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Inspection on 23/11/05 for 81 Lowther Street

Also see our care home review for 81 Lowther Street for more information

This inspection was carried out on 23rd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The picture is of a well-led, well-managed and dynamic service, which regards the promotion of service users mental well-being as its paramount business. Service users continue to be particularly appreciative of a non-hospital environment in times of crisis. For some people one stay is sufficient to stabilise their condition, while other people have built a stay at the Home into their coping strategies across the year. This flexibility and responsiveness is a positive feature of the service. The staff underpin all these positive features by offering a warm and positive experience and service users confirm that they feel safe and have confidence in the staff to support their mental health needs. Staff are well supported in this role by an organisation with a good track record of offering effective training and support to its staff.

What has improved since the last inspection?

The staff team continue to gain further qualifications, and these more recently have been specific to the area of mental health. The lounge had been redecorated with new curtains and cushions and service users said it was much more homely.

What the care home could do better:

Staff could be more familiar with the local Adult Protection procedures and it is suggested that this be raised at the next staff meeting.

CARE HOME ADULTS 18-65 81 Lowther Street Whitehaven Cumbria CA28 7RB Lead Inspector Liz Kelley Unannounced Inspection 23rd November 2005 10:00 81 Lowther Street DS0000029268.V259992.R01.S.doc Version 5.0 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 81 Lowther Street DS0000029268.V259992.R01.S.doc Version 5.0 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. 81 Lowther Street DS0000029268.V259992.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 81 Lowther Street Address Whitehaven Cumbria CA28 7RB 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) 01946 691234 The Croftlands Trust Mr Mark Barrett Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places 81 Lowther Street DS0000029268.V259992.R01.S.doc Version 5.0 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 in the category of MD (Mental Disorder). 27th June 2005 Date of last inspection Brief Description of the Service: The home is operated by The Croftlands Trust; a non-profit making organisation, which runs a number of residential and community based services in the County for people with mental heath problems. Six places are available to respond to people with severe and enduring mental health illness, living in the community who are in need of short-term crisis intervention and to reduce the need for a hospital admission. The average length of stay was around three weeks and the home had taken 140 admissions in the last year. 81 Lowther Street is a large Georgian property situated in the town centre of Whitehaven. It is therefore central for all amenities, transport links and is convenient for both service users and visitors. Each person is given a bedroom of their own and use of a communal lounge, dining room, no smoking lounge and kitchens. Service users are not charged for the service as the Health Authority fund the scheme. The admission criteria states that individuals must be under the care of a mental health team in either the Allerdale or Copeland area. The home is managed by Mark Barrett, two staff are on duty and an aftercare 24 hours telephone support line is also available. 81 Lowther Street DS0000029268.V259992.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 3 hours. Two service users were in across the day and spoken to. Two staff members were on duty and interviewed. Feedback cards had been received from visiting professionals earlier in the year. A partial tour of the premises took place, and administration records and service users files were examined. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 81 Lowther Street DS0000029268.V259992.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 81 Lowther Street DS0000029268.V259992.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 The service is constantly reviewing its performance and has now established its self as an integral part of the mental health service in the area. EVIDENCE: The admission criterion is well-developed and ensured appropriate placements. A positive development is the recent change in emphasis in referrals to crisis and responsive services and a move away from planned regular stays. The home was reviewing its effectiveness in the continuum of care for people with mental health problems in light of other community developments. To this end it was considering expanding its geographical intake for referrals to possibly include North Cumbria. And to take service users over the age of 65 were there was a clear mental health need. 81 Lowther Street DS0000029268.V259992.R01.S.doc Version 5.0 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 and 9 The home had developed a good balance between risk-taking and a duty of care, and much of the dialogue with service users is around rights, choices and developing positive coping strategies. EVIDENCE: Service users are treated very much as individuals and their rights and needs respected and addressed. Any restrictions to individuals rights to ensure wellbeing or safety, of the Home and the individual, were appropriately consulted upon and consent given by the individual. Contingency Care Plans were identified as an example of good practice in ensuring appropriate response in emergency’s and at times of crisis. The Home exceeded the standard by: comprehensive computer systems for recording daily notes and monthly reviews; which in turn informed regular multi-disciplinary meetings; these plans included individualised contingency plans with indicators in changes in behaviour that would trigger staff to seek further advice or putting agreed strategies in place. Staff spoke of a training course arranged for later in the month on “Therapeutic Risk Taking” which was to be delivered to the whole staff team. 81 Lowther Street DS0000029268.V259992.R01.S.doc Version 5.0 Page 9 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 and 17 Staff were aware of each persons support needs in regard to relationships and family contact. A good quality and healthy diet is a key feature in promoting a persons wellbeing whilst staying a the Home. EVIDENCE: Family contact is indicated in each persons individual plan and staff were knowlegble about the extent of this contact. Staff were also supportive of the family and relationship dynamics for each person. Where, appropriate family were encouraged to visit and arrangements are made to allow privacy on visits. Menus are planned with service users on a weekly basis and a communal evening meal is encouraged. Service users spoke of very much enjoying the food and appreciated having a cooked meal in the evenings. Service users are encouraged to make snacks and light meals across the day and to carry out shopping for the house. Staff are given training on the importance of healthy diets and the role in promoting good mental health. 81 Lowther Street DS0000029268.V259992.R01.S.doc Version 5.0 Page 10 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were covered and met at the last inspection. EVIDENCE: 81 Lowther Street DS0000029268.V259992.R01.S.doc Version 5.0 Page 11 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 The home has good systems in place to protect the rights and well-being of service users during there stay. EVIDENCE: The Home has induction training that covers adult protection issues and the various forms of adult abuse. Staff also have a good knowledge on self-harm and the various strategies to support service users. The home has established working relationships with Community psychiatric nurses, psychiatrist and mental health social workers and frequently make referrals and seek advice on service users being supported at the home. In discussion with staff they were clear that any concerns on adult abuse would be reported to their line manager, however they were less clear on the local multi-disciplinary procedures and the role they had within this framework. A recommendation was made that this be discussed at the next team meeting. 81 Lowther Street DS0000029268.V259992.R01.S.doc Version 5.0 Page 12 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 Recent investment has improved the appearance of the home creating a comfortable and safe environment for those living there and visiting. EVIDENCE: The lounge had been redecorated with new curtains and cushions and service users said it was much more homely. Service users said they appreciated having a key to their bedrooms and having a non-smoking lounge. They also thought the location of the home was very convenient for local facilities and the town centre, and had enjoyed going out for walks around the town centre and harbour. 81 Lowther Street DS0000029268.V259992.R01.S.doc Version 5.0 Page 13 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): 32 Service users spoke very highly of the staff team and had confidence in their abilities to understand, listen and promote their mental health. EVIDENCE: Service users spoken to said the staff team “were fantastic”, “always had time” and made them feel valued. They had previously felt “dumped in hospital and felt helpless and hopeless” but now they had hope and felt more positive about their future. Staff stated that they had both the training and the support from the organisation that they needed to be effective in their role. All staff had either an NVQ 2/3 or were studying towards the Community Mental Health Diploma. The organisation runs a rolling programme of training for all its services to access and staff identify course in supervision. Arrangements had been made to up-date staff in the safe handling of medications, as recommended at the last inspection. 81 Lowther Street DS0000029268.V259992.R01.S.doc Version 5.0 Page 14 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): 42 Service users benefit from a service that is well-run by the manager and by the systems of the organisation, which ensure that service users are central, and their views are valued and acted upon. EVIDENCE: Staff and residents spoken to confirmed that they felt that the atmosphere in the home was relaxed and supportive. The administrative systems within the home were found to be up-to-date and in good order, ensuring the home was run in an efficient and effective manner. Risk assessments and Health & Safety policies and procedures had been reviewed ensuring that staff had the latest guidance. The home is to confirm that the five yearly wiring check has been carried out. 81 Lowther Street DS0000029268.V259992.R01.S.doc Version 5.0 Page 15 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x x x Standard No 22 23 Score x 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 x x 4 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 3 16 x 17 Standard No 31 32 33 34 35 36 Score x 3 x x x x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 81 Lowther Street Score x x x x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x DS0000029268.V259992.R01.S.doc Version 5.0 Page 16 yes 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. Refer to Standard YA20 YA23 Good Practice Recommendations Staff should receive formal medication training Staff should be familiar with the local multi-disciplinary guidance on Adult Protection 81 Lowther Street DS0000029268.V259992.R01.S.doc Version 5.0 Page 17 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 81 Lowther Street DS0000029268.V259992.R01.S.doc Version 5.0 Page 18 - 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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