Inspection on 19/06/07 for Laburnum House

This inspection was carried out on 19th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Laburnum House 28/04/08

Laburnum House 20/11/06

Laburnum House 09/01/06

Laburnum House 06/01/05

Laburnum House 07/07/04

Laburnum House 19/02/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Laburnum House 41 Grimston Avenue Folkestone Kent CT20 2QD Lead Inspector Wendy Gabriel Key Unannounced Inspection 19th June 2007 09:35 Laburnum House DS0000023475.V343943.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 Laburnum House DS0000023475.V343943.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. Laburnum House DS0000023475.V343943.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Laburnum House Address 41 Grimston Avenue Folkestone Kent CT20 2QD 01303 227192 01303 243416 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) Lothlorien Community Ltd Tracey Ann Coleman Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Laburnum House DS0000023475.V343943.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning Disabilities (LD) The maximum number of service users to be accommodated is 10. Date of last inspection 20th November 2006 Brief Description of the Service: Laburnum House provides support for six adults with learning disabilities and some challenging behaviour. The top floor, called Tree Tops, has been made into a flat and has a separate entrance as well as from the main home and is intended to provide support for four adults with learning disabilities in a more independent setting. Laburnum House is a large detached home in a quiet street with similar properties. All bedrooms are single. There is a large garden at the rear and some car parking space in the front. The home is situated close to Folkestone town centre and public transport. Fees are from £741.90. Please refer to provider for current fees. Laburnum House DS0000023475.V343943.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During the unannounced inspection an accompanied tour of the premises was undertaken. The registered manager, some staff and people who live in the home were spoken with and some documents and records were viewed. Some ongoing maintenance issues were reported at the previous inspection. The manager has now been registered and showed a good awareness of the issues raised during this unannounced inspection. Since the previous inspection the home has met 7 of the 8 requirements made and 1 of the 2 recommendations made. The unmet requirement and recommendation are to do with the general maintenance and repair of the home. Many of these problems are still evident. An earthquake earlier in the year hit Folkestone and the home suffered some damage including broken windows and cracks to many areas. Ongoing work to gauge the severity of the cracks has been undertaken by professionals with evidence of measurement apparatus in the home. Staff and residents in the home showed a great understanding of each other and communication was heard and seen to be comfortable and friendly. The home is bright and cheerful but has serious maintenance and repair problems. The Manager (now registered) had identified the maintenance and repair issues at the previous inspection and had at that time forwarded them to the Registered Provider for action to be agreed. Further evidence of communication between the Registered Manager and the Registered Provider was seen during this inspection. But no decision has yet been made about the repairs being undertaken. This undermines the good work the Registered Manager and staff are doing in the home. Requirements are made in this report for action to be taken in respect of these. Laburnum House DS0000023475.V343943.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Repair and maintenance is to be undertaken. The Inspector is aware that cracks to walls, ceilings and window and door-frames has been caused by the recent earthquake and that this was responded to positively by the registered Laburnum House DS0000023475.V343943.R01.S.doc Version 5.2 Page 7 manager and is currently being assessed by professionals for further movement. 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. Laburnum House DS0000023475.V343943.R01.S.doc Version 5.2 Page 8 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 Laburnum House DS0000023475.V343943.R01.S.doc Version 5.2 Page 9 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): Quality in this outcome area is good. New and prospective residents are assessed prior to coming to live in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home provides a useful information pack for prospective residents and their families. This includes a service user guide with a picture format for residents. A complaints procedure is included for residents that is also in a very simple to understand format. At the time of the inspection, the registered manager and deputy manager were arranging a re assessment for a resident due to that individuals changing needs. A previous inspection confirms that assessment of needs and interests have been viewed and were clearly written. Laburnum House DS0000023475.V343943.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): Quality in this outcome area is good. Residents know their personal choices and needs are reflected in their care plans and are enabled to make choices with support as required. Risk assessments support choices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two care plans were viewed and these contained a variety of information regarding guidance for staff to support residents. Individual risk assessments were in place with evidence of a monthly audit. There was information about the home regularly using the support and advice of Health care professionals. On the day of the inspection, matters regarding one resident were being discussed with appropriate professionals. The Registered Manager said that care managers review residents annually. Daily recording for individuals include maintenance of personal hygiene and Laburnum House DS0000023475.V343943.R01.S.doc Version 5.2 Page 11 activities as well as how their day went. The names of staff of duty are also recorded. Residents have key workers assigned to them. Two residents told the Inspector about their choices that day and it was clear that staff were supporting them with their different activities. Laburnum House DS0000023475.V343943.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): Quality in this outcome area is good. Residents are encouraged to take part in appropriate activities and risk assessments enable involvement with the community. Residents enjoy a healthy diet that they may choose and that suits special diets. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home offers a range of activities that includes going into the wider community. One resident works in the local café once a week. There is a range of activities available including several clubs and social events organised by the local co-owned homes. The sports centre is within walking distance of the home and plans are being made for competitions for people in the local homes at another sports venue. Residents are going to Butlins, Somerset or Euro Disney this year for their holidays. The company pays a substantial amount towards the holidays per person. Music therapy is undertaken as well as in house arts and crafts. The Inspector saw a lot of Laburnum House DS0000023475.V343943.R01.S.doc Version 5.2 Page 13 amazing craft work that some residents had made and that was to be photographed for the company magazine. One person attends an art class and is planning to choose a different activity when the Autumn term begins. Another resident who was introduced to the Inspector helps the Registered Manager in the office. Staff said that families are supportive and it was noted during the day that families were a general part of the conversation and naturally included in the life of the residents. Communication between staff and the people in the home was observed to be friendly and understanding. Staff were able to explain why actions were being undertaken for one resident to meet behavioural changes and that a re assessment was being arranged. Residents choose their own menus and alternatives are offered. There was plenty of fresh fruit and vegetables in the home and a notice in the kitchen encourages fluids and fruit to be given at different times during the day. Laburnum House DS0000023475.V343943.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): Quality in this outcome area is adequate. Suitable physical and emotional support in the way residents prefer is recorded. Medication administration is supported by the homes policies and procedures but Treetops must have a secure medication storage facility. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents will be referred to the appropriate Health care professionals where necessary. Most of the staff are trained in safe handling of mediation administration and then they have to undertake a competence test in the home before they are allowed to administer medication. Policies and procedures support medication administration. A suitable secure storage facility for medication is to be provided for Treetops. Currently this is being held in a cabinet that does not provide an adequate level of security. Treetops is used by more independent residents and a secure medication facility will safeguard their free access to all areas. A requirement was made for this. Laburnum House DS0000023475.V343943.R01.S.doc Version 5.2 Page 15 Laburnum House DS0000023475.V343943.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): Quality in this outcome area is good. An effective complaints procedure is used including one for the residents. Training in understanding adult abuse is given to staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A useful complaints procedure especially for residents has been provided that uses a picture description of how to report a concern or complaint. There is also a more detailed complaints procedure available. A notice promoting whistle blowing is on display in the lobby. Training is given to staff around POVA (the protection of vulnerable adults) and in understanding adult abuse. Primary intervention and challenging behaviour courses are undertaken. The home reported an area of concern to the csci during the year and employed suitable practices to deal with the matter. Laburnum House DS0000023475.V343943.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): Quality in this outcome area is poor. The home must undertake repair and maintenance to meet this standard. The home is clean and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the previous inspection the deputy manager showed the Inspector a list of maintenance work that had been made for approval by the company. The list included replacement windows, full external redecoration, change of access to staff sleep in room, new carpets and several other problems. A requirement was made at that time for this to be completed. The work had not been undertaken at the time of this inspection despite evidence seen of the Registered Manager having contacted the Registered Provider for approval to have the work completed. Laburnum House DS0000023475.V343943.R01.S.doc Version 5.2 Page 18 Treetops currently presents as poorly furnished with dreary decoration and with lumpy and uneven carpeting. The kitchen has a boarded window that a member of staff said had been like that for two years. This is unacceptable. The kitchen floor is a trip hazard because the linoleum is lifting where there is a join in the centre and work surfaces are worn. The cooker and fridge freezer are new. The entrance and stairway has old linoleum flooring. Treetops has substantial repair, refurbishment and redecoration to be undertaken but the Registered Manager believes this has been approved and is due to be undertaken by July. The main house also has extensive repair and maintenance to be undertaken. It includes replacing or repairing and repainting the old metal window frames. On the day of the previous inspection someone was in the home to give a quote for doing this work. The company has had ample time to make a decision about quotes and to arrange to have the work undertaken. This is an unmet requirement from the previous inspection. There are pieces of mortar cracked or missing from some outer window areas. Staff can only access their sleep-in room by going through the laundry on the first floor. The home must address the fire officers concerns of 2006 regarding the use of the room. The kitchen surfaces are worn and laminate facings to cupboards are missing or cracked. The flooring is old and lifting at the edges presenting a cleaning problem as well as being unsightly. The cooker top is worn and rusty at the edge. The gate to the top of the stairs needs re varnishing or painting. Some bedrooms need general redecoration and some refurbishment including new carpeting, as well as repair to earthquake damage that has broken some windows and left cracks around windows and walls and doorframes. Bathrooms, showers and toilets need new tiling and flooring in some areas. One empty bedroom that has been freshly decorated had evidence of a leak from the ceiling down the wall to the floor. The laundry has damp wood patches showing through the very worn paint on the windowsill. There is also damp showing on the wall in a small corridor outside of the laundry. Some windows had restrictors on but it was difficult to decide if windows were able to open wide as some were difficult to move with age or disrepair. Another requirement has been made for a response from the Registered Provider to provide details of when this work is to be undertaken. The garden is maintained and is attractive and a lovely facility for residents but there is an old and rusty oil tank situated directly to the rear of the building. A recommendation is made for this to be removed. Laburnum House DS0000023475.V343943.R01.S.doc Version 5.2 Page 19 The home is a lovely, spacious and light building but to make it homely and safe, suitable work must be undertaken. Staff have worked very hard to keep it clean and tidy but it is impossible to make kitchen surfaces look smart for example when the colour has worn away. The kitchen has new tables and chairs and this is fresh and attractive and let down only by the worn out kitchen cabinets and cooker. Staff have arranged what furnishings they have to the best effect and new, modern pictures and some ornaments have helped brighten the place up. Bedrooms are spacious and promote the choices and hobbies of the residents. Some bedrooms and day areas have been redecorated and present as bright and welcoming and are only let down by the state of the windows. Laburnum House DS0000023475.V343943.R01.S.doc Version 5.2 Page 20 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): Quality in this outcome area is good. The home has a robust recruitment policy and staff training is promoted by company procedures. An effective staff team supports residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home employs a robust recruitment procedure including CRB checks and references. Craegmore provides detailed induction material for all new staff and supervision is undertaken. All staff receive an employees handbook with details of their job including the disciplinary procedure. The company promotes staff training. As well as mandatory training staff are also able to undertake specialist training such as epilepsy awareness and introduction to autism. NVQ level 2 and 3 are undertaken and the home and the company also promote this. Several staff have left employment at the home since the previous inspection and the Registered Manager has six new staff commencing Laburnum House DS0000023475.V343943.R01.S.doc Version 5.2 Page 21 employment at the home in the next few weeks. Some of them will come from others homes in the company and some have worked in the home in the past. Laburnum House DS0000023475.V343943.R01.S.doc Version 5.2 Page 22 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): Quality in this outcome area is good. Health, safety and welfare of residents is promoted by the Registered Manager. Residents’ benefit from the management approach of the home and policies and procedures safeguard their best interests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has been registered since the previous inspection. The Registered Manager has responded to the poor upkeep of the home by raising the issues with the owning company but has been let down by little or no response to an actual time scale for the work to be undertaken. The area manager called into the home during the inspection and agreed with the Registered Manager that a board meeting is to take place at the end of June Laburnum House DS0000023475.V343943.R01.S.doc Version 5.2 Page 23 and that it was hoped suitable responses would be undertaken then regarding repair. A requirement was made for a response with time scales for work to be undertaken. The fire log is in order and regular fire drills take place. Laburnum House DS0000023475.V343943.R01.S.doc Version 5.2 Page 24 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 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 1 25 3 26 X 27 X 28 X 29 X 30 3 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 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 X X X X Laburnum House DS0000023475.V343943.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 Regulation 23 (2) (d) Requirement Repair and maintenance is to be undertaken. Estimated dates for works by timescale to be provided. Staff sleep-in room is to be re-assessed for fire safety. A secure facility for medication storage is to be provided for Tree tops. Timescale for action 02/07/07 2. 3. YA24 YA20 23 13 (2) 09/07/07 01/08/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA24 Good Practice Recommendations Remove the old oil tank from the back garden. 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