CARE HOME ADULTS 18-65
Albert Promenade 97Albert Promenade Loughborough Leicestershire LE11 1RD Lead Inspector
Chris Wroe Unannounced 17 August 2005 at 9.30am 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 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 Stationary 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. Albert Promenade C51 C01 Albert Promenade 170805 V245086 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Albert Promenade Care Home Address 97 Albert Promenade Loughborough Leicestershire LE11 1RD 01509 550799 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Anthony Cliffe Mr Anthony Cliffe Care Home 3 Category(ies) of LD Learning Disability - 3 registration, with number of places Albert Promenade C51 C01 Albert Promenade 170805 V245086 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 15th March 2005 Brief Description of the Service: 97 Albert Promenade, (also called Cliffe House) is in Loughborough. Three people who have learning disabilities live at Cliffe House. It is close to local shops, pubs and bus stops. There are three bedrooms, but two residents choose to share a bedroom. The third bedroom is used as a lounge and there are two other lounges and a dining room for residents. There is a small patio back garden. The owners live in the house as well. Albert Promenade C51 C01 Albert Promenade 170805 V245086 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place on two weekdays, 17th and 23rd August 2005, lasting in total for four and a half hours. The three people living in the home were spoken with during the inspection. They said what they thought about living in the home. The things they said showed they were happy with the care given to them. One resident said: ‘They are so good to us here.’ A way of inspecting was used, called case tracking: the care of the residents was ‘tracked’ by checking written information, talking with the residents and with carers, looking round the home and watching the way things were done in the home. What the service does well:
A good, comfortable relationship was seen between people who live in the home and carers. Carers knew what residents liked or did not like and how to give them the care they wanted and needed. People who live in the home are like part of the carers’ family and are involved with them in the community. Residents go to day centres and learn new things. They also do other things they enjoy, like shopping and going out for meals. Residents’ health care needs are well looked after. There are written policies in the home which give information about how carers can do their job well. People who live in the home can complain about things if they are not happy. Carers have rules about how to keep residents safe. The home is clean and comfortable for residents. People who live in the home have their own rooms (two choose to share) and shared lounges. Staff get training to help them do their job. Albert Promenade C51 C01 Albert Promenade 170805 V245086 Stage 4.doc Version 1.40 Page 6 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. Albert Promenade C51 C01 Albert Promenade 170805 V245086 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Albert Promenade C51 C01 Albert Promenade 170805 V245086 Stage 4.doc Version 1.40 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 standard(s) 2 Carers provide good care by assessing changing needs. EVIDENCE: All three people living in the home have lived there for over ten years, so there are no new residents. But the carers look at what people living in the home need and make sure that the placement agreements with Social Services tie in with changing care needs. Albert Promenade C51 C01 Albert Promenade 170805 V245086 Stage 4.doc Version 1.40 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 standard(s) 6, 7, 9 Carers make sure that individual needs and choices are met. EVIDENCE: Each person living in the home has a care plan written about them, which describes things that are important to them and what help they need in their daily living. People living in the home are helped to do things they want to do and to be safe. Reviews take place with carers and social workers to make sure everyone is getting the care they need. To help make sure residents are safe in things the choose to do, carers could let social workers have more information about the ways that residents like to spend their time, and make sure that they write about it in care plans. Albert Promenade C51 C01 Albert Promenade 170805 V245086 Stage 4.doc Version 1.40 Page 10 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 standard(s) 11, 12, 13, 17 Carers help residents to do the things they want to do. EVIDENCE: All three people living in the home go to day centres and do different courses that they choose to do. They are involved with the local community, and spend time with carers and their families. The carers in the home want to provide a family-like home for the residents, and the people living in the home are included in their lives. People living in the home enjoy doing different things, like going shopping, going out for meals, and taking the dog for a walk. Sometimes they go out to places, like Staunton Harold. The owner of the home cooks meals for people who live in the home, and they said they like his cooking. Albert Promenade C51 C01 Albert Promenade 170805 V245086 Stage 4.doc Version 1.40 Page 11 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 standard(s) 18, 19, 20 Health care needs are mainly well met. EVIDENCE: The carers make sure that the health of people living in the home is looked after, with help from other people, such as doctors and dentists. Carers provide help with personal care if needed. Carers look after medication for people living in the home. There is a policy about medication which gives information about how medicine should be looked after and given to residents. One daily log showed that medication (a mild painkiller), which was not prescribed, had been given to a resident by someone who was not trained to give medicine. This must not happen, and medicine must only be given by someone who has been trained to give it. A policy needs to be written about which medicine can be given to residents without a prescription. This needs to be done with the GP’s help. The owner needs to make sure that old medication is taken back to the pharmacist. Albert Promenade C51 C01 Albert Promenade 170805 V245086 Stage 4.doc Version 1.40 Page 12 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 standard(s) 22, 23 Residents are able to complain if they want to and they are protected from harm. EVIDENCE: There is a complaints procedure in the home, for residents to use if they are not happy about something. No complaints have been made since the last inspection. Carers know about how to make sure people living in the home are safe. There are policies written about how residents need to be protected from harm, and carers have followed these. Albert Promenade C51 C01 Albert Promenade 170805 V245086 Stage 4.doc Version 1.40 Page 13 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 standard(s) 24, 25, 26, 27, 28 Residents are mostly comfortable in their home. EVIDENCE: The home is clean, comfortable and furnished and decorated in a homely family style. Each person living in the home can have their own bedroom if they want to but two residents choose to share a bedroom. The other room is used as a lounge. The bedrooms do not really have personal pictures or things that residents have chosen or like. It would be good if carers could help residents to decide if they want other things in their room that they choose themselves, such as pictures. One carer (who lives in the home) keeps some of her things in one of the wardrobes in the shared bedroom, because there is a lot of space in the room. The residents have signed that they accept this. Laundry is taken away from the home to be washed.
Albert Promenade C51 C01 Albert Promenade 170805 V245086 Stage 4.doc Version 1.40 Page 14 Albert Promenade C51 C01 Albert Promenade 170805 V245086 Stage 4.doc Version 1.40 Page 15 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35 Residents are partly protected by staffing and recruitment procedures. EVIDENCE: People who live in the home get on well with carers. Carers are part of their religious community also. Carers are doing training to help them to do their job. They are going to do a course called ‘person centred planning’, which will help them to make sure they really understand what people living in the home need and want. It is important to the owners that carers working in the home have the same values as they do about caring for people living in the home. They choose carefully who will work in the home. Some checks have been done to make sure they are safe people. But important documents like application forms and references have not been filled in. The owners need to make sure that people who want to be carers in the home give all details about themselves, to show that they are right for the job and safe to work with people in the home. They should also get the same sort of information from volunteers. Albert Promenade C51 C01 Albert Promenade 170805 V245086 Stage 4.doc Version 1.40 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 41, 42 The home is mostly well run. EVIDENCE: There are policies in the home, which have written information about the way different things should be done. Information about people living in the home was a bit muddled and needs to be tidied up. This would help carers to more easily find out any important things they need to know about people living in the home. The owner and carers try to make things safe in the home. Fire safety checks are done, and the fire officer inspected the home recently. It would be helpful if training were given to the housekeeper to make sure she knows how to do all parts of her job safely. Albert Promenade C51 C01 Albert Promenade 170805 V245086 Stage 4.doc Version 1.40 Page 17 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 x 3 x x x Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 3 3 x x Standard No 11 12 13 14 15 16 17 3 3 3 x x x 3 Standard No 31 32 33 34 35 36 Score x 3 3 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Albert Promenade Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x 2 3 x C51 C01 Albert Promenade 170805 V245086 Stage 4.doc Version 1.40 Page 18 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. 1. 2. 3. Standard 20 20 20 Regulation 13 13 13 Requirement The owner must make sure that only carers who have been trained to give medication do so. The owner must make sure that only prescribed or authorised medication is given to residents. The owner must develop a list of medicines for use in the home as homely remedies in conjunction with the GP/pharmacist. The owner must return old unused medication stocks to the pharmacist The owner must make sure that for all paid workers and volunteers application forms are completed, two references obtained and all information required under 2 is collected. Timescale for action Forthwith Forthwith By 30th September 2005 By 30th september 2005 By 30th september 2005 and ongoing. 4. 5. 20 34 13 Schedule 2 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 9 Good Practice Recommendations It is recommended that more information is included in care plans and provided to social workers about how
C51 C01 Albert Promenade 170805 V245086 Stage 4.doc Version 1.40 Page 19 Albert Promenade 2. 3. 4. 5. 26 41 42 residents choose to spend their time, to make sure that residents are safe (specifically re spending time at staffs house). It is recommended that the owner asks residents if they would like to choose things, such as pictures or ornaments, that they would like in their rooms. It is recommended that the files containing information about residents are tidied to provide easier access. It is recommended that the housekeeper is give training to help her do her job, such as infection control and health and safety Albert Promenade C51 C01 Albert Promenade 170805 V245086 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection The Pavillions, 5 Smith Way Grove Park Enderby Leicestershire LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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