Inspection on 19/06/05 for Laglin House

This inspection was carried out on 19th June 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 no outstanding requirements from the previous inspection report, but made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Laglin House 07/05/08

Laglin House 12/12/06

Laglin House 21/02/06

Laglin House 02/02/05

Laglin House 16/06/04

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

CARE HOME ADULTS 18-65 Laglin House 168 Leigham Court Road London SW16 2RG Lead Inspector Mary Magee Unannounced Inspection 19/09/05 10:00 DS0000022801.V252310.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000022801.V252310.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000022801.V252310.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Laglin House Address 168 Leigham Court Road London SW16 2RG 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) 0208-769-8655 Mr Hussain Modile Mrs Elizabeth Modile Mrs Elizabeth Modile Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places DS0000022801.V252310.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd February 2005 Brief Description of the Service: Laglin House is a mid-terraced house located on a residential road in Streatham. The home is in keeping with the local community and is not identifiable as a care home. It is a short bus ride to the main shopping area, where rail services link North and South London. It is owned by Mr & Mrs Modile who live on the ground floor of the house. The home is registered to provide care and accommodation for a maximum of three individuals who have ongoing mental health needs and have varying levels of independence. Bedrooms are single occupancy and located on the first and second floor. Service users have a separate lounge on the first floor. The kitchen is spacious and domestic in style with a large kitchen table that accommodates service users and staff for all meals. DS0000022801.V252310.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took half a day. One service user was living at the home. She shared breakfast with the inspector and spoke of her positive experience at the home. The sister of a service user that recently moved to supported housing spoke to the inspector. The registered manager and the owner met with the inspector. A tour of the entire home was undertaken. A selection of records that included service user personnel files was viewed. What the service does well: What has improved since the last inspection? The manager has helped a service user move to supported housing in a planned manner. A service user’s sister spoke of the kindness and support given to her sister throughout her stay as well as at the critical time of her discharge. DS0000022801.V252310.R01.S.doc Version 5.0 Page 6 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. DS0000022801.V252310.R01.S.doc Version 5.0 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 DS0000022801.V252310.R01.S.doc Version 5.0 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): 2 Service users benefit from living in a small family scale environment that is inclusive and mutually supportive. EVIDENCE: One service user was currently living at the home. She chatted with the inspector during breakfast. She said that she found the lifestyle she experienced from living at the home had really helped her. Since moving to the home over five years ago she has made steady progress. She has benefited from living in a small family type environment with just one other service user. Care and support have been personalised and provided in a manner that is consistent in its approach. This has enabled her to re establish security and stability in her life. She attends college courses, a day centre and participates in meaningful activities. The manager she said has understood her previous difficulties and understood why she needed to live in the residential setting. She said that she found the support given “has helped her to re-establish her independence” and that she was now ready to be reassessed for supported housing. The registered manager had already contacted the social worker to request a statutory/placement review. A service user that had lived at the home for some years had recently moved to supported living. She had made steady progress over a six year period and established independent living skills. The registered manager had helped her with her move to her new home. Her sister was complimentary on the DS0000022801.V252310.R01.S.doc Version 5.0 Page 9 excellent support given to her sister. She had found that the manager really cared for service users welfare and continued with this valuable support right through to their discharge to a new environment. DS0000022801.V252310.R01.S.doc Version 5.0 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): 579 Care planning arrangements are good at the home with service users fully involved in developing their own care plans. EVIDENCE: An up to date care plan was in place for the current service user. It had been developed with the service user and she had signed to acknowledge her agreement of the written care plan. The risk management strategy reflected the current changes to the individual and how these identified risks were managed. Examples of these changes in risk management included documentation to evidence that the kitchen door no longer needed to be locked at nighttimes. Another service user living at the home for a number of years was supported to move to independent living in recent months. At the previous inspection a local authority review completed confirmed that she was ready to move to more independent living. A suitable supported housing unit was found and which the service user liked. She had been supported to visit a number of vacant supported housing units by staff at the home before making a final choice. DS0000022801.V252310.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11 12 13 15 17 Service users receive the opportunity to develop confidence and self esteem and overcome many obstacles they have previously experienced due to mental health related issues. EVIDENCE: Service users are encouraged to participate in all aspects of life in the home. The accommodation is on a family scale with the owner and the manager living on the ground floor of the house. During breakfast the service user helped herself to cereals while she talked with the manager. Her relaxed manner reflected how much she was at ease with the manager. She spoke of her plans for the day ahead at the day centre. She also spoke of feeling ready to move to supported housing. She had remained in contact with another service user that recently moved to supported housing. She spoke of how staff at the home supported her to take risks as part of the plan to enable her to lead an independent lifestyle. She said she was” relishing DS0000022801.V252310.R01.S.doc Version 5.0 Page 12 moving to more independent living but would not wish to forget what the home had helped her achieve”. The proprietor and the manager are familiar with the local community and have a wide knowledge of the various resources available. Information is provided to service users on activities and support services available for those with mental health needs. Contact with relatives is encouraged according to agreed care plans. A service user spoke of the contact that she had maintained with her relatives. A telephone is available on the first floor for service users to use. Service users are encouraged to prepare snacks and drinks at the home and use the kitchen freely. This was witnessed by the inspector. Meals served are according to individual choices. With one service user residing currently meals are planned on a daily basis as in a family setting. The service user spoke of enjoying healthy meals that reflected her cultural needs. DS0000022801.V252310.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 20 The physical and emotional conditions of service users are closely monitored. Prompt action is taken to address any concerns identified and prevent relapse. EVIDENCE: The manager has a system in place for the service user to self administer her medication safely. It was observed that the service user used a dosset box and that she had an awareness of the importance of taking the prescribed medication at the correct time. Checks are undertaken regularly to check on compliance. This is an area where the service user has made excellent progress towards moving to independent living. No support is required with personal care by the current service user. She takes a keen interest in her appearance and prides herself on being well groomed. The manager spoke of her experience in working with people with mental health related issues. She told of the important role staff had in monitoring service users’ conditions and that early indicators such as loss of interest were significant indicators of likelihood of relapse. Previous progress notes for a service user demonstrated that staff took prompt action to respond to issues of concern. DS0000022801.V252310.R01.S.doc Version 5.0 Page 14 Service users are supported to attend outpatient’s clinics for dental and well woman check ups and other essential services such as psychiatric reviews. Areas of progress are recorded and held on care files. This information is collated with assessments and used to determine the extent of the independent living skills developed. All this information is used to assess suitability of a service user in progressing to move to housing that is more independent. Records for the current service user demonstrated the excellent progress was made. There was also present on the file a copy of the referral made for a placement review. DS0000022801.V252310.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 23 The environment is conducive to people expressing themselves and encourages and promotes service users views. Staff require up to date training in order to safeguard service users from neglect or abuse. EVIDENCE: A relaxed environment is provided where people are listened to and encouraged to give their views. The current service user spoke of the relationship she had established with the registered manager. She said that she found that management listened to service users and took on board their views. She said that she valued the opinions of the manager but that she was now ready to move to more independent living housing unit. The registered manager has secured a copy of the local authority Adult Protection Policy and procedure. However staff had not received up to date training on safeguarding people from abuse or on the policy of physical intervention. This was the subject of a requirement in the previous inspection report and is restated as a new requirement. Confirmation was received after the inspection that this training had been provided to staff by the local Adult Protection Coordinator. DS0000022801.V252310.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 27 30 Comfortable homely surroundings are provided that are totally domestic in style. Service users feel valued and appreciated in the family scale environment. EVIDENCE: The premises are a four bedroom terraced house and is registered to accommodate three service users. The proprietor and his wife (the registered manager) live on the ground floor. The third bedroom is used as an office. The house is bright comfortable and, though not purpose built, accommodates service users comfortably in a homely environment. Bedrooms are single occupancy with sufficient numbers of toilets and bathrooms located conveniently. It is brightly decorated and well maintained. A recently vacated bedroom was undergoing refurbishment and must be completed before a new service user is admitted to it. The registered manager said that she was planning to change the way the home was run when the current service user leaves. She told of plans to use all of the accommodation for service users as the proprietor and herself would cease to reside there. DS0000022801.V252310.R01.S.doc Version 5.0 Page 17 Service users benefit from the security of knowing that the manager and the proprietor live on the premises. Service users’ bedrooms are located on the first and second floor and are homely and very domestic in style. A pleasantly furnished sitting room is also provided on the first floor for service users. The kitchen includes a large dining table with chairs. It is located on the ground floor. It contributes to the overall homely style fostered at the home with service users and staff sharing mealtimes. The lock on the toilet on the first floor was not operating effectively and needs to be replaced. The home maintains a high standard of hygiene throughout. DS0000022801.V252310.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 33 35 Training and development is needed for the staff team so that staff members individually and collectively have the necessary skills to meet the assessed needs of service users. EVIDENCE: The staff team at the home comprises of the registered manager, the owner and a bank staff member as and when necessary. For the majority of the time the registered manager or her husband, the proprietor, are on duty. At nighttimes the owner and the registered manager are available as they live on the ground floor. The current service user attends activities externally daily. She is awaiting a placement review regarding her move to independent housing. The low staffing levels reflect her assessed needs. When the current service user leaves and new service users are accommodated the registered manager must review the assessed needs of service users admitted and reflect this in staffing levels. The registered manager and the owner have completed the Registered Managers Award. They have not engaged in any further training other than recent POVA training. The home does not have a training and development programme for staff. There is no Induction and Foundation Training Programme available. DS0000022801.V252310.R01.S.doc Version 5.0 Page 19 Two requirements were set at the previous inspection so that the home made adequate provision for a staff team that were competent qualified and experienced. These have not been responded to. Both requirements have been restated and must be addressed within permitted timescales otherwise consideration will be given to enforcement action. Copies of supervision records were viewed. An external supervisee completed these for the registered manager and the registered provider. These were available for the previous four months. Supervision for staff should be regular and consistent and a minimum of six times a year. DS0000022801.V252310.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 39 42 Service users benefit from living at a small well run home. The registered manager needs to keep her skills and knowledge regularly updated to maintain her competence while managing the home. EVIDENCE: The sister of a service user recently discharged from the home spoke to the inspector of her experiences. She had found that her sister benefited from living in a well run home for the last five years. She had found the manager to be interested in the service users and understand mental health related issues. Her sister she said had progressed well during her time at the home and was now living in supported housing. It was good she said to see service users develop the confidence and self esteem and overcome some major obstacles as her sister had done. The registered manager has many years experience in the mental health field but she requires periodic training and development to keep her skills and knowledge updated. Evidence from reviews and progress notes as well as verbal feedback demonstrated that service users have been supported to successfully achieve DS0000022801.V252310.R01.S.doc Version 5.0 Page 21 their goals. The home has not however established a system to effectively monitor the quality of services delivered or how successful it is in achieving its aims and objectives. The home has written policies and procedures in place to protect the rights and safeguard the best interests of service users. These documents must be regularly reviewed and updated to comply with current legislation. As specified under Standard 35 re training and development there is no staff induction training and development programme to ensure that staff are knowledgeable on safe working practices. DS0000022801.V252310.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X 2 X X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 1 1 X 1 3 CONDUCT AND MANAGEMENT OF THE HOME 3 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 X 1 2 X 2 X DS0000022801.V252310.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA26YA24 Regulation 16 (2) c Requirement The registered person must ensure that the vacant bedroom is refurbished before any new service user is admitted. The registered person must ensure that the defective lock on the bathroom door is repaired or replaced. The registered person must ensure that a staff training and development programme is developed which meets Sector Skills Council workforce training targets and ensure that staff fulfil the aims of the home and meets the changing needs of service users. Previous timescale of 30/04/05 not met. The registered person must develop an induction and foundation-training programme that meet Skills for care requirements on all safe working practices, First aid training and food and hygiene require refresher training. Previous timescales of 30/04/05 not met. The registered person must review the assessed needs of DS0000022801.V252310.R01.S.doc Timescale for action 30/12/05 2 YA27 23 (2) j 30/11/05 3 YA35 18 (1) a, c 30/12/05 4 YA42YA35 18 (1) a, b, c 30/12/05 5 YA33 18(1) a 30/01/06 Page 24 Version 5.0 6 YA37 9 (2) b 7 YA39 24 (10 a, b, c Appendix 2 8 YA40 service users admitted in the future. This must be reflected in staffing levels. Copies of these to be sent to the inspector. The registered person must ensure that the registered manager undertakes periodic training to keep her skills and knowledge updated. Previous timescale of 30/06/05 not met. The registered person must ensure that an effective quality assurance system is developed for the home The registered person must ensure that the home’s written policies and procedures are monitored reviewed and regularly updated to comply with current legislation, and that they cover all topics set out in Appendix 2 30/12/05 30/01/05 30/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA36 Good Practice Recommendations The registered person should ensure supervision provided for staff is regular and consistent. DS0000022801.V252310.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH 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 DS0000022801.V252310.R01.S.doc Version 5.0 Page 26 - 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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