CARE HOME ADULTS 18-65
42-44 Lansdowne Road Leicester Leicestershire LE2 8AQ Lead Inspector
Chris Wroe Key Unannounced Inspection 22nd November 2006 2:00pm 42-44 Lansdowne Road DS0000006439.V319513.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 42-44 Lansdowne Road DS0000006439.V319513.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. 42-44 Lansdowne Road DS0000006439.V319513.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service 42-44 Lansdowne Road Address Leicester Leicestershire LE2 8AQ 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) 0116 283 2780 0116 283 3243 Lansdowne Road Limited Ms Lesley Wakefield Care Home 8 Category(ies) of Learning disability (8) registration, with number of places 42-44 Lansdowne Road DS0000006439.V319513.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. No additional conditions of registration. Date of last inspection 28/12/05 Brief Description of the Service: 42 - 44 Lansdowne Road is registered to provide care for eight adults with learning disabilities. The home consists of one semi-detached property and one detached property situated next door to each other. People who live in the home are able to live fairly independently. The home is situated close to Aylestone Road, not far from the city centre. A regular bus service to and from the centre runs close to the home. A number of shops, parks and a leisure centre are located nearby. The range of fees charged in £317-£892 per week. 42-44 Lansdowne Road DS0000006439.V319513.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This key inspection included a visit to the service. The inspector visited the home on 22nd November 2006. A senior member of staff helped the inspector during the visit. The visit started at 2.00pm and lasted for three hours. Some of the service users were at home during the inspection. Three people chose to speak to the inspector. The main method of inspection used was ‘case tracking’. This means looking at the care given to service users in different ways. The ways this was done are: • talking to the service users • talking to staff and the manager • watching how service users are given support • looking at written records. All the service users were happy about the care given by staff. They felt they got good support. They felt the home was comfortable and they had what they need. All the key standards were checked during this inspection. The information below is based only on those aspects checked in this inspection. Details about individual people has been kept out of the report, to make sure it is kept confidential. What the service does well:
Before people come to live in the home, the manager finds out about what they need and the things they like and don’t like, and writes this down. One person said that they were told about the home before they came to live in it. They were able to come and visit and stay for a while to see if they liked the home. There are contracts for each person who lives in the home, which explain their rights in the home and how much they have to pay to live there. Some service users get help from Social Services with paying their fees. There are care plans in the home for each person who lives in the home. Care plans tell about what is important for each person living in the home. Staff know what each person who lives in the home needs, and about the things they like and don’t like. Staff help people who live in the home to manage their money, if they need help. People are able to make choices independently about how they would like to spend their money. People who live in the home can choose things that they want to do. There are risk assessments in the home for each person. Risk assessments tell about how people who live in the home can be helped to do the things they want to do and be kept safe.
42-44 Lansdowne Road DS0000006439.V319513.R01.S.doc Version 5.2 Page 6 People who live in the home can do different things they want to do. One person does voluntary work helping older people, which they like doing. Other people who live in the home go to college. People who live in the home have friends and family that they keep in touch with. Staff help each person who lives in the home to see people they want to see. People are able to have relationships if they want to, and staff said that they have a positive attitude towards gay or straight relationships. Staff make sure that people living in the home have support from social workers and other people who can help them. Some people who live in the home cook their own meals, and some get help from staff. Staff help people who live in the home to look after themselves. People live fairly independently and mostly look after their own personal care. If people feel poorly they can see a local GP, and they have regular appointments for other check-ups, like dentist and optician. There is a policy in the home, which tells staff about how to give out medication safely to people who live in the home. Staff who give out medication have had training to show them how to do it properly. People living in the home have their own things in their bedrooms. Staff make sure they check the home is safe for people who live in it. For example, staff carry out checks of fire safety equipment. The people who live in the home are fairly independent, so there is just one member of staff on duty between the two houses. There are other staff on call to give support if they are needed at the sister home across the road. At night one member of staff sleeps in at the home, with two waking staff at the sister home to give support if needed. Staff are chosen to work in the home who are safe and able to support people well. Staff are given training to show them how to do their job well. For example, one member of staff said they had been given training about managing challenging behaviour and about different health conditions and needs. Staff get support from the manager and can talk about how things are going. The manager has now been registered with the Commission for Social Care Inspection. There are different ways that people who live in the home can say what they think about the home. The owner of the home carries out checks to see that everything is running well. There are policies in the home, which tell staff about how to work safely. What has improved since the last inspection?
42-44 Lansdowne Road DS0000006439.V319513.R01.S.doc Version 5.2 Page 7 Parts of the home have been decorated 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. The summary of this inspection report can be made available in other formats on request. 42-44 Lansdowne Road DS0000006439.V319513.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 42-44 Lansdowne Road DS0000006439.V319513.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are assessed so that staff can support them in the way they need, and make sure the home is the right place for them to live. EVIDENCE: Before people come to live in the home, the manager finds out about what they need and the things they like and don’t like, and writes this down. One person said that they were told about the home before they came to live in it. They were able to come and visit and stay for a while to see if they liked the home. There are contracts for each person who lives in the home, which explain their rights in the home and how much they have to pay to live there. Some service users get help from Social Services with paying their fees. 42-44 Lansdowne Road DS0000006439.V319513.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. This judgement has been made using available evidence including a visit to this service. Residents are enabled to fulfil their own needs and choices. EVIDENCE: There are care plans in the home for each person who lives in the home. Care plans tell about what is important for each person living in the home. Staff know what each person who lives in the home needs, and about the things they like and don’t like. Staff make sure other people, like social workers, keep in contact with people living in the home and know about what is happening. Staff talk with people who live in the home about their care plans, if they want to know about them. Staff help people who live in the home to manage their money, if they need help. People are able to make choices independently about how they would like to spend their money. One service user said they are happy about staff looking after their money, and they can have money when they want it. People who live in the home can choose things that they want to do. There are risk assessments in the home for each person. Risk assessments tell about
42-44 Lansdowne Road DS0000006439.V319513.R01.S.doc Version 5.2 Page 11 how people who live in the home can be helped to do the things they want to do and be kept safe. For example, people can choose to go out on their own, and staff work out with each person how they are safe doing this. 42-44 Lansdowne Road DS0000006439.V319513.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): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents generally benefit from a good lifestyle in the home. EVIDENCE: People who live in the home can do different things they want to do. The people who live in the home told the inspector about the different things they like. They like to do things like go shopping, play on their ‘X Box’, go out on bike rides and go out to the pub. One person does voluntary work helping older people, which they like doing. Other people who live in the home go to college. People who live in the home have friends and family that they keep in touch with. Staff help each person who lives in the home to see people they want to see. People are able to have relationships if they want to, and staff said that they have a positive attitude towards gay or straight relationships. People who live in the home are also involved with the sister home across the road, and have friends there.
42-44 Lansdowne Road DS0000006439.V319513.R01.S.doc Version 5.2 Page 13 Staff make sure that people living in the home have support from social workers and other people who can help them. Some people who live in the home cook their own meals, and some get help from staff. One person said that they like to cook shepherds pie and toad in the hole. For two people who cook their own food, there was a problem on the day of the visit, because the manager was off sick, and so there was not a way for them to get money to buy some food. They were going to go across the road to the ‘sister’ home to have an evening meal. During the inspection visit, the member of staff in charge managed to sort out some money so that the service users could buy some food to cook. 42-44 Lansdowne Road DS0000006439.V319513.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. This judgement has been made using available evidence including a visit to this service. Residents benefit from mostly good staff attention to health and medical care needs. EVIDENCE: Staff help people who live in the home to look after themselves. People live fairly independently and mostly look after their own personal care. If people feel poorly they can see a local GP, and they have regular appointments for other check-ups, like dentist and optician. There is a policy in the home, which tells staff about how to give out medication safely to people who live in the home. Staff who give out medication have had training to show them how to do it properly. Staff write down if they have to give some extra medicine to help someone who is having a difficult time. Medication records showed that one person had refused medication a few times, but there was no check with the GP to make sure that this would not have a harmful effect. One type of medication was out of stock, but the member of staff said it was not needed. Staff should not make decisions about what medication is needed. 42-44 Lansdowne Road DS0000006439.V319513.R01.S.doc Version 5.2 Page 15 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. This judgement has been made using available evidence including a visit to this service. Residents are protected from harm by policies in the home and awareness of staff. EVIDENCE: People who live in the home said that they could talk to the manager or staff if they had a problem. They felt they would be listened to. There is a policy, which tells people how they can make a complaint if they want to. Staff have had training about how to make sure people are kept safe from harm. The member of staff in charge knew what action to take if someone needs protecting from harm. There is a policy in the home, which tells staff about what they need to do if anyone is in any danger. There was a burglary in the home in August 2006, and there are now checks around the home to make sure everything is safe and secure. 42-44 Lansdowne Road DS0000006439.V319513.R01.S.doc Version 5.2 Page 16 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. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a generally clean and comfortable home, but some attention could be paid to improvements, to ensure residents’ safety. EVIDENCE: The inspector looked round the home, and saw the different rooms that people who live in the home use. People living in the home have their own things in their bedrooms. Parts of the home have been decorated since the last inspection. Staff make sure they check the home is safe for people who live in it. For example, staff carry out checks of fire safety equipment. There are some things that could be better: Staff said some of the floors can be slippery when they get wet – it would be good if the floors were made safe. In the downstairs bathroom of number 44, the carpets were dirty and mouldy. During the inspection visit the member of staff in charge took these away.
42-44 Lansdowne Road DS0000006439.V319513.R01.S.doc Version 5.2 Page 17 The laundry room in number 42 is not in a good condition. The floor has cracks, which could allow water/bacteria to get in and be a health hazard. One washing machine is chipped and rusting. There is paint peeling off the walls. Some of the carpet and flooring is looking tatty, and the provider should look at whether it is safe for the health and welfare of people who live in the home. 42-44 Lansdowne Road DS0000006439.V319513.R01.S.doc Version 5.2 Page 18 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 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. This judgement has been made using available evidence including a visit to this service. Residents benefit from supportive staff. EVIDENCE: The people who live in the home are fairly independent, so there is only one member of staff on duty between the two houses. There are other staff on call to give support if they are needed at the sister home across the road. At night one member of staff sleeps in at the home, with two waking staff at the sister home to give support if needed. Staff are chosen to work in the home who are safe and able to support people well. The manager gets written references for people who come to work in the home, and makes sure that all staff are checked by the Criminal Records Bureau. Staff are given training to show them how to do their job well. For example, one member of staff said they had been given training about managing challenging behaviour and about different health conditions and needs. Staff get support from the manager and can talk about how things are going. 42-44 Lansdowne Road DS0000006439.V319513.R01.S.doc Version 5.2 Page 19 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. This judgement has been made using available evidence including a visit to this service. Residents are kept generally safe by management systems in the home. EVIDENCE: The manager has now been registered with the Commission for Social Care Inspection. There are different ways that people who live in the home can say what they think about the home. There are residents meetings in the home, where people who live in the home can say what they think. The people who own the home make their own checks, to make sure that things are running well and that people who live in the home are satisfied. People who live in the home are also given questionnaires from time to time to see what they think about the home. 42-44 Lansdowne Road DS0000006439.V319513.R01.S.doc Version 5.2 Page 20 There are policies in the home, which tell staff about how to work safely. Staff have had training to make sure they work safely. For example, they have had training about how to stop infection spreading and keep the home clean. Staff do checks to make sure that equipment in the home is safe. There is also a health and safety committee, which is a group of people who look specially at how to keep the home safe for people who live there. 42-44 Lansdowne Road DS0000006439.V319513.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME 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 2 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 4 13 3 14 X 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 4 X X 3 X 42-44 Lansdowne Road DS0000006439.V319513.R01.S.doc Version 5.2 Page 22 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. 1 Standard YA24 YA30 Regulation 13, 23 Requirement The provider is required to ensure that the premises are kept in a good state of repair and are free from hazards to the safety of residents. Timescale for action 31/01/07 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 YA17 Good Practice Recommendations It is recommended that the provider ensures that service are always able to independently buy their own food to cook, where they have been assessed as living independently in this aspect. It is recommended that where medication is missed or out of stock, staff check with service users’ GPs to find out what the effect would be and whether the medication is needed. 2 YA20 42-44 Lansdowne Road DS0000006439.V319513.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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
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