Inspection on 27/09/05 for Kings Lane (32)

This inspection was carried out on 27th September 2005.

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 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) 10/10/06

Kings Lane (32) 05/05/05

Kings Lane (32) 20/10/04

Kings Lane (32) 01/09/04

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Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Pemdale

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 Matthew Bentley Unannounced Inspection 27th September 2005 11:50 Kings Lane (32) DS0000015131.V250780.R01.S.doc Version 5.0 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.V250780.R01.S.doc Version 5.0 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.V250780.R01.S.doc Version 5.0 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 01480 214928 l2m016birks@mencap.org.uk Royal Mencap (Housing & Support Services) Jeanette Birks Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Kings Lane (32) DS0000015131.V250780.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th May 2005 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. Kings Lane (32) DS0000015131.V250780.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took 2.5 hours and took place on 27 September 2005 between 11.45 and 14.15. The inspection was carried out by one inspector who spoke to a number of service users and staff. The inspection also included reading documents, speaking to the manager, and a tour of the building. What the service does well: 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. Kings Lane (32) DS0000015131.V250780.R01.S.doc Version 5.0 Page 6 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.V250780.R01.S.doc Version 5.0 Page 7 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): Information is available to help prospective service users make an informed choice about whether the home is suitable for them, and appropriate measures are in place to allow visits prior to their making a decision. Staff know each service user as individuals and have helped each person work towards identifying and achieving appropriate goals. EVIDENCE: The home has a statement of purpose and service user guide to inform people living in the home, or people who may be interested in doing so, about the services offered. The manager said that she was working on producing an updated service user guide in the form of an audio cassette which would be used to tell people about what they could expect from the home and help them make a decision about whether it would be suitable for them. A full assessment of each person’s needs, and the help that they are likely to need takes place before admission. Since the last inspection a new resident has moved in; the needs of the person concerned were assessed by care managers and also involved healthcare professionals, and the individual themselves. When appropriate, families are involved in the assessment process and are invited to be part of the reviews of the placement. Staff spoken to have the knowledge and skills to work with people who have a learning disability, and conversations and observation show that they are appropriately skilled and experienced. Kings Lane (32) DS0000015131.V250780.R01.S.doc Version 5.0 Page 8 A range of equipment is provided to help staff assist people with their mobility, and the manager said that healthcare professionals were very supportive and have regular contact with the home. The person who had moved into the home since the last inspection had visited on a number of occasions, and had stayed overnight so that he could make up his mind about whether he would get on with the other residents and staff. This had helped him decide that he wanted to move in permanently, and he confirmed that he was very happy with the way the move had gone. Kings Lane (32) DS0000015131.V250780.R01.S.doc Version 5.0 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): Systems of care planning are clear and well laid out. Residents are involved in making decisions about their lives to the best of their abilities with help and guidance from staff when necessary. Systems for assessing risk are effective, and appropriate measures are in place to ensure that confidential information about service users is kept securely. EVIDENCE: The care plan relating to the person new to the home was seen and contained good quality information about what help that was needed and how it should be given. A planned review of all the services provided to each person takes place every year, and during the week of the inspection each resident’s placement was being reviewed by a care manager from the Learning Disability Partnership which commissions the service. Staff encourage residents to make decisions about what they do during the day, and people were seen being asked about what they wanted to do later in the afternoon, and were involved in a variety of activities such as helping put shopping away, preparing sandwiches, and going out to pay the rent. Residents’ meetings take place every month and give each person the opportunity to say what they think about the service and make suggestions Kings Lane (32) DS0000015131.V250780.R01.S.doc Version 5.0 Page 10 about things such as food or outings that they would like to happen. A tape recording of the meetings is made so that residents who do not read, can hear what is said at a later date if they wish. The manager has carried out an assessment of the risk that might exist in a number of areas, and has included ways in which the risk might be avoided or lessened. Staff spoken to were aware of the need to treat information confidentially, and records relating to service users are kept safely in a locked cabinet in the office. Kings Lane (32) DS0000015131.V250780.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Staff provide appropriate support to facilitate contact with family and friends, and service users have access to leisure activities in the community that are appropriate to their needs and abilities. Residents’ dietary needs are properly met and they are also able to develop and maintain their cooking skills. EVIDENCE: Each resident has been helped to develop a range of meaningful things to do during the day, including trips out, shopping, working in a workshop, and the use of specialist learning disability services. A number of residents are past the age when they would ordinarily be retired and, given the choice, they would prefer an alternative to the ordinary day services. The manager is discussing with the Learning Disability Partnership, the possibility of getting funding for people to be supported to use community facilities from home. The home has it’s own vehicle so that residents can go out singly with a member of staff, or as a group. Staff members’ own cars are also occasionally used. Events that have taken place over the summer include trips to the seaside, a boat trip round the coast, and outings to a working farm. One Kings Lane (32) DS0000015131.V250780.R01.S.doc Version 5.0 Page 12 resident regularly goes to a disco in Cambridge, and another has been out to a tea-dance. Each resident has a specific member of staff to act as ‘key-worker’. Part of this role is to help maintain links with families at an appropriate level and residents spoke about planned trips to see family and friends. As far as possible, each person is involved in what happens in the home, and residents are asked about what activities they would like to take place. At the time of the inspection one man was preparing to go out for a coffee with a staff member, others were out paying their rent, using day services, and helping with household chores. Meals are planned at varying times depending on what is going on, and residents said that the food was good and confirmed that they were able to help prepare food if they wanted to. Kings Lane (32) DS0000015131.V250780.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Arrangements are in place to ensure each service user receives input from relevant professionals to ensure their health needs are met. Personal care is given sensitively so that individuals’ dignity and privacy are maintained, and each person is encouraged to maintain their personal care and daily living skills. Procedures for managing service users’ medication are satisfactory and were being properly followed, so that medication is safely administered. EVIDENCE: Staff were seen helping people with a range of tasks; the assistance given was appropriate for the needs of the people concerned and was given in a considerate respectful manner. If it is needed, help with dressing and other areas of personal care is carried out in private in individuals’ rooms or in the bathrooms, however, residents are encouraged to do as much for themselves as they can. The home is supported by specialist learning disability professionals including psychiatrists, occupational therapists, nurses, and speech and language therapists. On the morning if the inspection one member of staff had volunteered to come in on her day off to go with a resident to get the results of an x-ray that had been recently done. Kings Lane (32) DS0000015131.V250780.R01.S.doc Version 5.0 Page 14 Medication records were inspected and were complete, and accurate, and the systems for administering and storing medication are well organised. Staff have received training in giving out medication; this is provided both in-house and by the pharmacist, who carries out regular checks on the home’s medication procedures and record keeping. Kings Lane (32) DS0000015131.V250780.R01.S.doc Version 5.0 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): The home’s systems for dealing with complaints are satisfactory, as are the arrangements for ensuring the protection of service users from neglect or harm. EVIDENCE: The home has a policy and procedure to follow if a person wishes to make a complaint about the service; this is available as an audiocassette, which was shown to the inspector by one of the people living in the home. The home has a procedure for protection of vulnerable adults and had a ‘whistle-blowing’ policy detailing action staff should take if they have concerns about mistreatment of residents. Staff confirmed that they would have no hesitation in taking to the manager if they were worried that someone might have been mistreated or abused, and the manager has arranged for all staff to attend the County Council’s training on the procedures to be followed to ensure the protection of vulnerable adults. Records relating to the money kept on behalf of 1 of the residents was seen and was in order. Kings Lane (32) DS0000015131.V250780.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The building is suitable for the needs of those living in the home and sufficient equipment is provided, though attention needs to be given to a number of maintenance issues. EVIDENCE: The home is situated in the market town of St. Neots, which has a range of shops, places to eat, a regular market and other community facilities. Six of the bedrooms are on the ground floor, 2 are upstairs and have their own separate lounge and kitchen though these are not often used. Since the last inspection the carpet in the corridors has been replaced and the area has been painted; the suite in the lounge has also been replaced; this has greatly improved the environment and facilities in the home. The majority of the premises are well maintained, however, the locks on the shower room and one of the toilets are not working properly; a requirement has been made about this. The home has a garden area that can be used by residents, however, part of the garden was very overgrown and full of weeds; a requirement has been made about this, however, the manager said that she has now gained the funding to employ a gardener. Kings Lane (32) DS0000015131.V250780.R01.S.doc Version 5.0 Page 17 All of the bedrooms are single and are well decorated, and each reflects the interests and character of the person who uses them. The home has a portable hoist and a special bath for service users who need help to get in and out. One person’s bedroom is fitted with tracking for a hoist and stairs, toilets, bathrooms and corridors are fitted with handrails. The height of one of the kitchen work surfaces is adjustable for people who use a wheelchair to be able to help prepare food. The home is clean and there were no offensive odours. Laundry facilities are sited away from food preparation areas. Kings Lane (32) DS0000015131.V250780.R01.S.doc Version 5.0 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): The home has an adequate staff team, and staff are appropriately supervised so that service users’ needs are properly met. Staff are clear about their roles and have been given an appropriate induction and training in health and safety matters so that residents are supported by competent staff. EVIDENCE: On the day of inspection there were 5 staff on duty, in addition to the manager. It is clear from watching how staff support the residents, that they have built professional, warm and friendly relationships with each person. Staff are clear about what they are there to do and how they should provide help and support, and staff are aware of need to work with people rather than taking over and doing everything for residents, which can lead to a loss of skills. The manager said that since the last inspection, progress has been made to get staff on the National Vocational Qualification (NVQ) course along with the Learning Disability Award Framework (LDAF) training. The manager said that agency staff are rarely needed, and staff spoken to said that they all work well as a team. Staff files were inspected and contain Criminal Records Bureau (CRB) checks, 2 references and all of the other information to ensure that unsuitable people are not employed at the home. The manager said that staff are not appointed until Kings Lane (32) DS0000015131.V250780.R01.S.doc Version 5.0 Page 19 such checks and documents had been obtained. The manager said that 2 new male staff have recently been appointed, which she feels will be a positive development, especially for the male residents. New staff are required to do induction training so that they know what the needs of people with learning disabilities are likely to be, how they should be supporting the residents, what the home is trying to achieve, and what policies and procedures they needed to know about. Staff spoken to said that they had found the induction training useful and also told the inspector that they had been given health and safety training, so that they could help residents without putting themselves or the person concerned, at risk. One staff member said “one of the best things about working here is there is so much training; whatever you need it is there for you”. Staff said they feel well supported in their work and receive adequate and effective supervision from the manager. Staff meetings are held once a month and include an update review on each of the service users’ needs, matters of health and safety, and any other areas relating to the development of the service. Kings Lane (32) DS0000015131.V250780.R01.S.doc Version 5.0 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): The home is properly managed and the manager provides good leadership and guidance to staff to ensure that residents receive consistent, high quality care, which is monitored through effective quality assurance processes. EVIDENCE: The manager of the home is Mrs Jeanette Birks; since the last inspection Mrs Birks has been successful in her application to be registered with the Commission. Mrs Birks has progressed well towards achieving the Registered Managers’ Award and is confident that it will be completed by the end of 2005. Mrs Birks is appropriately skilled and experienced, and has done a variety of courses and training to help her in her work. Staff members said that the manager is very supportive and effective and they would be able to speak to her is they had any concerns, suggestions or requests. As part of its quality assurance processes, questionnaires are sent out to people connected to the home, such as care managers, GPs and the pharmacist. A survey is also given to residents and their relatives so that they Kings Lane (32) DS0000015131.V250780.R01.S.doc Version 5.0 Page 21 can say what they think about the home. The results of the recent survey were seen, and were all very positive about the service. Residents’ meetings are held every month at which they are able to ask questions and make suggestions or requests about such things as staff, outings, activities, and food. Records relating to the residents specifically and to the home in general were up-to-date, appeared accurate and were kept securely in the office. A member of the Mencap management team visits the home regularly and sends a monthly written report of visits to the Commission. The manager said that she had made sure that all of the equipment at the home was serviced when it was due. She had also made sure that staff had had training to make sure that they were able to work safely. A specific member of staff takes responsibility for doing a weekly health and safety check, and fire alarm systems have been tested every week, as have water temperatures. Kings Lane (32) DS0000015131.V250780.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 x 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 2 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Kings Lane (32) Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 x DS0000015131.V250780.R01.S.doc Version 5.0 Page 23 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 2 Standard 24 27 Regulation 23(2)(o) 23(2)(b) Requirement The garden area must be properly maintained and made fully accessible to service users. The locks on the toilet door referred to, and the shower room must be repaired or replaced Timescale for action 30/11/05 30/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 0 Good Practice Recommendations None Kings Lane (32) DS0000015131.V250780.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE 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 Kings Lane (32) DS0000015131.V250780.R01.S.doc Version 5.0 Page 25 - 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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