there is a shared kitchen, bathroom and lounge/dining room. Care Homes for Adults (18-65 years) Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 32 How we did our inspection: This is what the inspector did when they were at the care home This report contains information that we have gathered about the Home since the last Inspection (January 2007). It contains information gathered during a meeting with the Manager on 22nd January 2009 and an unannounced visit to the Home that we carried out on 12th February 2009. During the visit to the Home we spoke to staff and to residents, we looked at some records and were shown around the Home. Care Homes for Adults (18-65 years) Page 7 of 32 What the care home does well The Home is well managed by an experienced Manager who manages in a positive and enthusiastic way. The Home is managed in a way which puts the needs of the residents first. The views of the residents are sought in a variety of ways and residents feel that they are listened to. The residents receive appetising meals and their dietary needs are met. Care Homes for Adults (18-65 years) Page 8 of 32 The residents are encouraged to take part in a range of activities. The care plans contain good information about the residents needs and the way in which they would like these to be met. Staff receive ongoing training and support to carry out their roles effectively. Care Homes for Adults (18-65 years) Page 9 of 32 What has got better from the last inspection The staffing levels have improved since the last Inspection and this means that residents are supported to take part in a wider range of meaningful activities. Residents are also able to spend time at Care Homes for Adults (18-65 years) Page 10 of 32 home if they wish to rather than having to go out in a group. What the care home could do better There is a need for some improvements to the accommodation. One of the residents can no longer easily Care Homes for Adults (18-65 years) Page 11 of 32 use the bathroom and so there is a need for work to be carried out to enable the resident to continue to live at the Home. There is a lot of rubbish lying around the side of the bungalow and in the garage which needs to be moved. If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 12 of 32 If you want to speak to the inspector please contact Lella Hudson CSCI CPC1 Capital Park Fulbourn Cambridge CB21 5EX If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 13 of 32 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 14 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . There is an appropriate admissions procedure in place. Evidence: There have been no new admissions to the Home in the last few years. However, the organisation has appropriate procedures relating to the admission of prospective residents. Care Homes for Adults (18-65 years) Page 15 of 32 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The care plans contain detailed guidance for staff about how to meet the residents needs. Risks are recognised and assessed, with guidance about how to manage them within the care plans. The residents are encouraged to make their own decisions as far as is possible. Evidence: One of the residents gave us permission to look at their care plans. They said that they had been involved in reviewing this recently and are aware of what it contains. They said that they know what risk assessments are in the care plan. The care plans have recently been changed into a different format which intends to be more person centred. The care plan that we saw contains detailed information about the residents needs and the way in which the resident likes to have their care provided. There is evidence of regular reviews of the care plans and risk assessments. There is also a financial care plan. Discussions with staff show that the staff have a good understanding of the needs of Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: the residents and that this is consistent with the care described within the care plans. The team leader said that she intends to prepare a quick reference guide for new or agency staff so that they can quickly have an idea about the care each resident needs prior to reading the whole care plan. Currently only the Manager has access to a computer and so the care plans are either handwritten or the Manager has to update them. One of the residents told us that the staff always discuss issues with them about their care and any issues that affect the running of the Home. They said that they feel that they are very involved in all that goes on in the Home. Discussions with staff show that they understand the importance of gaining the views of the residents about the way in which they live their life. Care Homes for Adults (18-65 years) Page 17 of 32 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The residents are supported to take part in a range of activities. Residents dietary needs are met and they enjoy their meals. Evidence: The Manager had notified us last year that the staffing levels at the Home had increased so that on some evenings during the week there are two staff on duty and there are now two staff on duty for most of the day at weekends. Discussions with residents and staff show that this has had a very positive effect on the residents lives as they are now able to be supported to take part in a far wider range of activities. It also means that if a resident chooses to stay at home they are able to do so whilst others go out. One of the residents told us about the activities that they take part in which includes shopping, pub, holidays, art and craft group, college, cooking group as well as meeting with friends on a regular basis. They also said that they are able to have visitors and Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: that staff provide support so that they are able to meet up with friends away from the Home. Since the last Inspection the activities that the residents take part in have been reviewed and there is less attendance at formal day services and more planning of individual activities that the resident is interested in and enjoys. The Home has a car and the staff also liase with other Homes within the organisation to share vehicles if necessary. The residents have television and dvd players in their rooms if they wish to have them. One of the residents said that they cannot get a very good reception in their bedroom as the aerial is not good enough. The menus are planned weekly and they are planned with the dietary needs of the residents in mind. The meal that was provided during our visit looked and smelled appetising and the residents said that they enjoy their meals. Since the last Inspection there has been a change to the way in which food shopping is done. Now the residents are more involved and instead of using the cash and carry shop they use the local supermarkets to do the shopping on a weekly basis. Care Homes for Adults (18-65 years) Page 19 of 32 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The personal and healthcare needs of the majority of the residents are met. Medication is managed in a safe way. Evidence: One of the residents told us that the staff are kind and that they are very helpful. They said that staff explain things well and that they involve the residents in making decisions. The care plans contain detailed information about how the residents like to receive care. The care plans also contain information about the physical and emotional health needs of the residents. There is evidence that residents are supported to attend regular appointments with healthcare professionals such as dentist, opticians, GP etc. One of the residents has recently had an assessment by the Occupational Therapist due to changing needs in their mobility. They now have equipment to aid them with their mobility. A ramp has also been fitted to the front of the bungalow to aid their mobility. However, the resident has started to find it difficult to use the bath and the Manager has made a referal for an assessment with regard to this. We looked at the medication system in use at the Home. Medication is stored appropriately and records of medication received at the Home and that which is Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: administered are kept. Regular audits of medication are carried out. Guidance is in place for the use of PRN (as required) medication. Care Homes for Adults (18-65 years) Page 21 of 32 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The residents feel confident in raising concerns. Complaints are taken seriously. Procedures and training are in place to protect the residents from abuse. Evidence: One of the residents told us that they feel confident in raising issues with the staff and that staff take action to address any concerns. One of the residents would have more difficulty in raising a concern due to their communication difficulties but staff described how they would recognise if the resident was not happy about something due to non verbal cues. The Commission has not received any complaints about the Home and there have been no Safeguarding referrals since the last Inspection. The Manager said that she has not received any complaints. The Home has a complaints procedure. The staff receive training with regard to the Safeguarding of Vulnerable Adults and the staff who spoke to us were clear about the procedure for raising a concern. They said that they were confident that the Manager would deal with concerns and allegations appropriately. Care Homes for Adults (18-65 years) Page 22 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The accommodation does not currently meet the needs of all of the residents. There are areas of the Home in need of maintenance and redecoration. Evidence: We were shown around the Home and one of the residents agreed to show us their bedroom. Some areas of the Home have been redecorated but this has not been finished as the maintenance staff were asked to do work at another Home within the organisation. Improvements have been made to the kitchen as there are new cupboards and a new cooker. The residents are encouraged to personalise their rooms and the communal areas of the Home. However, there are some areas in need of improvement in and around the Home. There is a broken electrical socket behind the cooker which has been taped over. There is no light in the pantry. We looked in the garage and there is a lot of rubbish there and down the side of the bungalow. There is also a broken window in the garage which has not been appropriately covered. As already mentioned in this report, the bathroom no longer meets the needs of one of the residents due to their decreasing mobility. The Home does not have a seperate Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: sleep in room and so there is a bed in the lounge which the staff use when they sleep in. Care Homes for Adults (18-65 years) Page 24 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Staffing is adequate to meet the needs of the residents. Staff receive training and support to enable them to carry out their roles effectively. Appropriate recruitment procedures are followed. Evidence: Staffing levels have been increased since the last Inspection and this has had a positive effect on the residents lives. The Home has a core team of permanent staff and then use agency staff when needed. The team leader said that they use regular agency staff who know the residents. One of the residents told us that the staff are kind and that they involve the residents in decisions about the Home. We observed staff communicating well and positively with the residents. Discussions with staff show that they know the residents well and have a good understanding of how to meet their needs. Staff said that they receive regular supervision from either the Manager or the team leader and that they receive regular training. Training is provided both by the in house trainer and through external training companies. The team leader has completed NVQ Level 3 and intends to do further management training. We looked at two of the staff files and these include all of the necessary checks on Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: staff prior to them starting work at the Home. Care Homes for Adults (18-65 years) Page 26 of 32 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The Home is well managed, in a way which puts the needs of the residents first. The views of the residents are sought on a regular basis. In general, the health and safety needs of the residents are met. Evidence: The Manager of the Home also manages two other Homes in the organisation. The day to day running of the Home is carried out by the team leader who said that the Manager regularly comes to the Home. The Manager has worked for the organisation for many years and knows the residents well. An on call system is in place for out of hours support for the staff team. The views of the residents are sought on a daily basis about the running of their Home and of issues which affect them. The organisation sends out surveys to relatives on an annual basis to gather their views about the service provided. The Home has smoke detectors and emergency lighting and we saw the records of regular checks that are carried out on these. A fire risk assessment has recently been carried out at the Home. The areas in need of improvement with regard to health and Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: safety are in relation to the rubbish that is lying around and to the broken socket in the kitchen. Care Homes for Adults (18-65 years) Page 28 of 32 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 29 of 32 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 19 23 It is required that the 30/04/2009 bathroom is suitable to meet the needs of all of the residents To ensure that all residents can safely access the bathroom 2 24 22 It is required that the rubbish is removed from around the bungalow and in the garage and that the window is mended properly. 31/03/2009 To ensure the safety of residents and staff 3 24 22 It is required that the broken 20/03/2009 socket in the kitchen is mended To ensure the safety of residents and staff Care Homes for Adults (18-65 years) Page 30 of 32 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 3 7 8 14 It is recommended that the Home has access to a computer to make it easier to update care plans and risk assessments It is recommended that a risk assessment is completed for the resident who smokes. It is recommended that the television aerials are improved so that residents are able to watch television clearly in their bedrooms Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 32 of 32 - 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!