Inspection on 03/05/06 for 90 Brackenborough Road

This inspection was carried out on 3rd May 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

90 Brackenborough Road 18/10/07

90 Brackenborough Road 08/12/05

90 Brackenborough Road 13/06/05

90 Brackenborough Road 08/03/05

90 Brackenborough Road 04/10/04

90 Brackenborough Road 04/03/04

90 Brackenborough Road 03/11/03

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

CARE HOME ADULTS 18-65 90 Brackenborough Road Louth Lincolnshire LN11 OAQ Lead Inspector Mr Ken Hague Key Unannounced Inspection 3rd May 2006 08:30 90 Brackenborough Road DS0000032053.V292351.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 90 Brackenborough Road DS0000032053.V292351.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. 90 Brackenborough Road DS0000032053.V292351.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 90 Brackenborough Road Address Louth Lincolnshire LN11 OAQ 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) 01507 600590 01507 600590 Northern Life Care Limited T/A U.B.U. Mr Paul Smith Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 90 Brackenborough Road DS0000032053.V292351.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Conditions of Registration. The placement of any service user in the home must not exceed a period longer than six months. 8th December 2005 Date of last inspection Brief Description of the Service: 90 Brackenborough Road is a care home owned by Northern Life Care Ltd. There is a registered manager in post. The care home is a detached house situated on the very edge of the town of Louth. The care home is a detached house which has been adapted by the company to provide respite care for service users with a learning disability. The home has enclosed gardens at the rear, car parking is available on the road outside the property and there is a small car park directly at the front of the home. The home is a two-level building, the access to the first four is via a staircase. There are no facilities for service users with a physical disability to use the top floor of the care home, although there are facilities on the ground floor to enable wheelchair users to be offered services and respite care. The accommodation consists of a communal lounge, dining room, kitchen and utility room. On the ground floor there are three bedrooms and two bathrooms. On the upper floor there are two bedrooms and one bathroom. Lincolnshire County Council have contracted with Northern Life Care Ltd to provide respite care for people with learning disabilities. There is no other care home offered as an alternative choice. 90 Brackenborough Road DS0000032053.V292351.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place between 7.45am & 12.00am. A tour of the building took place and care records were inspected. The main method of inspection used is called ‘case-tracking’; this involved ; reading the individual care records for residents being case tracked and discussions with staff and the registered manager. Observations are made of the manner in which care and help is provided throughout the inspection. Discussions were held with the residents being case tracked to ensure that their care plans were being followed and their choices and wishes were considered in the day-to-day management of the care home. This home has a contract with the Lincolnshire County Council social services to provide respite care for residents with a learning disability. It does not take private placements. The Inspector contacted the Lincolnshire county council social services department to obtain feedback in respect of the service being provided. The Registered Manager was present throughout the inspection. What the service does well: What has improved since the last inspection? The quality of care records for individual residents has improved since last inspection. The exception being the failure to write two care plans for to residents in the home on the day this visit. Assessments are more detailed and of much higher quality containing very detailed information which is easy to follow. The home can evidence now the balancing of staffing levels against the needs of residents. The registered manager is working to increase activity opportunities for residents staying in the care home. Staff teamwork has improved. 90 Brackenborough Road DS0000032053.V292351.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. 90 Brackenborough Road DS0000032053.V292351.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 90 Brackenborough Road DS0000032053.V292351.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): 2 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. The home completes an assessments prior to admitting a resident to the care home ensuring that all their needs are identified and the care home has the resources to meet individual residents needs. EVIDENCE: Three individual files for residents staying at home was examined. They all contained a very detailed assessment carried out prior to admission. The assessments set out the care and social needs of each individual resident. This includes their choices wishes and aspirations. 90 Brackenborough Road DS0000032053.V292351.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): 6,7 & 9 Quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to this service. The home has not consistently written care plans each time they have admitted residents. This could have placed residents at risk. The home considers the choice and wishes of residents when reviewing the day to day management of the care home. The registered manager balances resident’s choices and wishes against identified risk. EVIDENCE: There were two individual files for residents, which contained no care plan. Choices and wishes of residents in respect of the manner in which they wish to be helped was found to be recorded in the initial assessment and care records. Staff were able to describe individuals wishes and choices in the formal interview. Residents confirmed that staff do help them to make choices and offer opportunities to take part in activities of Choice. The registered manager stated that one resident wished to go to the local shop without a member of staff. He had balanced the risk in terms of the resident’s ability to manage traffic problems against identified risks. The resident is 90 Brackenborough Road DS0000032053.V292351.R01.S.doc Version 5.1 Page 10 allowed to go to the shop unaccompanied using an agreed route, which reduces the level of risks. 90 Brackenborough Road DS0000032053.V292351.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): 12,13,15,16 & 17 Quality in this outcome area is adequate . This judgement has been made using the available evidence including a visit to this service. Activities are organised for residents staying in the home, but opportunities for residents living beyond the local area is restricted. Residents are encouraged to make links into the local community. Family and friends are encouraged to maintain contact with residents while they are staying at the home. staff respect the rights and dignity of residents. The home’s menu meets the dietary needs of residents. Choice of food is offered. EVIDENCE: The registered manager stated residents attend their normal daily activities if possible while living in the home. Difficulties arise in the residents who live in Skegness area and Boston area alternative activities have to be organised. And the present moment in time these activities are limited the registered manager stated that he is negotiating staffing levels with a view of increasing some staffing hours to offer additional activities. 90 Brackenborough Road DS0000032053.V292351.R01.S.doc Version 5.1 Page 12 Staff confirmed friends and family are encouraged to keep in contact with residents however the purpose of respite care is to provide a holiday\rest for the carers so contact is often limited. Observations and discussions with residents provided evidence that they provide care in the sensitive manner respect the privacy and dignity of individual residents. Staff were seen to knock on bedroom doors and only enter bathroom areas with the permission of the resident. 90 Brackenborough Road DS0000032053.V292351.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 & 20 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. The home provides personal support in the manner preferred by each individual resident. Residents physical and emotional health needs are being met. Staff have been trained to ensure they can administer and manage the storage of medication for residents. EVIDENCE: Three individual files of the residents being placed are contained details of the preferences relating to the manner in which care should be provided. One resident stated that they prefer a particular brand of soap. It was observed that this item was provided to the resident during the inspection. A resident observed during this visit needed one-to-one supervision. Staff was seen to be offered him support both in activities and personal care in a sensitive manner talking to him and reassuring him frequently throughout the visit. Another member of staff was heard to be reassuring a second resident about a family situation. 90 Brackenborough Road DS0000032053.V292351.R01.S.doc Version 5.1 Page 14 The Minimum Standard in relation to medication was not met at the last inspection as staff had not been provided with appropriate training. Staff have now been trained in the administration and storage of medication. They have completed a number of training modules assessed by an independent trainer. All staff are now judged to be competent by the independent trainer to administer medication. A formal exam will be completed during May 2006. 90 Brackenborough Road DS0000032053.V292351.R01.S.doc Version 5.1 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 at least once during a 12 month period. 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 the available evidence including a visit to this service. The home listens to residents views and wishes and acts on them. They are procedures in place to protect residents from any possible abuse. Staff had received appropriate training to protect residents from being harmed. EVIDENCE: The home’s procedures manual contains policies and procedures to manage any complaints and any allegations of abuse. These policies meet the National Minimum Standards. Staff confirmed that they had received training in the identification and management of abuse in August 2005. The registered manager confirmed that further training is to be provided in August 2006. The member of staff, interviewed during this visit was able to describe the companies abuse procedure. They told the Inspector the action they would take if they suspected any abuse was taking place. This action was appropriate and in line with both the Lincolnshire County Council vulnerable abuse procedure and the company policy. 90 Brackenborough Road DS0000032053.V292351.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is excellent. This judgement has been made using the available evidence including a visit to this service. Residents live in a well maintained clean environment . Staff follow the infection control policy of the care home. EVIDENCE: The home has a rolling maintenance programme. A new three-piece has been ordered for the lounge, all bedrooms are being redecorated. Three bedrooms are being fitted with new carpets. The home was found to be clean and tidy and smelt fresh. Not health and safety or infection control problems were identified at this inspection. 90 Brackenborough Road DS0000032053.V292351.R01.S.doc Version 5.1 Page 17 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): 32,34 & 35 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. The home is staffed with appropriate numbers are care staff who are sufficiently trained to be able to answer the needs of residents who fit within the registration category of the care home. The homes recruitment policy is being followed. Staff are well supported by an experienced registered manager. EVIDENCE: The home is registered to take up to five residents. There is always a minimum of two staff on duty. On a day of this visit there were two residents in the home during the day period two members of staff and the registered manager where in the building. The registered manager stated that he ensures there are always sufficient staff on duty to meet the needs of the residents. The numbers of residents admitted may be restricted if an increased staffing ratio is required for a group of residents. An inspection of the recruitment records provided evidence that the appropriate information is being obtained prior to any member of staff commencing employment at the home. The Company has an agreement with their staffing agency that the National Minimum Standards in respect of recruitment will be followed for all agency staff. 90 Brackenborough Road DS0000032053.V292351.R01.S.doc Version 5.1 Page 18 Staff and residents stated the register manager is very helpful and supportive. 90 Brackenborough Road DS0000032053.V292351.R01.S.doc Version 5.1 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 at least once during a 12 month period. 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 the available evidence including a visit to this service. Residents live in a care home, which is safe and free of any health and safety hazard. Staff listen, and take into account the wishes of residents when planning the development of the care home. The register manager offers positive leadership to all staff EVIDENCE: There were no health and safety issues identified from the tour of the care home or discussions with residents and staff. Resident stated that staff do listen to them and they feel that they are actively involved in discussions relating to the day to day running of the care home. The home is managed by an experience registered manager who staff state is very supportive. Staff told the Inspector staff morale is high and teamwork has improved since the last inspection. 90 Brackenborough Road DS0000032053.V292351.R01.S.doc Version 5.1 Page 20 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 4 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 X 27 X 28 X 29 x 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x 90 Brackenborough Road DS0000032053.V292351.R01.S.doc Version 5.1 Page 21 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15 Requirement Residents must have written care plans Timescale for action 01/06/06 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 90 Brackenborough Road DS0000032053.V292351.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 90 Brackenborough Road DS0000032053.V292351.R01.S.doc Version 5.1 Page 23 - 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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