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

This inspection was carried out on 5th May 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) 27/09/05

Kings Lane (32) 20/10/04

Kings Lane (32) 01/09/04

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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 05 May 2005 @ 10:00 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 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 Stationary 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) Version 1.10 Page 3 SERVICE INFORMATION Name of service Kings Lane (32) Address 32 Kings Lane, St Neots, Cambridgeshire. Telephone number Fax number Email 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 Royal Mencap Society Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Kings Lane (32) Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 20 October 2004 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 24 hours a day. Kings Lane (32) Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took 3.5 hours and took place between 10.00 and 13.30. On the day of inspection thee service users were at home and were spoken to. The inspection also included reading documents, speaking to staff, and a tour of the building. What the service does well: What has improved since the last inspection? What they could do better: Whilst individual rooms were well decorated, the corridors were in need of painting and the carpets were worn and stained. The furniture in the communal areas was unsuitable for people with poor mobility and needed replacing, and part of the garden area needed tidying up. Kings Lane (32) Version 1.10 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Kings Lane (32) Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Kings Lane (32) Version 1.10 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 standard(s) 1, 2, 3, 4 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 to work towards achieving and identifying goals. EVIDENCE: The home has a statement of purpose and service user guide, but this is not in a format that would be accessible to the home’s residents. 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 recommendation has been made about this. A full assessment of each person’s needs, and the help that they would require, took place before they moved in. The assessment was done by care managers and also involved healthcare professionals, the individual themself and, when appropriate, members of their families. Staff spoken to have the knowledge and skills to work with people who had a learning disability, and were appropriately skilled and experienced. Kings Lane (32) Version 1.10 Page 9 A range of equipment was provided to help staff when moving people from one place to another, and the manager said that healthcare professionals were very supportive and had regular contact with the home. At the time of the inspection there was a vacancy at the home; the person who was planning to move in 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, and so decide whether he wanted to move in permanently. Kings Lane (32) Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9, 10 Systems of care planning were clear and well laid out. Residents were 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 were effective. Appropriate measures are in place to ensure that information about service users was kept confidential. EVIDENCE: The care plans relating to two of the people living in the home were seen and contained good quality information about what help each person needed and how it should be given. Reviews of care plans were going to take place every month to make sure they were up to date, but the manager said that this had not yet happened. A planned review of all the services provided to each person took place every year. Family members, keyworkers, and professionals such as nurses or care managers were invited to the review meeting, along with the person themselves. One staff member said that when she had started working at the home she had found the care plans helped her to get to know each person’s needs, what help they might require, what their interests are, and information about each person’s personal history. Staff encouraged those living at the home to make decisions about what they did during the day, and one person had decided to stay at home instead of Kings Lane (32) Version 1.10 Page 11 going to a party at a local day centre. The person planning to move into the home had been put in touch with an advocacy service so that they could help him make a decision about whether to move into the home. Residents meetings took place regularly to give each person the opportunity to say what they thought about the service and make suggestions about things such as food or outings that they would like to happen. The manager said that she was recording the meetings so that residents who did not read could be sure that staff did not write the minutes incorrectly. The manager had carried out an assessment of the risk that might exist in a number of areas, and had 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 were kept safely in a locked cabinet. Kings Lane (32) Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15, 16, 17 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. Service users are offered a healthy diet and meals are taken in a homely atmosphere. EVIDENCE: Each resident had been helped to develop a range of things to do during the day, including trips out, shopping, woodwork and the use of specialist learning disability services. The manager was discussing with the Learning Disability Partnership (who pay much of the cost of the people to live at the home) the possibility of getting funding for people to be supported at home as a number were past the age when they would ordinarily be retired and didn’t really want to go to the day services. Kings Lane (32) Version 1.10 Page 13 On the day of inspection one person said he was planning to go on a day trip to the coast, and another person was talking to staff about where she was going to go on her summer holidays. The home had it’s own vehicle so that residents could go out singly with a member of staff, or as a group. Staff members’ own cars are also occasionally used. Each resident has a specific member of staff to act as ‘key-worker’. Part of their tasks were to help maintain links with families at an appropriate level. As far as possible each person was involved in what went on in the home and were asked about what activities would take place; at the time of the inspection one man was playing dominoes with a staff member. Staff spoken to said that one of the things they liked about living at the home was the fact that they were encouraged to take residents out and to get involved in what was going on in the town and elsewhere. Meals are planned at varying times depending on what was going on and menus were on display on the wall in the kitchen. During the inspection one resident went out shopping to the supermarket with a member of staff using cash from the household budget. The meals that had been eaten were recorded so that staff could be sure each resident was getting a healthy diet, and fresh fruit was freely available. Kings Lane (32) Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20 Care is provided in a manner which suits those living in the home. Service users physical, emotional and health needs were being met. Arrangements for the administration of medication were appropriate and the home’s procedures were being followed ensuring that service users were not put at risk. EVIDENCE: Staff were helping people with a range of tasks; the assistance given was appropriate for the needs of the people concerned. Help with dressing and other areas of personal care is carried out in private in individuals’ rooms or in the bathrooms. The home is supported by specialist learning disability professionals including psychiatrists, occupational therapists, nurses, and speech and language therapists. Due to their disability those living at the home would not be able to look after their own medication. Medication records were inspected and were complete, and accurate, and the systems for administering and storing medication were well organised. Staff had received training in giving out medication, this was provided both in-house and by the pharmacist, who carried out 3-monthly checks on the home’s medication procedures. Kings Lane (32) Version 1.10 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 standard(s) 22, 23 The home’s systems for dealing with complaints were satisfactory, as were 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 wished to make a complaint about the service; this was available as an audio cassette, 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 had concerns about mistreatment of service users. Staff confirmed that they knew what to do if they were worried that someone might have been mistreated or abused, and the manager reported that staff were going to be going on the County Council’s training on the protection of vulnerable adults. Kings Lane (32) Version 1.10 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 standard(s) 24, 25, 26, 27, 28, 29, 30 The building is suitable for the needs of those living in the home and sufficient equipment was provided. Though it is clean and generally well decorated, areas of carpet let down the apppearance of the home as did the decoration in the hallway and some of the areas outside. 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 were not often used. A report of an assessment carried out by a specialist Occupational Therapist identified that the suite in the main lounge was unsuitable for people with physical disabilities; a requirement has been made about this. The majority of the premises were well maintained, however, the paintwork in the corridors was in a poor state of repair and the carpets in the same areas were badly stained and worn; requirements have been made about this. The home has a garden area which can be used by residents, however, part of the garden was very overgrown and full of weeds; a requirement has been made about this. The manager reported that she intended to get the garden tidied up and a member of staff was hoping to help one of the residents make a vegetable patch. Kings Lane (32) Version 1.10 Page 17 All of the rooms are single and are well decorated and each one shows the interests of 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; the manager told the inspector that all the equipment was serviced every year to make sure it was safe. Stairs, toilets and bathrooms are fitted with handrails and grab rails, and 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 was clean and there were no offensive odours. Laundry facilities are sited away from food preparation areas. Kings Lane (32) Version 1.10 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35, 36, The home had a staff team which meant that service users’ needs were properly met and staff were appropriately supervised. Staff were clear about their roles and were competent and had been given an appropriate induction though little progress had been made to ensure that the targets for NVQ training would be met. EVIDENCE: It was clear from watching how staff worked with the residents, that they had built professional, warm and friendly relationships with each person. Staff were clear about what they were there to do and how they should be providing help and support, and staff were aware of need to work with people rather than taking over and doing everything for residents. The manager reported that though staff were keen to do the NVQ training, progress was very slow and there was no one currently doing the course. It is strongly recommended that staff are enabled and encouraged to undertake NVQs, along with the Learning Disability Award Framework (LDAF) training. Kings Lane (32) Version 1.10 Page 19 The manager said that in recent months she had been able to build up the staff team so that agency staff were no longer needed, and staff spoken to said that they all worked well as a team. Staff files were inspected and contained Criminal Records Bureau (CRB) checks, 2 references and all of the other information to ensure that unsuitable people were not employed at the home. The manager stated that staff were not appointed until such checks and documents had been obtained. New staff are required to do induction training so that they know what the needs of people with learning disabilities were likely to be, how they should be supporting the residents, what the home was 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 done all of the health and safety training so that they could help residents without putting themselves or the person concerned, at risk. Staff confirmed that they felt well supported in their work and received adequate and effective supervision from the manager. Staff meetings were held once a month and included an update review on each of the service users’ needs, matters of health and safety, and any other areas of concern. Kings Lane (32) Version 1.10 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 41, 42 The home was properly managed and the manager provided good leadership and guidance to staff to ensure that residents receive consistent, high quality care, which would be monitored through effective quality assurance processes. EVIDENCE: The person managing the home was not yet registered with the Commission, however, an application for her registration had been made and was being processed. The manager had begun work towards getting the Registered Managers’ Award and had done a variety of other courses and training that would help her in her work. The manager said that she tries to run the home so that everyone knows what is happening and is kept up to date with anything that might affect them. Staff members said that they thought the home was well-managed and they would be able to speak to the manager is they had any concerns, suggestions or requests. Kings Lane (32) Version 1.10 Page 21 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 was also given to residents so that they can say what they think about the home. Residents meetings are held every month at which they are able to ask questions and make suggestions or requests for such things as 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, and fire alarm systems had been tested every week and practice drills had taken place. Kings Lane (32) Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 3 3 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 2 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 2 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 3 3 x 3 3 x Kings Lane (32) Version 1.10 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. 1. 2. 3. 4. 5. Standard 24 24 24 24 24 Regulation 16(2)(c) 23(2)(d) 23(2)(b) 23(2)(d) 23(2)(o) Requirement All furnishings must be suitable to meet the assessed needs pf service users All parts of the home must be kept reasonably decorated Carpets in the halls and corridors must be replaced Walls and woodwork in the halls and corridors must be reasonably decorated External grounds must be properly maintained Timescale for action 31 July 2005 31 July 2005 31 July 2005 31 July 2005 31 July 2005 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 1 32 Good Practice Recommendations The Service User Guide should be reproduced in a format which is accessible to service users It is strongly recommended that staff undertake National Vocational Qualification (NVQ) training Kings Lane (32) Version 1.10 Page 24 Commission for Social Care Inspection 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) Version 1.10 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. 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