Inspection on 07/02/07 for Community Living Project

This inspection was carried out on 7th February 2007.

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

Community Living Project 21/01/09

Community Living Project 12/07/05

Community Living Project 05/10/04

Community Living Project 10/06/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Community Living Project 29 Loughborough Road Quorn Loughborough Leicestershire LE12 8DU Lead Inspector Mick Walklin Key Unannounced Inspection 7th February 2007 11:30 Community Living Project DS0000001789.V324311.R01.S.doc Version 5.2 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 Community Living Project DS0000001789.V324311.R01.S.doc Version 5.2 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. Community Living Project DS0000001789.V324311.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Community Living Project Address 29 Loughborough Road Quorn Loughborough Leicestershire LE12 8DU 01509 620858 01509 620858 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) Mrs Deborah Ann Plant Mrs Laura Jane Booker Care Home 11 Category(ies) of Learning disability (11) registration, with number of places Community Living Project DS0000001789.V324311.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 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. 12th December 2005 Date of last inspection Brief Description of the Service: The Community Living Project is a Care Home for 12 adults who have a Learning Disability (currently one extra person lives in the home, which has been agreed with the CSCI). The home is in the village of Quorn and is close to local village shops and a park. There are good bus links with Loughborough and Leicester. The home has a shared lounge and a small patio garden. Everyone has their own bedroom with a sink, but bathrooms are shared. The range of fees charged is between £332 - £1217 per week. Community Living Project DS0000001789.V324311.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was undertaken using a review of all the information available to the inspector regarding the service history of the Community Living Project, and through undertaking a visit to the home. The fieldwork visit took place over 6 hours. The main method of inspection used was called case tracking which involved selecting three residents and tracking the support they receive through the checking of their records, discussion with them, the care staff and observation of care practices. A tour of the building was undertaken with the deputy manager. Documents connected with the running of the home were also inspected. The manager had completed a Pre-Inspection Questionnaire in June 2006. What the service does well: What has improved since the last inspection? What they could do better: Important information about some staff had not been asked for before they had started work at the home. This meant that the manager did not have enough information to decide if they were the right person for the job, and this could have put residents at risk. Residents should have better information about how to complain. Community Living Project DS0000001789.V324311.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Community Living Project DS0000001789.V324311.R01.S.doc Version 5.2 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 Community Living Project DS0000001789.V324311.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Pre-admission procedures are satisfactory, to ensure that residents needs can be met. EVIDENCE: There have been no recent admissions to the home, so this standard could not be fully inspected. The owner outlined how she would deal with any new referrals to the home. Referrals are usually received from Social Workers, who will provide information about the persons needs, both verbally, and in writing. Staff will then assess the persons suitability, and invite them and their family to visit. Staff will conduct their own pre-admission assessment, and a programme of visits, including overnight stays will be arranged. Admissions are usually for a two-month trial period. Community Living Project DS0000001789.V324311.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments identify residents support needs. Residents are assisted to make decisions about their lives, and develop independent living skills within a safe environment. EVIDENCE: Staff are working with all residents to develop person centred plans (PCP’s). These identify short and long-term wishes and ambitions. These were not inspected, as they are personal to residents, but some residents had action plans displayed in their bedrooms. Most staff have received PCP training, and two staff are trained as facilitators. Staff said that working with residents on their PCP’s had helped them look at residents lives in a different way, and had broadened residents activities. This had led to one resident attending gospel concerts, and another planning a visit to his parents in Turkey, and planning for his retirement. Community Living Project DS0000001789.V324311.R01.S.doc Version 5.2 Page 10 Care plans contain a good range of assessments, which give details about residents support needs. However, they are not presented in a way that gives staff clear step-by-step guidance on what they need to do to support residents with their key needs, for example, in areas of personal care or behaviours. There are good daily records, and key workers review plans on a monthly basis, and write progress reports. Staff talked about how they help residents make decisions about their lives, and the various ways that residents communicate. They said that person centred plans had helped residents make lifestyle decisions. Most residents have verbal communication, but some use signing or pictures/symbols to help them communicate wishes and choices. One member of staff said, “We get to know their ways, and what they want. Most can tell you, but some may take you by the hand and show you what they want”. One resident chooses to smoke, and she said, “I can’t smoke in here – I have to go outside, but that is alright”. Care plans contain a good range of risk assessments. Staff said that risk taking is part of developing skills, and one said, “Cooking could be risky, but we don’t say to residents that they can’t do it. Some residents are safe in the kitchen, and others need more supervision”. The external doors to the house are locked with slide bolts, as one resident is at risk of wandering off. The use of the bolts has been agreed with the fire officer. Those residents able to go out into the community independently can open the doors. One said, “I have just been down to the shop to get some things”. The kitchen is also locked for health and safety reasons, but residents said that they can ask for a key to make drinks and snacks. Community Living Project DS0000001789.V324311.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are a good range of activities for residents to participate in. Family contact is encouraged. Residents are treated with respect. Catering arrangements reflect individual choices. EVIDENCE: Residents have busy activity timetables, which are a combination of college, day centres, home based activities and outings. There is a new activity organiser, who described her forthcoming plans with enthusiasm. Some residents attend a local community college, and take part in courses such as IT, woodwork, numeracy and literacy and art. Several residents were attending evening classes. One said, “I enjoy cooking - apple crumble is my favourite”. No residents have employment or voluntary work, but in the past, residents have worked in gardening, car washing, and catering. Staff said that they are actively pursuing other opportunities for residents. One member of staff said, Community Living Project DS0000001789.V324311.R01.S.doc Version 5.2 Page 12 “We use a lot of local facilities such as pubs, bowling, and cinema. One resident goes fishing”. A resident said, “We go out a lot – it is fun”. Another resident said, “I’ve been at work today – I like washing the car”. The home has a 7-seater people carrier for outings. Most residents had a holiday at Butlins last year. Those that did not go had day trips planned. Family contact is encouraged. Some families visit regularly, and others maintain contact by telephone. Staff said that visits do not have to be prearranged. There is a payphone available to residents. One resident said that she was looking forward to visiting her brother at Easter. Residents said that staff are respectful towards them, and respect their personal space. One said, “They always knock on my door before they come in”. Staff gave good examples of how they promote privacy and dignity. Care staff are responsible for meal preparation. There is a choice of two or three meals, with the main meal being served in the evening. Residents attending day services take a packed lunch. Staff cater for low cholesterol and diabetic diets, but no residents have any cultural or religious dietary needs. A resident said, “I like the food here – it’s OK”. Smaller dining tables have been purchased since the last inspection, as larger tables led to some arguments between residents at mealtimes. Community Living Project DS0000001789.V324311.R01.S.doc Version 5.2 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. 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 available evidence including a visit to this service. Residents receive good support, and there are excellent arrangements with health care providers to ensure that residents needs are met. Medication procedures ensure that medication is administered safely. EVIDENCE: Residents said that they receive good support. One said, “The staff are nice – they help me when I need it”. Another said, “The staff are OK”. There is good communication between staff and residents, and residents are encouraged to be as independent as possible, with staff offering assistance when needed. Residents are registered with a doctors surgery in a neighbouring village. There are excellent arrangements with local health care providers, with a wide range of services available. Eight of the eleven residents have health action plans, which identify health needs and health promotion. Community Nurses have done health awareness sessions with residents and staff covering breast awareness, and testicular awareness. A district nurse is teaching a resident to Community Living Project DS0000001789.V324311.R01.S.doc Version 5.2 Page 14 do their own blood monitoring. Nine of the residents are seen by a consultant psychiatrist, and residents have had input from speech and language therapists, and occupational therapists. A chiropodist visits every six weeks, and an optician will visit the home as required. Dental services are available through community dentists and the hospital. The home uses a pre-packed administration system. No residents selfmedicate, but one resident takes her medication to her room after staff have given it out. Senior staff administer medication, and they have had training in the safe handling of medication. They have to complete ten supervised administration rounds before being assessed as competent. Medication is properly stored, and administration records are fully completed. Homely remedies are only given after the pharmacist has been contacted. Community Living Project DS0000001789.V324311.R01.S.doc Version 5.2 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. 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 available evidence including a visit to this service. Residents are not enabled to make complaints as they are not provided with the complaints procedure in an accessible format. There are good arrangements to ensure that residents are safe. EVIDENCE: The home received one complaint from a local day centre about residents changing from cooked meals at the day centre to packed lunches, but this has been resolved. There is a complaints procedure displayed in the building, but this is not in an accessible format for residents. The procedure should be made available in easy read and pictures format. All new staff receive a copy of the adult protection policy, and the whistle blowing policy with their job offer. The subject is also covered on induction. There has been an adult protection investigation since the last inspection, following a resident getting sunburnt. This was investigated, and no further action taken. Staff interviewed were clear on their responsibility for reporting suspicions or allegation. Community Living Project DS0000001789.V324311.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and clean environment for residents to enjoy. EVIDENCE: Some improvements have been made since the last inspection, with new furniture being brought for the lounge and dining areas. A resident said, “ I like it here – I like the new furniture”. Bedrooms are well decorated, and personalised. One resident, who has dementia, has his bedroom clearly identified by a picture of a player from his favourite football team. A new walkin bath has been installed in the past few weeks. A cleaner is employed for 15 hours per week, but residents are encouraged to clean their own bedrooms. The home was clean on the day of the inspection. Residents are also encouraged to assist with other household tasks, such as washing up, ironing, cleaning the car, and recycling. Community Living Project DS0000001789.V324311.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff are well trained, and staffing levels enable residents to receive good levels of support. Recruitment and selection of staff is not robust enough, and could put residents at risk. EVIDENCE: There are usually between three to five staff working during the day, with two night staff. Both residents and staff said this was enough to provide good support to residents. One member of staff said, “We are able to provide good care with the staffing that we have got”. New staff use a detailed induction workbook called ‘Developing Competent Carers’. One said, “I really enjoyed my induction – it was good going through the workbook”. The home does not use the Learning Disabilities Awards Framework (LDAF - a training programme for staff working with people with a learning disability, which the Government recommends all staff complete). However, the owner said that she was actively looking for someone to provide Community Living Project DS0000001789.V324311.R01.S.doc Version 5.2 Page 18 this. Staff said that they training that they receive is good. She said that a lot of the training is provided by a company, who tell her when staff are due updates. Staff have individual training records, which showed a good range of training. Twelve staff are doing, or have done a National Vocational Qualification (NVQ). Three staff files were inspected, all of whom had been employed by the home last year. All contained evidence of a formal recruitment procedure, but all three had been employed before a Protection of Vulnerable Adults (POVA) check, or Criminal Records Bureau (CRB) check had been received. Two of the staff had worked at the home for or over three months, before a CRB had been received. The owner was not aware of the new guidance about CRB and POVA checks, which had changed in 2005. An immediate requirement was made. Community Living Project DS0000001789.V324311.R01.S.doc Version 5.2 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. 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 available evidence including a visit to this service. This service is well managed and consults with residents and their families in order to improve the service provided. Staff make sure that the environment is safe, so that residents are protected from harm. EVIDENCE: Staff and residents said that the home is well managed and organised. The manager has worked at the home for 10 years and has been manager since 2003. The owner and manager are completing the Registered Managers Award, and the deputy manager is completing NVQ level 4. Staff said that they felt valued for the work that they do. One said, “We have a nice staff group – everyone gets on. The home is well managed, and senior staff are helpful and Community Living Project DS0000001789.V324311.R01.S.doc Version 5.2 Page 20 approachable if you need to know things. We have regular staff meetings, and can put forward ideas”. The owner sends out an annual questionnaire to all families. This was last done in August 2006, and four families replied. All replies were positive. Residents are asked to complete a questionnaire twice a year. Key workers help them with this, and the questionnaire uses symbols of ‘smiley’ and ‘unhappy’ faces. The owner also does regular unannounced visits to check on how the home is run. Health and safety, and maintenance checks were up to date. Hand sanitizer is kept in the staff room and the hallway. This product is potentially dangerous if used wrongly, and the owner arranged for a risk assessment to be done during the inspection. Community Living Project DS0000001789.V324311.R01.S.doc Version 5.2 Page 21 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 3 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 1 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 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 4 3 X 3 X 3 X X 3 X Community Living Project DS0000001789.V324311.R01.S.doc Version 5.2 Page 22 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 YA34 Regulation 19 Requirement The registered person must ensure that the documents outlined in Schedule 2 of the Care Homes Regulations be obtained before staff are employed at the home. Immediate requirement left Timescale for action 07/02/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA6 YA22 Good Practice Recommendations Care plans should be reviewed to give staff clearer guidance about the support that service users require. The complaints procedure should be available to service users in easy read and other formats. Community Living Project DS0000001789.V324311.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 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 © 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 Community Living Project DS0000001789.V324311.R01.S.doc Version 5.2 Page 24 - 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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