CARE HOME ADULTS 18-65
347 Old Laira Road 347 Old Laira Road Laira Plymouth Devon PL3 6DH Lead Inspector
Antonia Reynolds Announced Inspection 5th January 2006 10:00 347 Old Laira Road DS0000050032.V262527.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 347 Old Laira Road DS0000050032.V262527.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 347 Old Laira Road DS0000050032.V262527.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service 347 Old Laira Road Address 347 Old Laira Road Laira Plymouth Devon PL3 6DH 01752 310531 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) Michael Batt Foundation (Valued Life Projects) Mrs Beverley Anne Nichols Care Home 2 Category(ies) of Learning disability (2) registration, with number of places 347 Old Laira Road DS0000050032.V262527.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Ms Nichols is to complete NVQ4 / RMA by December 2006 Date of last inspection 23rd September 2005 Brief Description of the Service: Old Laira Road is a care home providing personal care and accommodation for two people, aged 18 - 65, with learning disabilities. It is owned by the Michael Batt Foundation (Valued Life Projects) which is a not for profit organisation providing services for people with a range of needs who require support and care to live in the community. The home was purchased by the present owners in October 2003 and is a mid-terraced, two storey property located in the residential area of Laira in Plymouth. It is close to local services and facilities. All the homes bedrooms are single and are on the 1st floor. None of these have wash hand basins or en suite facilities. There is a bathroom on the 1st floor and a separate toilet on the ground floor. There are separate lounge and dining rooms on the ground floor as well as a kitchen and conservatory/laundry. There are small gardens at the front and back of the property. The front of the property is accessed via a flight of steps, as is the back garden. Unlimited on street parking is available in the vicinity. 347 Old Laira Road DS0000050032.V262527.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This announced inspection took place between 10.00am and 12 noon. The Registered Manager, Bev Nichols, was present throughout and the Team Leader, Jason Bardell, was also present for some of the time. A tour of the premises took place and records relating to care, staff and the home were inspected. The only service user living in the home at the time of inspection was not available but had completed a comments card expressing satisfaction with the care provided. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 347 Old Laira Road DS0000050032.V262527.R01.S.doc Version 5.1 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 347 Old Laira Road DS0000050032.V262527.R01.S.doc Version 5.1 Page 7 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 4 The home’s pre-admission processes ensure that prospective service users are provided with information about the home and have opportunities to visit the home to meet other service users and staff, and decide whether they would like to live there. EVIDENCE: No new service users have been admitted to the home since the last inspection. However the organisation’s processes ensure that any prospective service users are assessed prior to admission and a detailed assessment tool has been devised. Introductory visits are arranged for prospective and existing service users to meet each other and become familiar with the home prior to admission. General information is provided in the booklet “Information for people” provided by the Michael Batt Foundation. Individual records are kept for each of the service users and these contained assessments, care plans and risk assessments, all of which had been recently reviewed. Ongoing evaluation is recorded daily. 347 Old Laira Road DS0000050032.V262527.R01.S.doc Version 5.1 Page 8 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 Service users are enabled to participate in, and make decisions about, all aspects of their lives. EVIDENCE: Each service user has a care plan and risk assessments that are regularly reviewed. The organisation has introduced a user friendly system for planning care and finding out the wishes and aspirations of service users. The staff are fully aware of the needs of each service user. All the routines and activities are centred around service users’ needs and choices. Service users participate in the day to day running of the home, including domestic activities and tasks, and staff assist where necessary. Staff support service users to make decisions about their lifestyle, activities and movements both inside and outside the home. The Registered Manager, as well as documentation, confirmed that individuals are encouraged to administer their own finances, with staff support if necessary. 347 Old Laira Road DS0000050032.V262527.R01.S.doc Version 5.1 Page 9 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15 and 16 Service users can learn life skills, attend work placements, participate in any community and leisure activities and choose their own daily routines. EVIDENCE: Discussion with the Registered Manager, as well as documentation, showed that service users are enabled to live as full a life as they wish to and have opportunities for personal development, risk taking and decision making. The ethos of the home is based on promoting opportunities to broaden experiences, support service users to develop socially and emotionally and to understand responsible risk taking. Service users are encouraged to participate in all the domestic activities in the home and to take part in leisure activities of their choice. Service users are supported to obtain and keep paid or voluntary employment, and participate in educational opportunities, in the local community. The home does not provide transport as service users are encouraged to use public transport wherever possible. Contact with relatives and friends is encouraged and promoted. Privacy is respected, bathroom and bedroom doors have locks and service users have keys to their own bedrooms and the front door.
347 Old Laira Road DS0000050032.V262527.R01.S.doc Version 5.1 Page 10 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 19 Service users receive support in the way, and at the time, that they want and need. Health care needs are addressed as soon as they are identified. EVIDENCE: Service user plans provide information about personal, emotional and health care needs. Information contained within service users’ files, as well as discussion with the Registered Manager confirmed that external professional advice and guidance is sought when necessary from local health care professionals or social services. 347 Old Laira Road DS0000050032.V262527.R01.S.doc Version 5.1 Page 11 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Service users are protected from abuse, neglect and self-harm. Service users can be confident that the Registered Provider always deals with complaints seriously and any concerns from service users are listened to and acted upon immediately. EVIDENCE: Neither the home nor the Commission for Social Care Inspection have received any complaints regarding the service since the last inspection. The home has a complaints procedure and service users are aware of how to use this. Regular house meetings are held where any issues can be raised and dealt with immediately, although it was also clear from discussion that service users can raise any issue at any time. The Registered Manager was knowledgeable about adult protection issues, the effects of discrimination and the rights of individuals to be treated respectfully in a non-judgemental way. All staff are expected to attend in-house training regarding the protection of vulnerable adults. 347 Old Laira Road DS0000050032.V262527.R01.S.doc Version 5.1 Page 12 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28 and 30 The standard of the environment and décor within this home is good, providing service users with an attractive and homely place to live. EVIDENCE: The home is spacious, comfortable, safe, clean and well maintained, providing a warm and welcoming environment that is homely and comfortable for the service users. Each service user has a single bedroom on the 1st floor, none of which have en suite facilities or wash hand basins. Bedrooms are individually and attractively furnished and contain many personal possessions. The Registered Manager confirmed that service users choose the décor and furnishings for their bedrooms. Bedroom doors are fitted with appropriate locks and service users are provided with keys, subject to risk assessment. The Registered Manager confirmed that the spare bedroom will be refurbished, to include at least two double electrical sockets, before a new service user moves in. Bathroom and toilet facilities are adequate for two service users. The home has a bathroom on the 1st floor consisting of a bath with an over bath shower, toilet and wash hand basin. Hot water is not regulated but the service user living in the home is able to modify the shower water temperature if required. There is also a separate toilet on the ground floor off the conservatory. The bathroom and toilet doors are fitted with locks that afford sufficient privacy but staff can gain access in an emergency.
347 Old Laira Road DS0000050032.V262527.R01.S.doc Version 5.1 Page 13 There are shared rooms on the ground floor consisting of a kitchen, dining room, lounge room and conservatory/laundry. All the communal rooms are attractive and homely, well furnished and clean. There is an office on the 1st floor that is also used as a sleeping in room for staff. The home has a ‘no smoking’ policy. Laundry facilities are in the conservatory at the back of the house and service users do their own laundry. Although laundry is carried through the kitchen en route to the washing machine, it is contained in laundry baskets with lids. There were no concerns at this inspection about the risk of any cross infection, based on the needs of the service user living in the home. There are small terraced gardens at the front and back of the house. There is a place to sit at the back of the house, as well as a garage, which is used for storage. 347 Old Laira Road DS0000050032.V262527.R01.S.doc Version 5.1 Page 14 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 and 36 Recruitment procedures are robust and service users benefit from a consistent, well supported and supervised staff team. EVIDENCE: The Registered Manager confirmed that there is a small staff team who have worked at the home for several years. Staff files inspected contained all the required information. There is usually one staff member on duty when service users are at home, with one staff member sleeping in at night. It has been agreed, with the Commission for Social Care Inspection and Social Services, that the service user presently living in the home does not require staff to be present in the home at all times as part of moving towards more independent living. Discussion with the Registered Manager, as well as documentation, confirmed that staff meetings and individual supervision sessions are held regularly. The organisation operates an ‘on call’ system, where members of the management team are available both in and out of office hours. Service users are encouraged to carry out all the domestic and household tasks, with staff support where necessary. The organisation has a designated staff member to coordinate and arrange training and pre-inspection documentation confirmed that staff were expected to attend a variety of training relevant to their roles. The organisation does not tend to enrol staff on National Vocational Qualifications but have devised their own training, in consultation with the local College of Further Education, as this reflects the needs of the service users they support.
347 Old Laira Road DS0000050032.V262527.R01.S.doc Version 5.1 Page 15 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 and 42 The management approach is open, inclusive and positive, providing clear leadership and guidance. Empowerment and enablement of service users is the focus of the organisation. Service users’ rights, health, safety and welfare are protected and promoted. EVIDENCE: The Registered Manager has been managing the home since December 2003 and is competent and experienced. She is in the process of completing a level 4 National Vocational Qualification and the Registered Manager’s Award. Lines of accountability are clear and the organisation has a management structure that enables it to cover absences when required, and provide an effective ‘on call’ system to support staff. Monthly provider visit reports are being carried out and copies of the reports sent to the Commission for Social Care Inspection. Health and safety checks, including fire equipment, gas safety and portable electrical appliances are carried out regularly. Fire safety training is carried out during supervision and service users have also received training in what to do in the event of a fire. The Registered Manager confirmed that all staff complete training in emergency first aid, health and safety and food
347 Old Laira Road DS0000050032.V262527.R01.S.doc Version 5.1 Page 16 hygiene. The use of hot water has been risk assessed and the organisation does not consider that thermostatically controlled valves, to regulate the temperature, need to be installed. The organisation has devised a quality assurance system, which includes consultation with service users. 347 Old Laira Road DS0000050032.V262527.R01.S.doc Version 5.1 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 4 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 N/A 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 3 3 3 X X 3 X 347 Old Laira Road DS0000050032.V262527.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 347 Old Laira Road DS0000050032.V262527.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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