Inspection on 10/10/06 for Kings Lane (32)

This inspection was carried out on 10th October 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

Kings Lane (32) 27/09/05

Kings Lane (32) 05/05/05

Kings Lane (32) 20/10/04

Kings Lane (32) 01/09/04

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Beau Sejour

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

CARE HOME ADULTS 18-65 Kings Lane (32) St Neots Cambridgeshire PE19 1LB Lead Inspector Dragan Cvejic Unannounced Inspection 10th October 2006 10:00 Kings Lane (32) DS0000015131.V315807.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 Kings Lane (32) DS0000015131.V315807.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. Kings Lane (32) DS0000015131.V315807.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kings Lane (32) Address St Neots Cambridgeshire PE19 1LB 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) 01480 214928 F/P 01480 214928 h2m016birks@mencap.org.uk H4037@mencap.org.uk Royal Mencap Society Jeanette Birks Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (3) of places Kings Lane (32) DS0000015131.V315807.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The three (3) places for LD(E) are for named individuals for the duration of their residency 27th September 2005 Date of last inspection Brief Description of the Service: 32 King’s Lane is a large, detached house in a residential area of St Neots. The home is close to the town centre where there are shops and a variety of leisure facilities. The home has six single bedrooms on the ground floor, plus a lounge, dining room, kitchen, bathroom, laundry and staff office. On the first floor there are two bedrooms, a lounge, kitchen/dining room and a bathroom. Car parking space is available at the front of the house and there is a garden with patio and raised flowerbeds at the rear. The service is registered for up to 8 people who have a learning disability, some of whom also have associated physical disabilities. Service users are supported by staff during the day, and waking night staff are provided in case support is needed. The fee for the home is between £261 and £863 per week. Kings Lane (32) DS0000015131.V315807.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out in the morning hours and lasted for 3.5 hours. The main methodology used to collect evidence was case tracking whereby two service users were case tracked. One staff member was interviewed and the manager was present most of the time during the site visit, except when other people were interviewed and spoken to. Two service users’ files were checked and two staff files, among other documents that were displayed or shown on request. The requirements set previously were also checked. The inspection demonstrated constant improvements in services and provisions and the home exceeded many standards. What the service does well: What has improved since the last inspection? What they could do better: The home demonstrated that they could identify areas for improvement and that they reacted continuously monitoring and improving services and provisions. Kings Lane (32) DS0000015131.V315807.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. Kings Lane (32) DS0000015131.V315807.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 Kings Lane (32) DS0000015131.V315807.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): 1,2,3,5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The information about the home was made very accessible to potential and existing users and using different formats, audio and picture format, made it very user friendly. The home carried out an effective and comprehensive assessment prior to a offering place to potential users to ensure that they could make a clear and informed choice. The home exceeded minimum standard requirements. EVIDENCE: The home regularly reviewed the documents that provided information about the home to keep them up to date and to ensure potential service users were given up to date information. Statement of purpose was updated when the company’s area manager changed. The service user’s guide was produced on audio tape. The complaints procedure, as part of the user’s guide, was also produced on the tape. In two checked files there was evidence that the home obtained all necessary information for deciding if the new service user would fit into the home, if their needs could be met and provided an opportunity for them to choose the home they wanted. Kings Lane (32) DS0000015131.V315807.R01.S.doc Version 5.2 Page 9 The residence was legally regulated with the Licence Agreement. This document was also produced in picture format, allowing service users to really understand their terms and conditions. The home’s efforts to include service users in decision making through adapting these documents, and other practical help offered to service users, was outstanding. Kings Lane (32) DS0000015131.V315807.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users were in control of their lives through involvement in care plans, risk assessments and participation in running the home. EVIDENCE: Two service users’ files were checked. They contained very well organised and presented information that staff used in their work. Service users case tracked confirmed that they were actively involved in creating and reviewing care plans. This was demonstrated by signatures on risk assessments, that were closely related to care plans and addressed how the users’ independence could be further promoted. Users were given the opportunity to exercise their rights by undertaking reasonable risks, which were recorded. Both care plans and risk assessments were regularly reviewed, generally once a year, but the two checked files showed some monthly and other three monthly reviews when changes for service users care occurred. Kings Lane (32) DS0000015131.V315807.R01.S.doc Version 5.2 Page 11 Road safety was assessed for one user. The same user expressed trust in his key worker and stated: “I am happy here. My key worker is excellent.” When a family member got more involved in the life of a service user, this was recorded in his file. The health part of the plan was produced in picture format. Service users were encouraged to make their own decisions. This was observed when a service user chose how many cigarettes and how much money he wanted to take while preparing for a day trip to Great Yarmouth. Another user confirmed: “I withdraw money from my Halifax account when I need it. Staff help me when I need help with money.” The files contained clearly stated limitations or restrictions for service users and addressed those in risk assessments. Service users were observed getting ready for the day trip and their participation in preparation was evident. They even check the minibus before getting in and taking their seats. They had regular users meetings and discussed the home’s life. Kings Lane (32) DS0000015131.V315807.R01.S.doc Version 5.2 Page 12 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): 11,12,13,14,15,16,17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service users were able to control their lives and were supported to exercise choice, independence, their rights, and to explore reasonable risks. EVIDENCE: All service users had a set daily programme. They were involved in college, voluntary work and attending day centres as part of their involvement in programmes promoting practical skills. Apart from these, they all enjoyed a variety of recreational and leisure activities in and out of the home. The case tracked service user’s certificate “National Skills Profile Certificate” was displayed in the home. The home kept records of service users activities. The other case tracked user was doing voluntary work in a charity shop. She also stated: “I do drawing, and bake cakes sometimes.” Service users regularly went swimming. Kings Lane (32) DS0000015131.V315807.R01.S.doc Version 5.2 Page 13 On the day of the site visit three service users were going on a day trip to Great Yarmouth. In the home, users were taking part in cooking, washing up, loading the dishwasher –this was observed during the site visit – cleaning their rooms and helping with cleaning communal areas. A case tracked service user also helped in painting his room. A case tracked service user showed his room to the inspector and showed how he used his room key. Since the changes affecting the day centre, the home had organised day centre activities to continue being organised from the home. One service user used an independent advocate. Service users chose the menu and after their choice it was produced and presented in picture format that most service users appreciated. The home demonstrated and users confirmed that standards from this group were exceeded. Kings Lane (32) DS0000015131.V315807.R01.S.doc Version 5.2 Page 14 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. The home respected service users wishes, privacy and dignity when their healthcare was dealt with. Service users were protected with clear and safe healthcare and medication procedures and practices. EVIDENCE: “When I am unwell staff call a doctor for me”, a service user explained the staff’s approach to her health and care. A service user was allowed to stay in bed until very late in the morning, as he sometimes preferred to have a lay in. The home did not have a set time or place for meals. Instead, service users could choose when and where they wanted to eat. The home did not have to deal with cultural differences as all service users and all but one staff member were English and had their background and choice were in accordance with the English culture. A diabetic specialist remained involved in a service user’s care even after admission to this home and was taking part in reviews. However, a diabetic Kings Lane (32) DS0000015131.V315807.R01.S.doc Version 5.2 Page 15 service user commented: “I can’t have chocolate because I am diabetic, but they (staff) give me diabetic chocolate instead.” All service users had a designated key worker. The files contained records of regular visits of other health professionals, such as an optician and dentist. The file contained a record of a user who did not need or want any dental care. Medication procedure and records were accurate. No one was prescribed controlled drugs. Kings Lane (32) DS0000015131.V315807.R01.S.doc Version 5.2 Page 16 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 excellent. This judgement has been made using available evidence including a visit to this service. The home valued highly the safety of service users and a number of procedures and policies were in place to ensure users’ protection. The home exceeded minimum standards in this area. EVIDENCE: The home developed a clear and concise complaint procedure and produced it in a picture format, making it very accessible to all service users. Service users spoken to confirmed that they were clear of the procedure. The procedure was included in the Service User’s guide and in the terms and conditions given within a licence agreement. This standard was exceeded by the home’s efforts to make the procedure effective and open to all. The home had not had any complaints. Service users were well safeguarded not only within the home, but in all other identified potential hazardous situations as well. For example, the home closely monitored users safety in public places and on public roads. A different day and night fire procedure was drawn up to increase the effectiveness of the procedure in regard to users’ safety. The home produced a “Disaster plan” and had negotiated with a town hotel to accept service users in case of disaster. Kings Lane (32) DS0000015131.V315807.R01.S.doc Version 5.2 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. 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 service users felt free and comfortable in a safe and well maintained environment. EVIDENCE: A service user proudly took the inspector around the home, showing the communal area and his room. He demonstrated comfort and knowledge of the home’s environment and showed how service users had access to all areas and were aware of the areas where staff support was essential, such as the laundry room. The home was safe, bright and clean, and everybody felt responsible for maintaining safety and cleanliness. Service users were involved in decoration, not only by choosing the wall colours, but some of them even helped physically in decorating the home how they preferred. Kings Lane (32) DS0000015131.V315807.R01.S.doc Version 5.2 Page 18 The location close to the centre and shops and communal amenities also contributed to the judgement of the suitability of the home. Laundry was well equipped and tidy. Infection control measures were in place. Kings Lane (32) DS0000015131.V315807.R01.S.doc Version 5.2 Page 19 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): 31,32,33,34,35,36, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team was skilled, experienced and able to meet the service users, needs. Service users were protected by procedures that ensured proper vetting of new staff and training appropriate to their roles. EVIDENCE: The staff were clear of their roles and responsibilities. They knew service users well and knew their preferences, likes and dislikes. A staff member showed commitment by patiently reading a book to a service user. She knew how to communicate with the user in way that created trust, comfort and a professional friendliness. A service user stated how much he trusted his key worker. A new staff member was interviewed and stated: “I only work supervised. The deputy is my direct supervisor and I get all the help that I need from her.” The home encouraged training and 75 of staff already held an NVQ qualification, significantly exceeding the standards. The team atmosphere was visible through the observation of staff working in the home in an organised, structured and meaningful way. The staff ratio was Kings Lane (32) DS0000015131.V315807.R01.S.doc Version 5.2 Page 20 appropriate and a service user stated that staff were always able to respond to their needs and that “sometimes they had time to chat”. The other user judged the staffing level as appropriate. The balance of male and female staff reflected the gender of service users. The new staff member confirmed that all checks were carried out during the recruitment procedure and that she worked strictly supervised while waiting for her Criminal Record disclosure. She also stated that her induction was detailed and comprehensive. Two staff files were well organised and contained all required documents. Supervision records and staff comments confirmed effectiveness and the regularity of supervision sessions. Kings Lane (32) DS0000015131.V315807.R01.S.doc Version 5.2 Page 21 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): 37,38,39,41,42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home promoted and encouraged safe working practices and listened to staff and service users to identify all potential hazards and minimise them. Service users were protected, but still allowed to exercise autonomy, individuality and creativity. EVIDENCE: The manager was very skilled and created an open, constructive and innovative atmosphere, not only among staff, but also among service users. Her training was up to date. The ethos of the home was exceptionally good and the inclusive style allowed service users and staff to be constantly involved in the running of the home. Kings Lane (32) DS0000015131.V315807.R01.S.doc Version 5.2 Page 22 Service users were deciding on daily routine and were supported by the staff to achieve their set aims. Quality assurance surveys were organised and carried out according to the company’s (Mencap) programme. An independent manager from another project facilitated the review to ensure impartiality and to be objective. In addition, the area manager was monitoring an improvement plan on a monthly basis. The manager showed the action plan that identified paving the garden as one task, now completed, and the decoration of bathrooms, another objective, one of which was completed and another in progress. Records kept in the home were accurate, up to date, regularly reviewed and were used as working documents. Two service users stated that they knew of and could have access to their files and care plans if they wanted. Safe working practices were in place. All staff were up to date with their mandatory training. Several service users were using the kitchen and the home had safe working procedure in place to minimise the hazard while the reasonable risk was allowed to enable service users to express their creativity and independence. Written risk assessments were detailed and very well organised and addressed potential hazards with the plan to minimise them. New staff were trained and inducted on LDAF principles. Kings Lane (32) DS0000015131.V315807.R01.S.doc Version 5.2 Page 23 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 4 2 3 3 4 4 X 5 4 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 4 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 3 4 X LIFESTYLES Standard No Score 11 4 12 3 13 3 14 4 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 4 4 X 4 3 X Kings Lane (32) DS0000015131.V315807.R01.S.doc Version 5.2 Page 24 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 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Kings Lane (32) DS0000015131.V315807.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Kings Lane (32) DS0000015131.V315807.R01.S.doc Version 5.2 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. 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