Inspection on 22/03/06 for 47 Sandy Lonning

This inspection was carried out on 22nd March 2006.

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 16/05/07

47 Sandy Lonning 17/08/05

47 Sandy Lonning 01/03/05

47 Sandy Lonning 11/11/04

47 Sandy Lonning 08/03/04

Similar services:

Ruskin Lodge

Clover House

Dystlegh Grange

The Good Companions

Springfield Cottage

Cuerden Grange Rest Home

Parkside

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 Gordon Chivers Unannounced Inspection 22nd March 2006 09:45 47 Sandy Lonning DS0000022560.V280086.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 47 Sandy Lonning DS0000022560.V280086.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. 47 Sandy Lonning DS0000022560.V280086.R01.S.doc Version 5.1 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) 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.V280086.R01.S.doc Version 5.1 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) 17th August 2005 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 four of these 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. 47 Sandy Lonning DS0000022560.V280086.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, commencing at 09.45 and lasting five and a half hours. The inspection took place in the presence of the manager Debbie Whitby. The inspection included a tour of the premises, reference to a range of documents including a sample of service users’ case files, talks with four service users and one member of staff. The inspection focused upon the standards which had a requirement or recommendation, and those standards which were not assessed, by the last inspection. The inspector would like to thank the service users and staff of 47 Sandy Lonning for their welcome and cooperation during this inspection. What the service does well: What has improved since the last inspection? The care planning system is currently being improved. The staff are having refresher training to protect the service users from abuse and neglect. The new manager has settled in well, and an annual Service Plan has been produced which is partly based upon the views of the service users. 47 Sandy Lonning DS0000022560.V280086.R01.S.doc Version 5.1 Page 6 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. 47 Sandy Lonning DS0000022560.V280086.R01.S.doc Version 5.1 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.V280086.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 4 Any future admission to the home will follow Westhouse’s Admissions procedure and records will be kept and stored. EVIDENCE: The manager will make sure that all records of the process by which new service users are admitted to the home will be filed away and stored within the home. This was a recommendation from the last inspection. 47 Sandy Lonning DS0000022560.V280086.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,9 The service users needs and goals form the basis of the care plans. The whole system is currently being improved upon. The home is making focused efforts to help the service users to do more and more things for themselves. EVIDENCE: The home has assessments of the service users’ daily living skills and any particular hazards which the staff have identified. These and other identified needs form the basis of the care plans. The care plans set out to meet these needs, but under the current format there are no clear links between the assessed needs, the plan of care, the actions undertaken to meet the needs and the outcomes of these actions. This makes it difficult to follow how appropriate or effective the care plan has been in any systematic way. Moreover, some of the assessed needs are to be found in the Person-centred plan, whilst others are in the care plan, and so this adds to the difficulty. The manager is aware of this lack of clarity in the system. She and some colleagues from Westhouse have developed a new care planning format which is intended to make the links between needs, actions and outcomes much clearer. This is to be tested out in the home. This will be based upon a new risk assessment format in which all aspects of service users’ lives are assessed and scored against a common set of criteria. The care plan will then be based 47 Sandy Lonning DS0000022560.V280086.R01.S.doc Version 5.1 Page 10 upon this general or ‘generic’ risk assessment, but will also take into account the service users’ personal wishes and goals for the future. The manager also wants to make a clearer distinction between the care plan and the personcentred plan. All of the specific plans to meet specific needs are reviewed at different times and over different periods of time. Sometimes it appears that the need is being reviewed, and sometimes it is the action to meet the need which is reviewed. All this makes it difficult to get a clear, whole view of how well each service user is being supported to meet all their needs and aspirations at any one time. The manager gave several examples of how service users are supported in doing more for themselves. This also includes testing out previously held assumptions about what individual service users are or are not capable of. These varied from small things like getting on to the toilet unaided but with support if necessary, to going into the bank alone, to going to Spain on holiday. It has been arranged for one service user with severe mobility problems to have a test drive in a brand new mini from the showroom (not driving personally but as a passenger). Another is a member of a selfadvocacy group which has become involved in reviewing quality across a range of services and service providers in West Cumbria, and this experience has helped to improve his communication skills. The home is developing the opportunities available to the service users to extend their horizons through the person-centred process. Starting with the wishes of the service user, the various stages necessary in achieving a goal are broken down in detail and the supports necessary to complete each stage are identified. Picture aids are used to help the service user keep track of progress and what comes next. 47 Sandy Lonning DS0000022560.V280086.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13,15,16 Service users have plenty of opportunities to experience the local community. They are all supported in their relationships with their families and friends. Their rights are respected and staff try to help them to understand their responsibilities towards others. EVIDENCE: Service users have plenty of opportunities to experience the local community from shopping to bar meals to visits to the cinema and theatre. One service user is due to celebrate a birthday at the local rugby club among seventy invited guests. Another will occasionally walk into town to pay a social visit to ex-members of staff. All the service users have contact with families and relatives to varying degrees. One service user visits her family in Manchester on the train unescorted. Several of the service users have friendships with people from the day services and other activities they engage in such as horse riding and weekly discos. There is some consideration being given to some of them going on holiday with their friends from other Westhouse homes. Respect for the rights of the service users is very evident in the general approach of the manager and the staff. It is clear that it is their home and the staff are there to support them. They are given dignity and privacy in their 47 Sandy Lonning DS0000022560.V280086.R01.S.doc Version 5.1 Page 12 own rooms and are supported in choosing their own lifestyles. However the manager is also aware of the balance between their right to choose and the staff’s duty of care to ensure their welfare and safety. Helping the service users to understand that they have responsibilities can be more difficult. One service user has particular behaviours in the home which are anti-social. The manager and staff are testing out different ways to manage and overcome these issues. 47 Sandy Lonning DS0000022560.V280086.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 Service users are given personal support in the way they prefer, and their health needs are met. EVIDENCE: Fortunately all the service users are able to communicate how they prefer to be supported, if at all, with their personal care such as dressing, washing and toileting. This recorded in the case files. The case files have health records for each service user. These include personal and family medical histories, and all records or referral to and contact with medical professionals and specialists. There is a separate section in the case files for health issues. However, the service users do not have individual Health Action Plans as a sub-section of the main care plan. The staff respect service users’ rights to make their own choices and decisions, and they support them in the event of unforeseen and unwished for consequences of those choices. 47 Sandy Lonning DS0000022560.V280086.R01.S.doc Version 5.1 Page 14 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): 22,23 Service users are consulted and directly involved in a number of different ways. The staff are having refresher training to protect the service users from abuse and neglect. EVIDENCE: The service users have been directly involved in developing their person centred plans and in the reviews of their care plans. Some of them have been involved in the process of selecting new members of staff. They also have their own house meeting which the manager chairs and produces the agenda and record of what was said and agreed. Most of the topics discussed are domestic issues. Making this meeting interesting to them all is not always easy, and sometimes the staff have to make sure that certain service users do not dominate the discussion. The manager is consider ways of supporting the service users themselves in taking a more active role in preparing and running these meetings. Some of the staff have received recent training in the protection of vulnerable adults from abuse and neglect, and the others are due to have the same training in June 2006. The manager has supplemented this training with some additional in-house training in staff meetings. 47 Sandy Lonning DS0000022560.V280086.R01.S.doc Version 5.1 Page 15 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): 24,25,30 The home is extremely well furnished and decorated. It is comfortable, clean, safe and hygienic. EVIDENCE: The home is purpose built and has been extended to provide additional living space for service users. The accommodation standards are very high, comfortable, spacious and pleasant with a high standard of furnishings and decorations. The home is very clean and hygenic. All but two of the private bedrooms are on the ground floor, four of these have en-suite toilet and bathing facilities and work is due to start in April 2006 to bring the other two up to the same standard. A new ‘hi-lo’ bath is to be installed. There are smoke alarms, fire extinguishers and emergency lights placed in key points throughout the home. The fire exits are well marked. The Fisher Trust which administers the house has deceided to refurbish the empty ‘staff’ flat to accommodate the overnight staff sleep-in instead of it being in the office. Each bedroom has a call-alarm system and all of the service users know how to use it. 47 Sandy Lonning DS0000022560.V280086.R01.S.doc Version 5.1 Page 16 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): 35 The staff are well qualified and receive sufficient training. EVIDENCE: Five of the seven staff have achieved NVQ to level 2 or above and one other is in the process of doing the course. Staff have a personal development plan in which their training needs are identified and the manager refers them to Westhouse for the appropriate courses. Westhouse is developing a schedule of training courses for the forthcoming year which should help the manager to plan future staff training. The home does not use a forward planning matrix of its own. 47 Sandy Lonning DS0000022560.V280086.R01.S.doc Version 5.1 Page 17 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): 37,39,42,43 The new manager has settled in well and the home is well run. An annual Service Plan has been produced, and this is based in part upon the views of the service users. The home ensures the health and safety of the service users, and Westhouse ensures that the home administers their personal money properly. EVIDENCE: The home was managed / supervised by Dianne Newton, a senior support worker from another Westhouse home, until the present manager, Debbie Whitby, took up her position at the beginning of October, 2005. The two then worked together for the first month as part of Debbie’s induction. Staff members were very positive in their assessment of the new manager. The home has produced an Annual Development/Service Plan. Part of this plan has been informed by the views of the service users. The plan might be refined in years to come by focusing on specific goals which are easier to evaluate rather than high level, general goals. The last annual risk assessment of the home was carried out in November 2005. Allerdale District Environmental health department has recommended 47 Sandy Lonning DS0000022560.V280086.R01.S.doc Version 5.1 Page 18 controls on the hot water system to prevent legionnaires disease and the home has contracted a local plumber to complete this work. Staff undertake a range of checks on the systems on a daily or weekly basis and these are recorded and monitored by the manager. The home keeps records of all of the tests and maintenance undertaken by external contractors on equipment, key services and safety systems. The Borders Fire Service makes annual checks. A plan on how to respond to emergencies was developed by the manager in February 2006. Westhouse audit the home’s records of the administration of service users’ personal monies every three months. 47 Sandy Lonning DS0000022560.V280086.R01.S.doc Version 5.1 Page 19 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 X 3 X 4 3 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 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X 3 x LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 3 16 3 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X x 3 X 3 X X 3 3 47 Sandy Lonning DS0000022560.V280086.R01.S.doc Version 5.1 Page 20 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. 1. 2. 3. Refer to Standard YA6 YA19 YA37 Good Practice Recommendations The manager should consider reviewing all aspects of the service users’ care plans and person centred plans at the same time on a holistic basis. The manager should liaise with the specialist community nursing team to develop Health Action Plans for each service user The manager should develop the annual Service Plan to be based upon more specific targets. 47 Sandy Lonning DS0000022560.V280086.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 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.V280086.R01.S.doc Version 5.1 Page 22 - 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!