Inspection on 20/11/06 for Laburnum House

This inspection was carried out on 20th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 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 19/06/07

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 20th November 2006 10:00 Laburnum House DS0000023475.V306627.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.V306627.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.V306627.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 Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Laburnum House DS0000023475.V306627.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th January 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 to 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 back and car parking space in the front. The home is situated close to Folkestone town centre and public transport. Fees are £741.90. Laburnum House DS0000023475.V306627.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. At the unannounced inspection the deputy manager was in charge of the home and staff were in the process of taking Service Users to their trampoline session. One Service User remained in the home. A concern had been raised just prior to the inspection about the lack of maintenance to the premises and this was seen to be accurate. However, the deputy manager agreed with the maintenance issues and showed the Inspector a building and maintenance list of items that were earmarked to be done to the home and that had been forwarded to the owning company Craegmore. This included replacement windows, full external redecoration, change of access to the staff sleep in room, new carpets and several other refurbishment issues. During the inspection, a surveyor called in to the home by prior arrangement, to measure the windows in the property and the deputy manager confirmed to him that all the windows were to be replaced. There was scaffolding to the rear of the home for access to the roof for work being done to the chimney. The area manager called into the home during the day and said that Craegmore had not yet given a date for the work to be completed by. A concern had also been raised at the same time that Service Users who should receive one to one care were not always receiving it. The deputy manager indicated the rota and suggested that during one month recently it had been difficult to cover all the staff due to a large number of people off sick. The deputy manager and later the area manager confirmed that a response to the concerns was being made by the home manager. During the day an inspection was also taking place in the home from an independent assessor for auditing the water systems in the home. There was a ‘buzz’ of friendly chatter and activity when everyone arrived back in doors at lunchtime and some Service Users spoke to the Inspector about their day and kindly showed her their bedrooms. Although the home was in need of repair and some refurbishment it was clean and tidy at the time of the inspection. What the service does well: The deputy manager discussed the current activities offered to Service Users and future plans to become more person centred with more choice. A Christmas party is being planned in the home this year and parents are also invited. The deputy manager said that this is a first for the home and she had Laburnum House DS0000023475.V306627.R01.S.doc Version 5.2 Page 6 plans for the future to be able to involve parents much more in the life of the home. The home has good support including documentation from Craegemore the owning company regarding staff induction, training and supervision. The deputy manager said the home was fully staffed but believed the homes manager was to interview for more staff. 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. Laburnum House DS0000023475.V306627.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 Laburnum House DS0000023475.V306627.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2. Quality in this outcome area is good. The statement of purpose does not contain all required information. New and prospective Service Users are assessed prior to coming to live in the home. This judgement has been made using available evidence including a visit to the service. EVIDENCE: A previous requirement to include room sizes in the statement of purpose has not been met. The home does however provide a useful information pack for prospective Service Users and their family. This includes a service user guide that includes a picture format for Service Users. A complaints procedure is included for Service Users that is also in a very simple to understand format. The sample care plans viewed did not contain a pre assessment of the Service Users. The deputy manager and the area manager said that most of the Service Users had been in the home for a while and it was likely that the documents had been archived. They confirmed that the company provides a pre admission assessment format. A previous inspection confirms that assessment of needs and interests have been viewed and were clearly written. Laburnum House DS0000023475.V306627.R01.S.doc Version 5.2 Page 9 Laburnum House DS0000023475.V306627.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9. Quality in this outcome area is good. Service Users know their personal choices and needs are reflected in their care plans. Service Users are enabled to make choices with support as required. Risk assessments support Service Users with their every day living skills. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Two care plans were viewed and these contained a variety of information regarding guidance for staff in supporting Service Users. Individual risk assessments were in place with evidence of a monthly audit. Some information was recorded as ‘about me’, with the Service Users personal likes and dislikes. The deputy manager said that as an example of how this Laburnum House DS0000023475.V306627.R01.S.doc Version 5.2 Page 11 worked, a Service User had had recorded a particular food dislike but when staff considered the texture and contents of this and then presented the food in a different way it became a favourite for that individual. This is good practice. The deputy manager said she was currently working through the plans updating and removing dated information. Service Users have key workers assigned to them. There was evidence of support from Health care professionals and the deputy manager said they had good support from the local Learning Disability team. Laburnum House DS0000023475.V306627.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17. Quality in this outcome area is good. Service Users are encouraged to take part in appropriate activities. Involvement with the community and with families is enabled. Routines in the home are flexible within risk-assessed boundaries. Service Users 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 the service. EVIDENCE: The home offers a range of activities that includes going into the wider community. A choir made up from Service Users in the local homes was practising regularly in readiness for Christmas. A large poster advertised this in the home. Laburnum House DS0000023475.V306627.R01.S.doc Version 5.2 Page 13 One Service User works a few hours a week in the local café and in a social club on Fridays, where other Service Users also attend. Two people garden twice a week and help maintain the gardens of Laburnum House as well as other homes belonging to Craegmore. One person told the Inspector that he was having a day off that day as the ground was too wet to do very much out of doors. He said he liked gardening and going out with the other people to all the other homes. As part of living skills, trips are made on public buses to different places. Service Users attend hydrotherapy, snoozelan, trampoline sessions, horse riding and craft in-house twice a week. Outings in the evenings take the Service Users to the pub, disco, bowling and Gateway club. One person attends an art class and showed the Inspector her art-work on the walls of her room, she said she really liked going to the classes. Several people showed the Inspector pictures of their families and friends on their bedroom walls and told her about their visits to their families. The home uses picture cards to indicate aspects of Service Users lives. For example, staff will put a picture of a relative on one persons’ wall to indicate to them that a visit home is due. This is thoughtful and good practice. Communication between staff and the people in the home was observed to be friendly and understanding. The menu was chosen by Service Users and meets the needs of diets for particular medical conditions. There was evidence of a plentiful supply of fresh vegetables and fruit in the fridge. Lunch was a cheerful time and promoted communication between Service Users and staff. Laburnum House DS0000023475.V306627.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. Quality in this outcome area is adequate. Suitable personal support in the way Service Users prefer is recorded. Service Users receive physical and emotional care as required. Medication administration is supported by the homes policies and procedures but staff must secure all medication securely. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Care plans and risk assessments detail personal emotional and physical needs that the staff should offer Service Users. Service Users are supported by staff in maintaining health and will be referred to the appropriate Health care professionals where necessary. Laburnum House DS0000023475.V306627.R01.S.doc Version 5.2 Page 15 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. The deputy manager confirmed that medication is reviewed by the g.p. or consultant psychiatrist annually. The homes manager is to purchase a dedicated medication cabinet that will improve the current storage. An item of medication was left unsecured on the desk in Tree Tops and a requirement is made for all medication to be stored securely. Laburnum House DS0000023475.V306627.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. Quality in this outcome area is good. An effective complaints procedure is used including for the Service Users. Training in understanding adult abuse is given to staff. This judgement has been made using available evidence including a visit to the service. EVIDENCE: A useful complaints procedure especially for Service Users 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 office. Training is given to staff around POVA (the protection of vulnerable adults) and in understanding adult abuse. Primary intervention and an annual challenging behaviour course are undertaken. Laburnum House DS0000023475.V306627.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,30. Quality in this outcome area is poor. The home must undertake repair and maintenance to meet this standard. Service Users bedrooms are individual and suit their needs and lifestyle. The home was clean and hygienic. This judgement has been made using available evidence including a visit to the service. EVIDENCE: A concern had recently been raised with the inspector regarding the maintenance of the home and this confirmed during a tour of the premises. The deputy manager showed the Inspector a list of maintenance work that had been made for approval by Craegmore. The list included replacement windows, full external redecoration, change of access to staff sleep in room, new carpets and several other issues. A requirement was made for this to be completed. Laburnum House DS0000023475.V306627.R01.S.doc Version 5.2 Page 18 The kitchen in the main home was in need of replacement doors and some handles and facing to cupboards. Some broken chairs in the kitchen were awaiting removal by skip and a recommendation was made for them to be moved from the kitchen until that time. The shower in one bathroom is to be repaired as it currently has an out of order notice on it. Some windows had restrictors on but it was difficult to decide if windows were able to open wide as some were stuck with age or disrepair. The separate entrance to Tree Tops is in need of redecoration and the stairs and landing have basic lino covering. This does not present a homely or welcoming image to the flat. A requirement is made for a fridge freezer at the top of the stairs to be removed to enable clear access to the stairs and landing. Staff said they had asked for it to be removed but that they were waiting for it to be collected. The COSHHE cupboard was unlocked and a requirement is made for this to be locked. The maintenance audit includes new carpets for Tree Tops. The floor feels lumpy and uneven under the present carpet and it is recommended that this be sorted out when the carpets are laid. An item of medication was left on top of a desk in the office of Tree Tops and a requirement is made for all medication to be secured. A bedroom had an unused fireplace that needed smartening up to enhance the room. The bed base looked worn although the covers were fresh and clean. Tree Tops is spacious and the inspector spoke to two people who live in the flat who said they liked it being so big and that they enjoyed living there. But to make it homely and comfortable it is in need of redecoration and refurbishment. Service Users were able to indicate to the Inspector that they enjoyed their life at the home and the interaction noted between staff and Service Users was positive and friendly. It is a shame that so many maintenance issues undermine this. A requirement is made for redecoration and refurbishment to be undertaken as well as repair and maintenance. Laburnum House DS0000023475.V306627.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35. Quality in this outcome area is good. Qualified staff support Service Users. The home has a robust recruitment policy. Staff training is promoted by company procedures. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The home employs a robust recruitment procedure including CRB checks and two 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. Laburnum House DS0000023475.V306627.R01.S.doc Version 5.2 Page 20 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. Laburnum House DS0000023475.V306627.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42. Quality in this outcome area is adequate. Service Users will benefit from the manager being registered. The quality assurance will be improved by the addition of views of Service Users and other significant people. Health and safety of the home is compromised by the fire logs checks not being kept up to date. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The homes manager is to apply for registration. In the meantime the area manager who usually visits the home weekly and the deputy manager support her. Laburnum House DS0000023475.V306627.R01.S.doc Version 5.2 Page 22 The home is audited annually to measure the quality of the service. The deputy manager showed the Inspector some returned questionnaires sent to families. One parent had written, “staffing is superb” on the questionnaire. The Inspector made a requirement to strengthen the quality assurance process by collating the responses and add to the annual development plan so that issues raised may be addressed and developed for the benefit of the Service Users. Service checks for gas and electricity were seen and were in date. The fire service log for regularly checking different aspects of the homes fire system was not up to date by several weeks although had been kept up to date until then. The deputy manager agreed that this should have been undertaken and a requirement was made for this to be updated. An independent auditor was undertaking the annual bacteriological service checks on the day of the inspection. Laburnum House DS0000023475.V306627.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 2 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 3 X 2 X 2 X X 2 X Laburnum House DS0000023475.V306627.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES 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 YA1 Regulation Schedule 1 Requirement Include the bedroom and communal room sizes and features in the statement of purpose. Timescale for action 01/12/06 2. YA24 23 (2) (d) The bathrooms and several areas 11/12/06 around the home including Tree Tops, need refurbishment including repair/replacement of windows. Estimated dates for works by timescale to be provided. Fridge freezer to be removed from top of stairs in Tree Tops. The COSHHE storage is to be locked when not in use. Develop the quality assurance system to include views and action plan from service users in the home. The manager is to apply for registration. The fire log is to be kept in date. Medication is to be stored securely. 08/12/06 20/11/06 22/12/06 3. 4. 5. YA24 YA24 YA39 23 (2)(d) 13 (4)(a) 24 (1) (a, b) (3) 6. 7. 8. YA37 YA42 YA20 10 (1-3) 23 (2) (c) 13 (2) 22/12/06 20/11/06 20/11/06 Laburnum House DS0000023475.V306627.R01.S.doc Version 5.2 Page 25 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 YA24 YA24 Good Practice Recommendations Broken chairs stored in kitchen are to be removed for safety. The lumpy and uneven floors in several areas to be improved when new carpets are laid. Laburnum House DS0000023475.V306627.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Laburnum House DS0000023475.V306627.R01.S.doc Version 5.2 Page 27 - 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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