Inspection on 26/01/07 for 4 Laurel Drive

This inspection was carried out on 26th January 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

4 Laurel Drive 23/11/05

4 Laurel Drive 05/07/05

4 Laurel Drive 24/01/05

4 Laurel Drive 11/08/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 4 Laurel Drive Nailsea North Somerset BS19 2EZ Lead Inspector Paul Grey Unannounced Inspection 26 January 2007 09:30 th 4 Laurel Drive DS0000008085.V327926.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 4 Laurel Drive DS0000008085.V327926.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. 4 Laurel Drive DS0000008085.V327926.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 4 Laurel Drive Address Nailsea North Somerset BS19 2EZ 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) 01275 790073 0117 9699000 www.brandontrust.org The Brandon Trust Mr Norman Birch Care Home 5 Category(ies) of Learning disability (5), Old age, not falling registration, with number within any other category (5) of places 4 Laurel Drive DS0000008085.V327926.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 5 persons aged 35 years and over Date of last inspection 23/11/05 Brief Description of the Service: Laurel Drive is a small residential home for up to five people with Learning Disabilities and some additional support needs such as communication difficulties or autism. Laurel Drive is a moderate sized family house situated in a quiet cul de sac in Nailsea. The home is located near local amenities in Nailsea including shops, places to eat and a leisure centre. Laurel Drive does not offer nursing care. Charges vary depending on the needs of the individual. Typically the home charges in the region of £970 per week. 4 Laurel Drive DS0000008085.V327926.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted over the course of 2 half days. During this time, the Inspector met 5 service users, spoke with 3 staff members, the manager and conducted tour of the premises. The Inspector reviewed documentation including care files, policies and procedures and records of maintenance of the premises. The inspector found a good standard of care, well cared for service users and a positive staff team. Service users appeared happy and involved in all aspects of life at the home. Feedback from one external professional, the staff team, and service user, able to communicate was positive. The inspector issued one requirement, (a broken door), and 2 recommendations regarding the environment. What the service does well: What has improved since the last inspection? What they could do better: At the time of inspection, the Inspector observed no significant shortfalls in the service. One requirement was made regarding a broken door. 4 Laurel Drive DS0000008085.V327926.R01.S.doc Version 5.2 Page 6 2 environmental recommendations were made;0ne regarding the replacement of a worn sofa, the other regarding a central heating control. 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. 4 Laurel Drive DS0000008085.V327926.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection 4 Laurel Drive DS0000008085.V327926.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good Admissions are not made to the home until a full needs assessment has been undertaken. The assessment is conducted professionally and sensitively and involves the individual, and their family or representative, where appropriate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been no recent admissions to the service. The Inspector reviewed the process of assessment, spoke with one service user regarding her admission and reviewed two care files. The Inspector found evidence of a comprehensive assessment of service user s needs. Both care files outlined a comprehensive assessment procedure conducted by an appropriately trained member of staff. Both assessments included reviewing the service users physical and psychological needs in addition to reviewing how the service would be able to meet these. This assessment was then used to write care plans for the 2 service users sampled. One service user told the Inspector that staff had met her before she moved into the premises. The service user told the Inspector that she had been invited to come and meet people living at the home and to tea before she moved in. 4 Laurel Drive DS0000008085.V327926.R01.S.doc Version 5.2 Page 9 4 Laurel Drive DS0000008085.V327926.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good Care plans are developed following person centred planning principles. Each care plan includes a comprehensive risk assessment. The home consulted service users on a regular basis to about their care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Inspector reviewed two care plans, spoke with 3 staff members and two service users. Care plans are based around the assessment of needs conducted prior to admission. The care plans were regularly reviewed and updated according to the needs of the person concerned. The service uses the Brandon Trust, ‘Person Centred Planning’ format. This was focused around planning for an individual’s needs and understanding them from the perspective of that person. The staff team had involved service users when drawing up care plans. 4 Laurel Drive DS0000008085.V327926.R01.S.doc Version 5.2 Page 11 This was reflected in the way the care plans were written. One service user showed the Inspector her care file and was very proud that she was involved in maintaining it. The service user concerned had an understanding of what was contained within her file. Care planning did not restrict the rights or freedom of people living at the home. In one file there were restrictions placed on a service user. On further investigation and after speaking with the person concerned, the inspector found this limitation was based on the protection of the service user and others living at the home. This was good practice. The service user files sampled contained extensive assessment of everyday risk. Where a risk had been identified, an assessment had been made to minimise risk to the service user. These assessments had been regularly reviewed in light of changing needs of the person concerned. 4 Laurel Drive DS0000008085.V327926.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 13,14, 15,16, 17 Quality in this outcome area is good Residents are involved in meaningful daytime activities of their own choice and according to their individual interests and capability. Support is offered to the service group by a skilled and trained team. Service users are helped to access the opportunities available in the local community, This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector spoke with staff, a day care worker, a service user and the manager after reviewing files. The home supports service users access a range of every day community activities. This support is provided by staff at the home and by Freedom Day Care Services. Service users are supported to attend local facilities like local shops, post office, cinema or the hairdresser with staff support. Community 4 Laurel Drive DS0000008085.V327926.R01.S.doc Version 5.2 Page 13 access is enhanced by flexible working the staff team by the staff team. This ensures the team are able to take service users out flexibly. Service users have an active life accessing a wide range of activities. Day care planning and service user notes showed the service user group has access to activities such as Fitness club, Meals out, day trips, visits to concerts, swimming, a stable management course and horse riding. One service user showed the inspector her activity planner and felt she had a wide range of activities to keep her busy. Another service user told the inspector that she was supported to visit her brother and maintain family links. This was outlined in her care record and demonstrated a commitment by the staff team to maintain family contact. Staff told the inspector that visitors were welcome. Evidence from a service user, two care files and the statement of purpose indicated that the service user’s rights and views are respected at the home. During the inspection, service users had freedom to go or do as they wished within a risk-assessed framework. One service user wanted to show the inspector around the home and into a part of the garden they had particular interest in. The service user said that they could go to their room or be in the company of others should they wish. The inspector reviewed the menu at the home. During the inspection, service users were offered a light lunch and substantial evening meal. Both smelt and looked attractive. Meal times were relaxed and unhurried. People living at the home are actively supported to cook and prepare food for the small community. This includes shopping and food preparation with support from the staff team. 4 Laurel Drive DS0000008085.V327926.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good Specialist health and dietary needs are clearly recorded in each resident’s plan. Staff understand the key principles of giving personal support and are responsive to the varied and individual requirements of the residents. It is recognised that the delivery of personal care is highly individual and must be flexible, consistent and reliable. Staff ensure privacy and dignity when delivering personal care, if staff are sensitive to changing needs of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector observed care in practice, spoke with staff, reviewed care notes and spoke with two service users. The home’s philosophy of care and overall care planning outlined an approach that respected the individual’s rights to privacy, dignity and independence. Speaking with staff members and observing care, the inspector noted that service users were treated with respect and dignity. During the second day of inspection the inspector observed a staff member addressing challenging 4 Laurel Drive DS0000008085.V327926.R01.S.doc Version 5.2 Page 15 behaviour. This was done kindly and with awareness of the service user’s need for privacy and dignity. The service user responded well and the situation was rapidly resolved. The inspector observed the staff applying the care plan and a range of listening and communication skills. Reviewing documentation the inspector noted evidence of supported access to the local GP and NHS facilities. Care notes included assessment information regarding service users health needs and medical conditions. Staff at the home store and administer medication for the service users. The home maintains an accurate record of medication received, destroyed or administered on the premises. The inspector reviewed the home’s administration sheets and noted no crossings out or omissions. The staff on duty informed the inspector that they are only allowed to administer medication if they attend a ‘drugs administration’ training course. 4 Laurel Drive DS0000008085.V327926.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good The service has a complaints procedure that is up to date, clearly written, and is easy to understand. Residents and others associated with the home understand how to make a complaint and they are very clear of what can be expected to happen if a complaint is made. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector read the home complaints policy, protection of vulnerable adults policy and spoke to service users and staff. The home has a clearly laid out complaints procedure. Service users understood who they should tell if they are unhappy at the home. The service user guide gave a simplified procedure in a format easily understood by the service user group. The Brandon trust provides a good standard of training for care staff and managers regarding abuse. A review of training records showed that in the 4 staff records sampled, staff had accessed Protection of Vulnerable Adults training. Staff on duty understood the principles of safeguarding vulnerable people and knew how to implement procedures if there was a need. The home has clear policies and procedures to support staff in this process. Staff have 4 Laurel Drive DS0000008085.V327926.R01.S.doc Version 5.2 Page 17 appropriate training to understand and manage challenging behavior. As mentioned previously, the inspector saw staff managing challenging behavior and putting their training into practice. 4 Laurel Drive DS0000008085.V327926.R01.S.doc Version 5.2 Page 18 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, 30 Quality in this outcome area is adequate The home provides a physical environment that is appropriate to the needs of the residents who live there. The environment provides specialist aids and equipment to meet the needs of the residents. The home is well lit, clean and tidy and smells fresh. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection, a service user and staff member took the inspector on a tour premises. The premises were well maintained, clean and hygienic throughout. Laurel Drive is a moderate sized building with a pleasant family atmosphere. The fixtures and fittings are of reasonable quality. The inspector made one 4 Laurel Drive DS0000008085.V327926.R01.S.doc Version 5.2 Page 19 requirement regarding the back door near the kitchen area. The doorframe requires attention. The inspector also made 2 recommendations regarding the environment. The inspector recommends the sofa in the kitchen area should be replaced. It appears worn and discolored in areas. The inspector also noted that there was no mechanism to ‘advance’, (turn on), the central heating outside of set times. Both staff and a service user confirmed that at times they were cold in the day but had been told they must not reset the timer to heat the premises. The inspector recommends a modern electronic timer with ‘advance’ facility be installed. 4 Laurel Drive DS0000008085.V327926.R01.S.doc Version 5.2 Page 20 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, 34, 35 Quality in this outcome area is good The service ensures staff are given relevant training that is targeted and focussed on improving outcomes for residents. The service has a good recruitment procedure that clearly defines the process to be followed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Inspector observed staff working with the service user group. The service users were included in day-to-day chat with the staff group and appeared comfortable approaching staff at all times. Staff were actively involved with the service user group and appeared to be good listeners and good communicators. Staff at the home received training from the Brandon trust to understand the effects of learning disabilities on the service users. The trust provides staff with a training package called ‘positive response’. This helps staff understand and manage verbal and physical aggression. One service user told the Inspector that the staff were very nice and she felt able to talk to them. The service user felt staff had time to spend with her, although they could be busy cooking tea sometimes. 4 Laurel Drive DS0000008085.V327926.R01.S.doc Version 5.2 Page 21 The Brandon Trust operates a thorough recruitment procedure and stores staff records centrally at Trust headquarters. The manager reviews records and the details are stored on a purpose made form. This provided evidence that records stored centrally at Brandon Trust HQ contained 2 written references, appropriate ID checks, criminal records bureau checks, and are checked to see if potential staff have been placed on the protection of vulnerable adults list. Training at the home is provided by the Brandon trust. The manager has no specific training budget. The Inspector reviewed training provided from the trust and spoke with staff. 2 staff members informed the Inspector that they were able to go on any training relevant to their role. A review of the staff training files indicated that staff have excellent access to training. 2 staff sampled had received in excess of 5 training days in this financial year. The Inspector spoke with a new staff member to find out about her induction process. The staff member had completed her induction process within a fortnight of starting work at the home. The Inspector found documentary evidence of support from the manager and a level of training that meets national minimum standards. 4 Laurel Drive DS0000008085.V327926.R01.S.doc Version 5.2 Page 22 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, 42 Quality in this outcome area is good The service has sound policies and procedures, which the manager effectively reviews and updates, in line with current thinking and practice. Staff are positive in their approach to translate policy into practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has registered manager with over 30 years experience caring for people with learning disabilities. The manager is a registered nurse and has completed the registered managers award. The manager informed the Inspector that he had a job description. The job description was not reviewed by the Inspector. 4 Laurel Drive DS0000008085.V327926.R01.S.doc Version 5.2 Page 23 The Inspector found evidence of a comprehensive quality assurance package. The manager talked the Inspector through the implementation of the Brandon trust quality assurance system. This appeared to be a good system for identifying quality assurance areas and identifying any shortfalls. The Inspector tracked two administrative ‘quality markers’ and found that action had been taken to address potential shortfalls in these areas. There was evidence of service user and family feedback questionnaires contained within the quality assurance review. The home implements a quality assurance review yearly in accordance with its annual plan. The Inspector spoke with staff, conducted a tour of the premises and reviewed training and maintenance records. The Inspector found staff receive regular moving and handling training, first aid and fire training. The Inspector reviewed fire training provided to staff. The Brandon trust offers a rolling programme of updates for the staff team. Reviewing the fire log, the Inspector found evidence of regular fire tests, fire drills and fire training for staff members. The home had up-to-date certificates for fire safety equipment in the home. 4 Laurel Drive DS0000008085.V327926.R01.S.doc Version 5.2 Page 24 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 x 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 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 x 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 3 x x 3 x 4 Laurel Drive DS0000008085.V327926.R01.S.doc Version 5.2 Page 25 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA24 Regulation 23 2 b Requirement The inspector requires the provider make good the damage to the doorframe of the back door, (leading to the kitchen). Timescale for action 16/03/07 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 2 Refer to Standard YA24 YA24 Good Practice Recommendations The inspector recommends a modern electronic timer with ‘advance’ facility be installed for the central heating. The inspector recommends the sofa near the kitchen area is replaces. It appears worn and unclean. 4 Laurel Drive DS0000008085.V327926.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 4 Laurel Drive DS0000008085.V327926.R01.S.doc Version 5.2 Page 27 - 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. 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