Inspection on 07/12/05 for Laburnum House

This inspection was carried out on 7th December 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

Laburnum House 23/10/07

Laburnum House 03/08/06

Laburnum House 21/04/05

Laburnum House 14/09/04

Laburnum House 06/04/04

Laburnum House 28/10/03

Laburnum House 03/06/03

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

CARE HOME ADULTS 18-65 Laburnum House Second Drive Landscore Road Teignmouth Devon, TQ14 9JS Lead Inspector Sam Sly Unannounced 7 December 2005 th 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. Laburnum House D54-D07 S3733 Laburnum House V241753 071205 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Laburnum House Address Second Drive, Landscore Road, Teignmouth, Devon, TQ14 9JS 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) 01626 774662 01626 774662 rotellimited@tiscali.co.uk Rotel Limited Vacant Care Home 18 Category(ies) of Learning Disability (18) registration, with number of places Laburnum House D54-D07 S3733 Laburnum House V241753 071205 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 14th June 2005 Brief Description of the Service: Laburnum House cares for up to 18 adults with learning disabilites under 65 years old. The Home is run by a company called Rotel that owns two other homes for adults with learningi disabilites in South Devon. The Home is in a residential area of Teignmouth within walking distance of the town centre, bus routes and the train station.There is level access into the front of the Home, but steps throughout the rest of building may present difficulties to someone with a mobility problem. All of the bedrooms are en-suite and single, with additional toilets, showers and a bathroom.Seventeen of the bedrooms are in the main building with a selfcontained flat in the grounds. There are a number of communal rooms throughout the Home. Laburnum House D54-D07 S3733 Laburnum House V241753 071205 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection was unannounced and took place in the afternoon and early evening of a weekday in December. This is the third visit the Commission has made to Laburnum House this year. It is recommended that the Commission’s report dated 21st April 2005, and the follow-up report dated 14th June 2005 is read in conjunction with this report to get an overview of the service. Most of the time was spent talking to residents and staff on duty and observing interaction. Time was also spent examining staff and resident’s records and health and safety documents. 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. Laburnum House D54-D07 S3733 Laburnum House V241753 071205 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Laburnum House D54-D07 S3733 Laburnum House V241753 071205 Stage 4.doc Version 1.40 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 standard(s) 2 Resident’s needs and aspirations were thoroughly assessed prior to admission. EVIDENCE: Three resident’s files were examined, one with the resident themselves. All three residents had thorough assessments that reflected their needs, and which led into comprehensive care plans. The resident whose care plan was shared with them, confirmed that what was recorded was accurate and had been compiled and agreed with them. Laburnum House D54-D07 S3733 Laburnum House V241753 071205 Stage 4.doc Version 1.40 Page 8 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 Residents are involved in decision-making about their lives and in developing their care plans. The care plans reflect fully the needs and goals of residents. EVIDENCE: Three resident’s care plans were examined and were detailed. Each resident had goals that staff were helping him or her to achieve. One resident discussed their care plan in detail and it was evident that they had been involved in compiling it, the goals were relevant and it accurately reflected the care given by staff and others. There was evidence of regular resident meetings, and individual key worker meetings were residents were given the opportunities to make decisions about their lives. Any restrictions on resident’s rights or freedoms were considered carefully, agreed with residents and detailed thoroughly in care plans. Residents were supported to look after their own finances where possible, or the Acting Manager looked after money. Appropriate records were kept about resident’s finances. Laburnum House D54-D07 S3733 Laburnum House V241753 071205 Stage 4.doc Version 1.40 Page 9 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 Residents enjoy healthy meals, relaxed mealtimes, varied and interesting leisure, educational and work activities and their relationships with friends and family are supported by staff. EVIDENCE: Most residents attend day activities provided by Rotel called Focus 2000. This service includes some leisure, work and educational activities. On the day of Inspection there were four residents at home on arrival at 1.45pm, and the others arrived home shortly after from Focus 2000, earlier than usual due to Chiropody appointments. Discussion with resident found that they were happy with the activities they attended. Some residents went to local leisure and social groups, others to Church and shopping independently in the local community. One resident attended a local advocacy group. All residents had been on at least two holidays this year and there were regular trips to local pubs. It was recommended that information on educational, work, personal development and leisure opportunities are gathered by the Home and regularly discussed so that residents can make informed choices about what they do. Laburnum House D54-D07 S3733 Laburnum House V241753 071205 Stage 4.doc Version 1.40 Page 10 Residents were supported and encouraged to keep in contact with friends and family through visits, phone calls and letters. The staff on duty were observed to be respecting residents privacy and interacting with them at all times. Residents all had locks on their bedroom doors with keys provided. All the residents said the food was good. There was evidence that the menu was discussed with residents and changed regularly. Residents were encouraged to be involved with preparing meals. On the day of Inspection the meal was curry, which looked appetising, and the meal was shared in a relaxed and unhurried manner. One resident lived in a self-contained flat, and it was found that some of the food safety checks were not being regularly recorded. Laburnum House D54-D07 S3733 Laburnum House V241753 071205 Stage 4.doc Version 1.40 Page 11 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) 20 Medication procedures at Laburnum House protect residents. EVIDENCE: The receipt, recording, administration, storage, handling and disposal of medication are done in ways that protect residents. Staff have received training and the acting manager carries out regular checks to ensure procedures are followed. None of the resident’s self-administered medication based on a risk assessment format. Residents confirmed that they had agreed that staff could administer their medication. Laburnum House D54-D07 S3733 Laburnum House V241753 071205 Stage 4.doc Version 1.40 Page 12 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) EVIDENCE: None of these standards were assessed at this Inspection, as both were met at the Inspection on 14th June 205. Two complaints that had been received by the Commission since the last Inspection had been investigated appropriately by the Registered Provider and not upheld. Laburnum House D54-D07 S3733 Laburnum House V241753 071205 Stage 4.doc Version 1.40 Page 13 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) EVIDENCE: None of these standards were assessed at this Inspection although those parts of the home viewed were clean, well furnished and well maintained. Both standards were met at the Inspection on 21st April 2005. Laburnum House D54-D07 S3733 Laburnum House V241753 071205 Stage 4.doc Version 1.40 Page 14 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) 32 & 36 Residents are care for by well-supported, competent and qualified staff. EVIDENCE: The staff on duty were approachable, accessible, interested, motivated and committed to the residents. Resident’s views on staff were that they were ‘nice’, ‘helpful’, ‘fun’ and residents felt they could talk to them about worries. Residents were aware of who was their key worker and what key worker responsibilities were. Staff attended Total Communication training to ensure they could communicate effectively with residents. Staff had or were going to start NVQ courses at levels 2 and 3. Staff were being supervised regularly by the acting manager and said they felt supported. Laburnum House D54-D07 S3733 Laburnum House V241753 071205 Stage 4.doc Version 1.40 Page 15 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 & 39 Residents cannot be confident that their views underpin the review and development of Laburnum House. EVIDENCE: An application to register the acting manager is being processed by the Commission. She has improved the services provided at Laburnum House since beginning work in February 2005 and staff said she is approachable and effective at the role. The Responsible Individual has been carrying out regular quality assurance checks, which have been sent to the Commission. There was no written quality assurance system in place, and the acting manager did not know what progress has been made. Laburnum House D54-D07 S3733 Laburnum House V241753 071205 Stage 4.doc Version 1.40 Page 16 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 x 3 x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x 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 x 3 x x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Laburnum House Score x x 3 x Standard No 37 38 39 40 41 42 43 Score 2 x 2 x x x x D54-D07 S3733 Laburnum House V241753 071205 Stage 4.doc Version 1.40 Page 17 Yes 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 39 Regulation 24 Requirement There must be a complete Quality Assurance system in place, which captures the views of the residents and stakeholders. An annual report must be produced, with a copy available for CSCI and other interested people. (Timescale 27/09/05 - not met) Timescale for action 08/03/06 2. 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 12, 13 & 14 17 35 36 Good Practice Recommendations Information about educational, leisure and work opportunities should be kept at the home, regularly updated and shared with residents so that choice can be demonstrated. Fridge and freezer temperatures should be kept in the flat. There should be an overall staff training and development plan for Laburnum House. Staff that supervise should have training so they fully understand the process. 2. 3. 4. Laburnum House D54-D07 S3733 Laburnum House V241753 071205 Stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton Devon, TQ13 7UP 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 D54-D07 S3733 Laburnum House V241753 071205 Stage 4.doc Version 1.40 Page 19 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!