Inspection on 07/02/06 for Helen Ley House

This inspection was carried out on 7th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Helen Ley House 17/10/08

Helen Ley House 17/10/06

Helen Ley House 30/09/05

Helen Ley House 20/01/05

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Helen Ley House Helen Ley House Bericote Road Blackdown Leamington Spa Warwickshire CV32 6QP Lead Inspector Catherine Mundy Unannounced Inspection 7th February 2006 10:00 Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Helen Ley House Address 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) Helen Ley House Bericote Road Blackdown Leamington Spa Warwickshire CV32 6QP 01926 331550 01926 888972 www.helenley.org.uk Multiple Sclerosis Society Care Home 23 Category(ies) of Physical disability (23) registration, with number of places Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th September 2005 Brief Description of the Service: Helen Ley House is a respite care home with for adults with physical disabilities who have Multiple Sclerosis. The home is set in landscaped gardens in the Warwickshire countryside a short drive from Leamington Spa. The home is a single storey purpose built accommodation with 23 single rooms, the majority of which have track hoists. The home provides long-term accommodation to two service users; the remainder of the 21 beds are for respite care. The home has a physiotherapy department with a hydrotherapy pool for service users to use during their stay. The gardens are mature and well maintained. Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the second inspection of this home in the 2005/06 inspection year. This inspection focuses on the key standards that were not inspected at the last inspection and progress towards meeting the requirements and recommendations that were made. For a full overview of this service this report should be read alongside that written following the last inspection of this home, which took place on 30th September 2005. This inspection took place on 7th February 2006, between 10 am and 2.45 pm. The inspection was pre-arranged with the home. The inspection included observations of the interactions between staff and service users, a tour of the home, discussions with service users, staff, acting manager and the organisations representative. Records relating to the service users care and documents relating to the management of the home were also examined. Since the time of the last inspection the organisation has appointed a manager for the home. The manager is due to take up her post on 20th February 2006. An application to register the manager with the Commission for Social Care Inspection has been received. Standards relating to the environment were not assessed on this occasion as the home is currently undergoing major refurbishment. These standards will be inspected as part of the registration of the new facilities. The organisation anticipates that the building work will be completed in May 2006. What the service does well: All of the service users spoke highly of the home and staff. Comments from the service users include ‘the home is top class’, ‘you cant fault the staff’, ‘the staff are nice, you can have a laugh with them’, ‘I wouldn’t change anything’ ‘the food is lovely’. The service users said that they found the staff to be approachable and are confident that any concerns raised or complaints made will be addressed. The home continues to offer a broad range of activities, these include hairdressing, aromatherapy, Indian head massage, reflexology, beauty treatments, pet therapy, shopping trips, cinema, quiz nights and pub visits. The home also has a video library and loans radios, CDs and DVDs to service users for use during their stay. Service users are also able to maintain links with family and friends if they wish. On the day of the inspection the home had a jovial atmosphere with staff and service users chatting and laughing together. Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 6 The service users are also able to have physiotherapy, hydrotherapy and have access to a counselling service. The service users said that they valued these opportunities. Observations of the interactions between staff and service users confirmed that the service users are supported in a sensitive way that promotes their privacy, dignity and maintains their health. Service users are able to receive routine health screening by the nurses in the home, and are supported to access other services such as the opticians, emergency dentist and local GP if required. 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. Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 There is a needs assessment and care planning system in place that provides staff with the information they need to satisfactorily meet service user needs. EVIDENCE: Standard 2 was assessed at the last inspection of the home and was part met. The requirement made to ensure that changes to the service users needs assessment and care plans are clearly recorded has been met by the home. Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 The systems in place to assess and review the service users needs and develop care plans are good, providing the staff with detailed information as to how the service users identified needs are to be met. The staff support the service users to make decisions relating to the care that is provided in the home. EVIDENCE: Two service user care plans were examined. One belonged to a service user who lives permanently within the home and the other belonged to a service user receiving respite care. Each included an assessment of the service users needs, with care plans and risk assessments completed as appropriate. For service users receiving respite, these are reviewed and updated prior to each stay in the home. Care plans relating to the two permanent residents are reviewed every two months or as the residents needs change. Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 10 The service users confirmed that they are actively involved in developing their individual plans. There is evidence that the service users have given their consent to the care provided. Since the last inspection the home has improved one of the assessment tools used. This now identifies the action to be taken to reduce risks identified in the assessment and provides space for the staff member to sign to confirm that the strategy has been implemented. Discussions with the staff and service users confirmed that the service users are supported to make decisions relating to the care that is provided in the home, including choosing meals, therapies and activities. The staff confirmed that service users are able to bring their own communication aids when staying in the home and that the service users are supported to use these during their stay. Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13, 14, 15 and 16 The service users are provided with the opportunity to participate in a broad range of valued and fulfilling activities, which they enjoy. The service users are supported to maintain relationships with family and friends and have built positive relationships with the staff. EVIDENCE: Standard 17 was met in full at the last inspection. Standard 12 is not applicable to this service. These standards were not assessed during this inspection. Information provided by the home confirmed that the home continue to offer a broad range of activities for the service users. The service users are informed of the activities that are planned prior to their stay and, if relevant, the cost of each activity. These include hairdressing, aromatherapy, Indian head massage, reflexology, beauty treatments, pet therapy, shopping trips, cinema, quiz nights and pub visits. The home also has a video library and loans radios, CDs and DVDs to service users for use during their stay. Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 12 The service users spoken with confirmed that they are able to choose how they spend their time and are able to spend time alone, either in their rooms or in the quiet lounge, if they wish. The service user spoken with, who resides permanently in the home, confirmed that she is supported to maintain links with her family and friends. She confirmed that she is able to see her visitors privately in her room if she wishes. She is also supported by the home to visit and socialise with her friend and family away from the home. Service users who receive a respite service are also able to have visitors, and maintain friendships. Service users can request periods of care at the same time as their friends. On the day of the inspection the staff were making arrangements to go shopping and for coffee in Leamington Spa. Arrangements were being made for a service user to spend time away from the group and meet up with a friend. Information provided by the home in the pre-inspection questionnaire confirms that the staff assist the service users to write letters and cards and will wrap gifts purchased during the service users stay. Information provided in care plans, discussions with the service users and observations during the inspection confirmed that the service users are supported in a way that maintains and promotes their independence, using aids and adaptations as required. Service users were observed to move freely around the communal areas of the home, and are able to choose whether to spend time socialising in the lounges and dining room or to spend time alone. Observations of the interactions between the service users and staff and discussions with the service users confirmed that the staff chat and spend time with the service users. One service user stated ‘the staff are nice, you can have a laugh with them’. On the day of the inspection the home had a jovial atmosphere. Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 Appropriate arrangements are in place to ensure that the service users health care needs are identified and addressed. EVIDENCE: Standard 19 was met in full at the last inspection of this home and was not assessed on this occasion, other than to note that throughout the inspection the service users were supported in a way that promotes their privacy, dignity and maintains confidentiality. The requirements made at the last inspection relating to Standard 20, were assessed. The home demonstrated that these have been met. Discussion with the staff and service users and examination of care plans confirms that the home continues to support the service users to meet their health care needs. This includes routine health screening, such as blood pressure, weight, blood sugar levels and urinalysis, during the service users stay. This is either at the request of the service users, their GP or other health professional or as the service users needs dictate. The staff member stated that it is quite common for a service users GP to decide to prescribe medications immediately prior to the service users stay, to enable close monitoring of the effects of the medication, by the nursing staff. Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 14 The staff member also stated that part of their role is to support the service users, by making referrals to health professionals, to receive community based services once they return home and to offer advice to service users relating to their medication needs. Service users are able to see a local GP, during their stay if this is required. A dental service is also available for the service users to access in an emergency. The staff member stated that routine dental appointments are not provided by the dental practice. The service users are able to access an optician for routine eye examinations. The staff member said that it is possible for the service users to have an eye test at the beginning of their stay and collect their new glasses before they return home. Two of the service users spoke with said that they value the counselling service that is available to them during their stay. All of the service users confirmed that they continue to enjoy the opportunity to receive physiotherapy and hydrotherapy. Although at the time of the inspection the hydrotherapy pool was not in operation due to the building work. . Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The service users are confident that any complaints made or concerns raised will be addressed by the home. The homes policies and procedures protect the service users from abuse. EVIDENCE: The service users spoken with were very complimentary of the service that is provided in the home, they confirmed that they are aware of the homes complaints procedure and are confident that any concerns raised or complaints made will be addressed by the staff. Examination of the homes complaints log confirmed that complaints received are handled appropriately, where these are upheld, there is evidence that action has been taken to prevent reoccurrence. Discussions with the staff and examination of training records confirmed that the staff have received training relating to adult protection. The staff demonstrated in discussion that appropriate action is taken should abuse be suspected. The nurse was able to give examples of how she had assisted service users in the past. The organisations representative confirmed that all managers have received training relating to the Protection Of Vulnerable Adults (POVA) guidance issued by the Department of Health. The homes recruitment procedure is acceptable. This includes obtaining a disclosure from the Criminal Records Bureau (CRB) and the POVA list. The responsibility for referring a staff member to the POVA list is retained by the organisations representative and is not left solely with the homes manager. Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 16 Discussions with the staff and examination of the records relating to the service users finances confirmed that the arrangements in place for the management of the service users finances are acceptable. Service users are able to maintain responsibility for their own money during their stay if they wish. The staff said that most service users prefer for their money to be looked after by the home. Only nominated staff members have access to the service users monies. Records are maintained of all transactions. A copy of this record is provided to the service user on departure. Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 17 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): X EVIDENCE: Standard 30 was met in full at the last inspection and was not assessed on this occasion. The standards relating to the environment were also not inspected on this occasion as these will be inspected in full as part of the registration of the new building. It is anticipated that the building work will be completed in May 2006. Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 The homes recruitment practices protect the service users from risk of abuse. The service users are supported by a team of staff who have the necessary knowledge and skills to fulfil their roles effectively. EVIDENCE: Standard 33 was met in full at the last inspection of this home. Examination of a sample of staff files and discussion with the organisations representative confirmed that the home has acceptable procedures in place for the recruitment of staff. The requirement made at the last inspection to ensure that records detailed in Regulation 19 and Schedule 2 of the Care Homes Regulations 2001 are retained on the individual staff members file has been met. Information provided in the pre-inspection questionnaire and discussions with the staff confirmed that the staff have received training that is appropriate to their role. Including training relating to the management of staff, catheter care, gastrostomy pumps, swallowing, wound care, diabetes, fire safety, first aid, moving and handling and vulnerable adults. Annual learning and development plans are available. These indicate that both mandatory and specialist training is planned to take place in the coming year. Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 19 This will include training that is provided by a university relating to Multiple Sclerosis (MS). In addition the MS society also provides study programmes for care staff to assist them to care for people who have MS. The staff members demonstrated competency to fulfil their roles throughout this and the previous inspection of the home. Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 20 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 and 42 Despite the managers post being vacant for a period of time the service users continue to benefit from a well run home. The home regularly reviews its performance through a good programme of self-audit and consultation, which includes seeking the views of the service users and staff. The home takes appropriate action to promote and maintain the health and safety of the service users and staff. EVIDENCE: At the time of the inspection the homes manager post is vacant. A new manager has been appointed and is due to commence on 20th February 2006. In the interim the responsibilities of the registered manager have been divided between two nominated staff members, with additional support provided by a representative of the organisation. Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 21 Despite the complexities of the management of the home during such extensive building work, this arrangement does not appear to have had a negative impact upon the running of the home. The feedback provided from the service users confirms that the standard of care provided has been maintained throughout this period of instability. It is the inspector’s view that this is a direct result of the hard work and commitment of the management team and staff. The organisation completes its own annual quality audit, which includes seeking the views of the service users and staff. Each of the organisations 12 quality standards are audited each year. External auditors are employed to assess standards relating to clinical practice and the management of the home. A report is collated using the information provided and details areas of best practices, poor practice and improvements and suggestions. An action plan is developed to address the issues that are raised. This action plan also includes information relating to complaints and the requirements and recommendations identified during the inspections of the homemade by the Commission for Social Care Inspection and other regulatory bodies. Records relating to the health and safety of the home were examined. These confirm that the home continues to adopt good practices to maintain the safety of the service users and staff. Risk assessments and risk management strategies relating to safe working practices continue to be available with evidence of regular review and update. Responsibility for monitoring of water temperatures and fire alarm systems are delegated either to external contractors of the homes maintenance man. These were seen to have been completed at appropriate intervals. Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 22 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 N/A 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 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 N/A 13 3 14 4 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 4 X X 3 X 3 X X 3 x Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 23 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. Standard Regulation Requirement Timescale for action Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 24 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 YA24 Good Practice Recommendations It is strongly recommended that some ‘landmarks’ are provided to help service users to find their way around the home. This recommendation was made at the last inspection of the home. The organisations representative confirmed that there is a plan in place to address this. Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Helen Ley House DS0000063467.V282574.R01.S.doc Version 5.1 Page 26 - 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. 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