Inspection on 16/05/07 for 47 Sandy Lonning

This inspection was carried out on 16th May 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 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

47 Sandy Lonning 22/03/06

47 Sandy Lonning 17/08/05

47 Sandy Lonning 01/03/05

47 Sandy Lonning 11/11/04

47 Sandy Lonning 08/03/04

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Clover House

Dystlegh Grange

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Springfield Cottage

Cuerden Grange Rest Home

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Park Lodge

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

CARE HOME ADULTS 18-65 47 Sandy Lonning Netherton Maryport Cumbria CA15 8AS Lead Inspector Liz Kelley Unannounced Inspection 16th May 2007 11:00 47 Sandy Lonning DS0000022560.V333793.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 47 Sandy Lonning DS0000022560.V333793.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. 47 Sandy Lonning DS0000022560.V333793.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 47 Sandy Lonning Address Netherton Maryport Cumbria CA15 8AS 01900 812943 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) debby.whitby@zen.co.uk West House Miss Deborah Elizabeth Whitby Care Home 6 Category(ies) of Learning disability (6), Physical disability (2) registration, with number of places 47 Sandy Lonning DS0000022560.V333793.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home is registered for a maximum of 6 service users to include: - up to 6 service users in the category of LD (Learning Disability) - up to 2 service users in the category of PD (Physical Disability) 22nd March 2006 Date of last inspection Brief Description of the Service: West House provides the services and care at 47 Sandy Lonning for six people who have a learning disability, some of whom may have a physical disability. The home is located in a quiet lane half a mile from the West Coast Town of Maryport. Community facilities and amenities are within easy reach. The premises are purpose built and have been progressively extended and adapted. Recent extension work has provided additional living space for service users. This adds to the environmental standards that were already met by the home. Very comfortable and pleasant accommodation is provided with a high standard of furnishings and decorations. All but two of the private bedrooms are on the ground floor and all have en-suite toilet and bathing facilities. The lounge, dining room, kitchen and utility room are also on the ground floor. Additional toilets are available and separate bathroom and shower room have specialist facilities adapted to assist people with a physical disability. The office is situated on the first floor. The garden area is well maintained and there are car-parking facilities to the front of the home. The current scale for charging is £618.47 per week. A Handbook is available for prospective residents, and the latest Commission for Social Care Inspection report is made available on request. 47 Sandy Lonning DS0000022560.V333793.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an inspection where all the key areas of the National Minimum Standards were checked. Residents, and their families, and members of staff had given their opinions regarding the services and care to the inspector. Their comments, views and the observations made by the inspector have informed the judgements made in this report. The inspector also: • Received questionnaires from professionals and other people working with the home • Interviewed the registered manager and staff • Visited the home and examined files and paperwork • Received a self-assessment report/questionnaire from the home. • Visited the Head office of West House to check on recruitment staff files. The overall picture gained by the Inspector was that residents were being offered an individually tailored service that promotes choice and has greatly improved the quality of life for those living at Sandy Lonning. What the service does well: What has improved since the last inspection? What they could do better: There were no areas identified for improvement. 47 Sandy Lonning DS0000022560.V333793.R01.S.doc Version 5.2 Page 6 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. 47 Sandy Lonning DS0000022560.V333793.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 47 Sandy Lonning DS0000022560.V333793.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. This judgement has been made using available evidence including a visit to this service. The Home has robust and well-established procedures in place to introduce new residents in a manner which ensures successful placements. EVIDENCE: The service has not admitted any new residents for sometime, but still keeps all information on the home up-to-date. Resident’s files demonstrated that information and assessments were available which assisted in ensuring a successful introduction to the home. Close working relationships have been developed with social workers and other professionals to ensure that placements are reviewed closely over a trial period. These assessments form the basis of the individual’s plan of care and include any potential restrictions on choice, and limitations due to risk as agreed with the resident and their family. The manager ensures that they provide plenty of information for prospective residents. For example the homes Statement of Purpose and Service Users Guide contain relevant details to assist residents, relatives and professionals in making an informed choice on the appropriateness of the home. The latest Statement of Purpose includes pictures of all staff, photographs of the house and symbols which make the document user friendly. 47 Sandy Lonning DS0000022560.V333793.R01.S.doc Version 5.2 Page 9 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 and 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The individual needs and choices of people living at Sandy Lonning are upheld to exceptionally high standards. EVIDENCE: The manager and staff have encompassed all the values and beliefs of a person-centred approach and are skilled at promoting choice for individuals. This leads to residents having individualised plans of care and having different interests and lifestyles choices. This is demonstrated by the control that each person is given drawing-up their latest person centred plan. One person chose to have their meeting in the local pub, sent out invitations and arranged for a buffet for invited guests. The resulting plan having therefore been developed by this person was in a style unique to them. A large poster style plan was used to map out a spider type diagram to illustrate their needs, wishes and ambitions. From this support needs were worked out to ensure that wherever possible these could be met. 47 Sandy Lonning DS0000022560.V333793.R01.S.doc Version 5.2 Page 10 This style of meeting didn’t suit another residents who invited the relevant people to a meeting sat on their bedroom floor, where they felt at ease and able to express things better. Thiis persons plan was developed around a passion for cars and was in the style of a road map. The care plan includes a comprehensive risk assessment, which is regularly reviewed. The service has a ‘can do’ attitude and risks are managed positively to help people using the service lead the life they want. Any limitations on freedom, choice or facilities are always in the person’s best interests. Working in this way ensures that each person is supported to live a lifestyle of their choosing through the skilled support of the staff team. 47 Sandy Lonning DS0000022560.V333793.R01.S.doc Version 5.2 Page 11 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 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Central to the home’s aims and objectives is the promotion of the individual’s right to live an ordinary and meaningful life. EVIDENCE: The staff team understands the importance of enabling younger adults to achieve their goals, follow their interests and be integrated into community life and leisure activities in a way that is directed by the person using the service. This extends across both the home and in the community, and allows people living at the home to enjoy all the rights and responsibilities of citizenship. An example of how the approach of the staff team, using person-centred planning, has been successful is through one resident expressing an interest in horse riding. This led to fulfilling another of their ambitions of finding a job, this person now works in a local stables as a stable hand, and told the inspector how pleased they were to have a job that they loved. 47 Sandy Lonning DS0000022560.V333793.R01.S.doc Version 5.2 Page 12 Decision-making has a high profile in the home and staff have a good understanding of residents support needs. Risk assessments are in place to support decision-making and to assist in activities to take place rather than preventing them. Emphasis is on what residents can do rather than cannot. Family have expressed their satisfaction with the contact with the home and have said that communication has been good. 47 Sandy Lonning DS0000022560.V333793.R01.S.doc Version 5.2 Page 13 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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health care is well-managed by the careful monitoring and diligence of the staff team. EVIDENCE: Aids and equipment are provided to encourage maximum independence for people using services; these are regularly reviewed and replaced to accommodate changing needs. Specialist advice is sought by the home to ensure effective use of equipment. Staff members are alert to changes in mood, behaviour and general wellbeing and fully understand how they should respond and take action. Health Action Plans are also being developed in line with current good practice guidance. Staff are trained and competent in health care matters. The home arranges training on health care topics that relate to the health care needs of the residents, for example care of people with epilepsy and communicating with people with limited speech. Medications in the home are well managed, with an orderly medicine cabinet and well ordered and accurate medication charts. Staff have received training 47 Sandy Lonning DS0000022560.V333793.R01.S.doc Version 5.2 Page 14 in the care and dispensing of medications and this was an area well managed by the home. The home has developed efficient medication policy, procedure and practice guidance. Staff all has access to the written information and understand their role and responsibilities. Quality assurance systems confirm that policy is put into practice. The manager has recently been reviewing the homely remedies policy and how this can fit in with the practices of local GPs to ensure that residents receive relief from mild aliments in a timely fashion. This has included contacting CSCI pharmacy Inspector and the NHS pharmacist for advice. This is good practice to ensure that the procedures of the home are safe and in line with wider guidance. Health care plans were identified as an example of good practice in enabling the individual to be involved according to their capacity. Recording in these plans was in good detail making it easy to identify contacts and outcomes from health care professionals. This ensures that regular appointments and checks are carried out in all health areas, such as dentist appointments, drugs reviews, chiropody and well person’s clinics. 47 Sandy Lonning DS0000022560.V333793.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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good systems in place to protect the rights and well-being of service users. EVIDENCE: Residents were observed freely expressing opinions to staff, and other ways of expressing views more formally via the complainants procedure were seen. The open atmosphere created within the home ensures that residents feel free to express their opinions and are confident that they will be listened to and concerns acted upon. Residents have been given a brochure with ways to make complaints in it and this was in various formats to aid understanding. Residents have good and varied links with outside organisations and advocate groups which ensured that they had channels to express views and concerns if necessary. Also through the person-centred approach of the staff team residents have been encouraged to be assertive in their daily lives. The home has polices and practices that safe guarded the handling of residents monies Staff receive training in de-escalating any challenging behaviours. This ensures that the appropriate skills are used and positive approaches are used to help people when they may become upset or agitated. The Home has induction training that covers adult protection issues and the various forms of adult abuse. A specific training course is also available and attended at various times of the year by different staff to ensure that the whole staff team is briefed. 47 Sandy Lonning DS0000022560.V333793.R01.S.doc Version 5.2 Page 16 These measures and the approach of the staff team ensures that residents are safeguarded from harm and their rights promoted. 47 Sandy Lonning DS0000022560.V333793.R01.S.doc Version 5.2 Page 17 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): 24,26,27,28,29 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents live in a purpose designed, well maintained home that is adapted to meet their needs. EVIDENCE: The accommodation is a large and spacious detached house on the edge of a housing estate in Maryport, and was originally built for one residents by their parents to share with other people with a learning disability. It is now run by West House, but owned by a trust fund for the individual. The home is very well-maintained and constantly being up-graded. A recent programme of improvements has resulted in all bedrooms being made fully ensuite, some with bathrooms others with showers. Included in these improvements will be an extra lounge and improved office facilities. There are a wide range of up-to-date specialist equipment and adaptations to meet the individual needs of people who use the service. For example the bath seats and hoist are well maintained and up-graded when necessary. 47 Sandy Lonning DS0000022560.V333793.R01.S.doc Version 5.2 Page 18 The environment is fully able to meet changing needs of people who use services, along with their cultural and specialist care needs. It is fully accessible throughout to people with physical disabilities, adaptations and specialist equipment are designed to fit within the homely environment. The home is well lit, clean and tidy and smells fresh. The management has a good infection control policy; they seek advice from external specialists, e.g. infection control, and encourage staff to work to the homes’ policy to reduce the risk of infection. 47 Sandy Lonning DS0000022560.V333793.R01.S.doc Version 5.2 Page 19 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 and 36 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well trained and skilled staff team who are dedicated to promoting a good quality of life tailored to each persons needs. EVIDENCE: Staff have clear and thorough job descriptions and are, therefore, clear on their roles and responsibilities. Evidence was seen through staff individual involvement in developing care plans and how they used their knowledge and skills to carry this out in such a way that care plans meet the needs of the each person. Based on discussions with staff and service users, the Home had a wellmotivated, committed staff team. They were actively involved in supporting peoples holidays, hobbies, organising day trips, work and college placements. Staff stated they are receiving regular and effective supervision and annual appraisal has also been carried out. Staff said they felt well supported and felt able to raise any issues with both the manager of the home and senior managers. 47 Sandy Lonning DS0000022560.V333793.R01.S.doc Version 5.2 Page 20 The organisation, West House, has good and varied ways of keeping staff informed and of creating a positive and developing workforce. All care staff had either completed or were registered on NVQ’s to level 2, and followed a rolling programme of mandatory training essential to ensuring a skilled work force. 47 Sandy Lonning DS0000022560.V333793.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well managed by an experienced and competent manager who in turn is supported by a committed staff team and together they run the home in the best interests of residents. EVIDENCE: The manager promotes an open, positive and inclusive atmosphere in the home through a variety of ways: regular staff meetings; regular supervision; and by inclusion of residents in the use of feedback and encouraging participation in West House service users groups. The manager communicates a clear sense of direction, is able to evidence a sound understanding and application of ‘best practice’ operational systems, particularly in relation to continuous improvement, customer satisfaction, and 47 Sandy Lonning DS0000022560.V333793.R01.S.doc Version 5.2 Page 22 quality assurance. She is proactive in the organisation in training and development groups. Equality and diversity issues are given priority by the manager who is aware of the varying strands this involves. Record keeping is of a consistently high standard. Records are kept securely and staff are aware of the requirements of the Data Protection Act. People who use the service can gain access to their records and contribute to them. The administration systems within the home were found to be up-to-date and in good order, ensuring the home was run in an efficient and safe manner. The home has a comprehensive range of policies and procedures to promote and protect residents’ and employees’ health and safety. Staff are trained, understand, and consistently follows these. There is full and clearly written recording of all safety checks and accidents, including analysis, and there is no evidence of a failure to comply with statutory reporting requirements and other relevant legislation. The home proactively monitors its health and safety performance, consults other experts and specialist agencies about health and safety issues as required. There is evidence of organisational monitoring by senior management, and effective lines of accountability and communication. 47 Sandy Lonning DS0000022560.V333793.R01.S.doc Version 5.2 Page 23 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 4 25 x 26 3 27 4 28 3 29 3 30 4 STAFFING Standard No Score 31 x 32 4 33 x 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 x 4 x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 4 x 3 x x 3 x 47 Sandy Lonning DS0000022560.V333793.R01.S.doc Version 5.2 Page 24 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. 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 47 Sandy Lonning DS0000022560.V333793.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 47 Sandy Lonning DS0000022560.V333793.R01.S.doc Version 5.2 Page 26 - 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!