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Inspection on 21/01/09 for Community Living Project

Also see our care home review for Community Living Project for more information

This inspection was carried out on 21st January 2009.

CSCI found this care home to be providing an Good service.

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.

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

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Community Living Project 29 Loughborough Road Quorn Loughborough Leicestershire LE12 8DU The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Fiona Stephenson Date: 2 1 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 31 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Community Living Project 29 Loughborough Road Quorn Loughborough Leicestershire LE12 8DU 01509620858 F/P01509620858 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Deborah Ann Plant Name of registered manager (if applicable) Mrs Laura Jane Booker Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 11 0 care home 11 learning disability Additional conditions: The home is permitted to accommodate one additional named service user as specified in registration variation number V33495. Accommodation of additional named service user. The service user, named in registration variation number V33495, is only to be accommodated in the bedroom specified in correspondence between the National Care Standards Commission and the registered care provider. Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 31 A bit about the care home The Community Living Project is a Care Home for 12 adults who have a Learning Disability. The home is in the village of Quorn and is close to local village shops and a park. There are good bus links to Loughborough and Leicester. The home has a shared lounge and dining room, and a small courtyard. Everyone has their own bedroom with a sink, but bathrooms are shared. There is one bathroom for every three people living in the home. The service takes people who are funded through their Local Authority, and fees are based on the Local Authoritys assessment of their need. Care Homes for Adults (18-65 years) Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 31 How we did our inspection: This is what the inspector did when they were at the care home This key inspection included a visit to the service. We (the CSCI) visited the Community Living Project (CLP) on Wednesday 21st January 2009. We arrived at 12.15pm and left at 6.10pm. Laura Booker, (the registered manager), and Debbie Plant (the owner) helped us during our visit. The main method we used when inspecting this service was case tracking. This means we looked at support given to people in different ways. We did this by - talking to people who live at the CLP, - talking to staff and management who support people living at the CLP, - looking at records, - watching how people are given support. We looked at the Annual Quality Assurance Assessment (AQAA). This is a document the provider (the person who owns the service) sends to us to tell us what they think about how they deliver a service to people who live at the CLP. As well as this, we looked at other information sent to us by the provider and manager since the last key inspection of the service. Page 7 of 31 Care Homes for Adults (18-65 years) We sent Have your Say questionnaires to people who live at the CLP, and to staff who support them. We had nine responses back from staff who work at the CLP, and nine responses from people who live in the home. Many of the questionnaires completed by people living at the home, were done with the support of staff. All those who completed a questionnaire who live in the home, said they could do want they wanted during the day, evening and week-end. Seven people said they knew how to make a complaint, with one not answering the question, and one reporting that they knew how to sometimes. Eight people said that staff treat them well always, with one saying usually. When asked whether carers listened acted upon what they said, five people said always, one person said usually and two said sometimes. One person did not answer this question. When asked if there was anything more they would like to tell us, one person said I would like to do more cooking. There were mixed responses from staff who completed the staff questionnaire. Most felt they had enough information and support from management to undertake their roles, however three said they never met with management to get support. Some felt that communication in the home could be improved. During our visit, we spoke at length with two people who live at the Community Living Project and spent some time in the Care Homes for Adults (18-65 years) Page 8 of 31 lounge chatting to other people who live in the home. We spoke at length to two support staff, and chatted to other staff who were on duty during the time we were there. We checked all the standards the CSCI has decided are key standards during this inspection. The information given in this report is based only on the evidence found during the inspection process. We have kept details of individuals out of this report to respect their confidences. What the care home does well The service is homely, and there is a friendly atmosphere between staff and people who live at the Community Living Project. The bedrooms are decorated to suit the wishes of the people who use them. Care Homes for Adults (18-65 years) Page 9 of 31 People living at the Community Living Project have a range of activities and choices about how they live their lives. People are encouraged to be independent, and good support is given to enable independence outside of the home. The service has good links with health and social care professionals who support people who live at the Community Living Project. Good attention is paid to the management and administration of medication. What has got better from the last inspection The home is being redecorated. There is new furniture in the lounge, and a walk-in bath has been installed to help the less able residents continue to have a choice of bath or shower. Care Homes for Adults (18-65 years) Page 10 of 31 What the care home could do better Management should look at simplifying the care records, and ensure that all staff have a clear understanding of the purpose of the records being completed. The service could replace the black chalk menu board in the hallway, and the fabric calendar in the dining room with boards that are easier to maintain, and give information to people who live in the home that is easier to see and understand. The inclusion of information about the medication people are prescribed, why they are prescribed it, and the effects of medication, should be included in the individuals support plan. This will help staff, and people who use the medication know why they are taking the medication prescribed. The provider must ensure that staff have a good understanding of the Safeguarding Adults policy and procedures. This will further protect and safeguard people who live in the home from abusive situations. Care Homes for Adults (18-65 years) Page 11 of 31 Fire drills could be undertaken more regularly to ensure that both staff and people who live in the home understand what to do in the event of a fire. The provider must ensure that the service has a medication cupboard suitable for the safekeeping of controlled drugs. This must comply with the Misuse of Drugs (Safe Custody) regulations 1973 as amended. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Fiona Stephenson CSCI CPC1, Capital Business Park Fulbourn Cambridge CB21 5XE Tel: 01223 771300 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Adults (18-65 years) Page 12 of 31 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 13 of 31 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 14 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People thinking of moving into the Community Living Project are provided with good information to help them make their decision. Evidence: The service provides good information to people who are thinking about moving into the Community Living Project. The information tells people about the type of service they should expect if they decide to live there. The service provides people with good opportunities to visit the home to get to know staff and other people who live in the home prior to making a decision to move in. People living at the Community Living Project are Local Authority funded and before they move in a full needs assessment is carried out by the local authority. Care Homes for Adults (18-65 years) Page 15 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living at the Community Living Project have their individual needs and choices well supported. Evidence: We talked to people who live in the home, the staff who support them, and looked at the records, which show how staff are supporting people who live in the Community Living Project to meet their needs and personal goals. We found that people who live there feel able to communicate with staff about how they feel and what they want in their lives, and that staff respond positively in supporting people in trying to fulfill their aspirations. The manager told us that people who live in the Community Living Project are involved in the selection of staff, and one of the people who live in the home, told us that there are regular residents meetings. We saw by looking at the records and by talking to staff and people who live in the home, that people are supported to take risks as part of an independent lifestyle, but Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: not at the expense of their safety. We saw that people who live at the home had undertaken training to enable them to become more independent in the community. We saw that staff record a lot of information about the daily life of people who live at the Community Living Project. Although there were a lot of records, they did not always give clear directions to staff, or give clear objectives or outcomes for people who live at the home. Care Homes for Adults (18-65 years) Page 17 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living at the community living project enjoy a good lifestyle. Evidence: We saw by looking at the records that people who live at the Community Living Project lead a varied and stimulating life. We talked to people who live in the home who told us about the work they are doing, and the activities they enjoy. On the day we visited, many people who live at the home were out for the day either working, or at a day centre. On arrival back at the home, some did not have much time before they were getting ready to go out to the disco. We saw photos and records, which showed people had gone on day trips to places like Bradgate Park and Mountsorrel farm. We found out that people use the local pub, go into town and some independently use the local buses and trains. We were told by staff that people living at the home have the opportunity to go on holiday each year, Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: although some prefer to stay at home and go out on day trips instead. We looked at the menu and found out by talking to staff and people living at the home, that the residents are consulted on what they would like for their meals. We were told by people we spoke to that they enjoyed the food. We saw a two week menu plan which showed a range of food choices, and we were informed that the pack-ups people take out to college or the day centre include sandwiches, fruit, cake or alternatives of rice or pasta salad. We saw that the large blackboard style menu board in the hallway did not reflect the menu on offer, and we were told that it was difficult to rub the menu off the board and instead the menu was written on lined paper at the bottom of the board. Care Homes for Adults (18-65 years) Page 19 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living at the Community Living Project are provided with good personal and healthcare support. Evidence: We looked at the personal and healthcare records of people who live at the Community Living Project. We also looked at the AQAA sent by the provider. On talking to staff as well as looking at the records, we found that staff have acted promptly to any medical concerns they have had about people who live in the home. We found that there is good access to health care professionals such as opticians, and chiropodists that visit the home; and other health care professionals such as G.P.s, district nurses, and dentists. We watched staff giving medication to people who live at the Community Living Project. We also checked the medication administration records (MAR). We found that staff were giving medication as they should, and writing up the records correctly. We saw where medication is kept and found that it is not kept in the type of cupboard that it should be kept in. (the requirement for this has only recently changed and the service were acting on previous requirements). Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: The support plans did not include information about the reasons why people were being prescribed medication and what the effects of the medication might be. The service does keep information about the different types of medication being administered to people but this is not linked to the individual. Care Homes for Adults (18-65 years) Page 21 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living at the Community Living Project have their concerns and complaints listened to and responded to promptly, but staff need clearer understanding of safeguarding policies and procedures. Evidence: We (the CSCI) have not received any complaints since the last key inspection about any aspect of care being provided by staff or management at the Community Living Project. We looked at the complaints record in the home, and this showed no formal complaints have been recorded in the last year. We were informed that any complaints or concerns are dealt with informally and resolved as soon as possible. We were told that people living in the home can also use the residents meeting to discuss any concerns they may have. We talked with staff about safeguarding policies and procedures, to find out whether they had a good understanding of what theirs and the services responsibilities are, if they are concerned that a person living in the home is being abused in any way. Although staff were clear that abuse was not acceptable, they didnt have a clear knowledge of what should be done and who should be contacted. The AQAA told us that staff are due to have training in this area. Care Homes for Adults (18-65 years) Page 22 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The environment is homely, and clean and tidy. Evidence: We looked at the communal living room and dining room, and we looked in the bedrooms of some of the people who live in the home. The living room now has new two seater sofas for people to use and a large flat screen TV, and Wii for general use. The bedrooms seen were decorated to the tastes and preferences of those who lived in them, and had their own personal possessions. The bathroom/shower rooms were checked and these were in a satisfactory condition. All areas of the home were seen as clean and tidy. Care Homes for Adults (18-65 years) Page 23 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who live at the Community Living Project are supported by a good team of staff. Evidence: We looked at the staff records and found that the service had made sure staff had been properly checked before working with people who live at the Community Living Project. On the day of our visit, we saw a good level of staffing to support the needs of people living at the home. We also checked the staff rota and found good levels of staffing throughout the week. We saw that staffing is increased at key times to help support people living at the Community Living Project attend activities in the evening and at the week-end. We were told that all staff have either been trained to a minimum of an NVQ2 in care, or are currently undertaking their NVQ2 in care. We saw that some staff have higher qualifications. We saw that staff are given good support from management, with regular supervision. We were told that staff meetings are not always well attended, but that management are looking at different ways to get information to the staff group. Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: We saw that staff had a good rapport with people living in the home, and knew about the needs of the people they were supporting. Care Homes for Adults (18-65 years) Page 25 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The service is well managed. Evidence: The registered manager is well qualified and has many years experience working with people who have learning disabilities. Staff spoken with said they are given good support by the manager, and most staff responding to the Have your Say questionnaire felt supported by manaement. People living at the Community Living Project are supported to be involved in the running of the home, through being part of the staff recruitment process, through resident meetings, and through day-to-day discussion with management. There hasnt been any formal quality assurance process recently, however both people who live in the home, and their relatives are kept fully informed about the day to day running of the home, and are invited to respond to any changes if they are not happy with them. We checked to see whether there were safe working practices. We found that there Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: were good systems in place for safe working, but saw that the last fire drills were undertaken in May 2008 for day staff, and February 2008 for night staff. Care Homes for Adults (18-65 years) Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 31 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 20 13 25/02/2009 The provider must ensure that the service has a medication cupboard suitable for the safekeeping of controlled drugs. This must comply with the Misuse of Drugs (Safe Custody) regulations 1973 as amended. To comply with their legal responsibilities. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 6 Management should look at simplifying the recording system, and ensure that all staff have a clear understanding of the purpose of the records being completed. To remove the large black board and replace with a Page 29 of 31 2 17 Care Homes for Adults (18-65 years) different type of board which makes it easier to change and update information to people living in the home. 3 19 The manager should consider the inclusion of information about the medication people are prescribed, why they are prescribed it, and the effects of medication, in the individuals support plan. The provider must ensure that staff have a good understanding of the Safeguarding Adults policy and procedures. The manager should ensure that staff contracts are signed within a short period of time on commencement of taking on employment. The provider should ensure fire drills are undertaken regularly, and particularly when new members of staff have commenced employment. 4 23 5 31 6 42 Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 31 of 31 - 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!