CARE HOME ADULTS 18-65
Andlaw House 126 Bartholomew Street West Exeter Devon EX4 3AJ Lead Inspector
Susan Lyons Announced Inspection 10th November 2005 10:00 Andlaw House DS0000021875.V265078.R01.S.doc Version 5.0 Page 1 Andlaw House DS0000021875.V265078.R01.S.doc Version 5.0 Page 2 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 Andlaw House DS0000021875.V265078.R01.S.doc Version 5.0 Page 3 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. Andlaw House DS0000021875.V265078.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Name of service Andlaw House Address 126 Bartholomew Street West Exeter Devon EX4 3AJ 01392 490366 01392 490399 liz.lodge@selsewelt.org.uk 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) Sense Mrs Elizabeth Mary Hodge Care Home 10 Category(ies) of Learning disability (10), Physical disability (6), registration, with number Sensory impairment (10) of places Andlaw House DS0000021875.V265078.R01.S.doc Version 5.0 Page 5 SERVICE INFORMATION
Conditions of registration: 1. Age Range:- 18 to 50 years Date of last inspection 29th June 2005 Brief Description of the Service: Andlaw house is a two-storey purpose built home, close to the centre of Exeter. It is divided into two flats with separate staffing. However it is registered as one home. Due to the multiple needs of the service users the home has developed various ways of communicating using smell and touch. Each day of the week has an associated perfume. as you enter the home and each member of staff carries a small square of fabric, which is impregnated with the perfume. To identify themselves each member of staff carries a key ring with an object on it which service users are able to feel to know who is with them. Andlaw House DS0000021875.V265078.R01.S.doc Version 5.0 Page 6 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection which took place at 10.30 am. The inspector met several of the staff and residents, looked around some areas of the home and talked to the manager and one of the senior members of staff. Records were looked at as well as feedback cards and preinspection documents completed by the home What the service does well: What has improved since the last inspection?
The organisation is looking at using induction and foundation training which is specific to Learning Disabilities. Andlaw House DS0000021875.V265078.R01.S.doc Version 5.0 Page 7 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. Andlaw House DS0000021875.V265078.R01.S.doc Version 5.0 Page 8 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 Andlaw House DS0000021875.V265078.R01.S.doc Version 5.0 Page 9 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): The core standard was assessed on the last inspection see report for 29/06/05 EVIDENCE: Andlaw House DS0000021875.V265078.R01.S.doc Version 5.0 Page 10 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. There is clear and consistent, care planning in place, which provides staff with the information they need to meet residents’ needs. This is marred by a lack of review. With minor adjustments the identification and management of risk will protect residents. EVIDENCE: Care plans were looked at in detail during the last inspection. They contain good detail of how residents need to be supported and they also contain details of likes and dislikes as well as detailed daily routines and behavioural guidelines. It was noted that some of the daily routines had not been reviewed for more than a year and in one case had been removed from the file as they were in the process of being reviewed thus making them not readily available. Risk assessments are available for individual residents and in general. It was noted that one risk assessment had not been reviewed since February 2004. Andlaw House DS0000021875.V265078.R01.S.doc Version 5.0 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): 15, 16 & 17. The home has created an environment, which supports residents with family and friend relationships. The rights of residents are respected and recognised within the home affording them independence. The meals at the home are good offering both choice and variety. EVIDENCE: There are no restrictions on visiting times and relationships between residents and families are supported. Some times this means that staff will assist with transport so that residents are able to maintain relationships. Restrictions to areas within the house and gardens are only restricted on the grounds of safety. Staff were seen to knock on residents bedroom doors and were also seen to be interacting and communicating appropriately with residents and using whatever form of communication is understood by the individual resident. Mail is given to residents and they are supported to read or look at it. The record of meals eaten are entered on each residents daily recording sheet. If there are concerns about food and drink intake then the actual amounts are recorded. Where possible residents do assist in the kitchen areas and are supported to make a drink or snack.
Andlaw House DS0000021875.V265078.R01.S.doc Version 5.0 Page 12 Andlaw House DS0000021875.V265078.R01.S.doc Version 5.0 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 Residents rights and choice are recognised and acted upon. The systems for maintaining residents medical needs are good. With a minor adjustment the administration procedures for medication will be robust. EVIDENCE: Personal support preferences and guidance from other professionals is well documented in individual care plans. Staff were seen to be assisting residents in a way in which maintained their choice, dignity and privacy. Evidence was seen that healthcare support is sought and in particular that it is pursued when there is a concern about a resident. Staff accompany residents to appointments to see healthcare professionals and undertake prescribed exercises etc. with residents in the home. Medication was looked at. The home uses a monitored dosage system from a local pharmacy and has lockable storage for the medication. It was noted that on some recent sheets the amount of medication which came into the home was not recorded. Andlaw House DS0000021875.V265078.R01.S.doc Version 5.0 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 Residents are protected by the complaints and adult protection procedures. EVIDENCE: The home has not received any complaints since the last inspection. All the feedback cards received from relatives indicated that they were aware of the complaints procedure. The manager said that they send out a copy of the complaints procedure with the annual review. Guidelines in relation to reporting suspected abuse were seen displayed on the wall within the home and a member of staff who spoke to the inspector was able to describe correctly what she would do if she saw a resident being treated inappropriately. Andlaw House DS0000021875.V265078.R01.S.doc Version 5.0 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 & 30 With minor adjustments all bedrooms will meet residents needs. The standard of the environment within the home is good providing residents with an attractive, clean and homely place to live. EVIDENCE: The bedrooms which were seen contain suitable furniture and equipment and residents have been able to personalise them. One of the bedrooms has had the radiator removed due to the resident damaging it and causing themselves possible injury. The staff are monitoring the temperature in the room but it felt cold on the day of the inspection. On the day of the inspection the home was seen to be clean and there were no unpleasant odours. The home has a small laundry on the ground floor and has washing machines on each individual flat. An infection control policy is available as well as disposable gloves and aprons. Andlaw House DS0000021875.V265078.R01.S.doc Version 5.0 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): 34 & 35 Robust recruitment procedures protect residents. Residents will benefit from specialist trained staff. EVIDENCE: The recruitment paperwork was seen for the last two members of staff to be recruited. The paperwork was seen to be in order. A recommendation was made following the last two inspections that the induction and foundation training be LDAF (Learning Disability Award Framework ) accredited. The manager said this was being piloted in one of the other Sense homes. Andlaw House DS0000021875.V265078.R01.S.doc Version 5.0 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 Residents benefit from clear and supportive management. Views sought from all involved ensure that there is a clear vision for the home. EVIDENCE: The current manager is planning to retire next year. She has many years experience and a management qualification. Staff said that they found the manager and senior members of staff very approachable. Questionnaires in relation to the quality of the service have been sent out this year to the relatives and the funding authority. This is an annual exercise and an action plan is produced once questionnaires have been received. Andlaw House DS0000021875.V265078.R01.S.doc Version 5.0 Page 18 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 X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X 2 X Standard No 24 25 26 27 28 29 30
STAFFING Score 1 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 4 16 3 17 Standard No 31 32 33 34 35 36 Score X X X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Andlaw House Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X X X DS0000021875.V265078.R01.S.doc Version 5.0 Page 19 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 YA24 Regulation 23 (2) (p) Requirement You are required to ensure that heating is provided in all bedrooms used by residents. Timescale for action 31/12/05 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 YA9 YA20 Good Practice Recommendations You should ensure that all areas of care plans are kept under review You should ensure that risk assessments are kept under review You should ensure that the amount of individual medication coming into the home is recorded. Andlaw House DS0000021875.V265078.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Andlaw House DS0000021875.V265078.R01.S.doc Version 5.0 Page 21 - 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!
