Inspection on 21/02/06 for Laglin House

This inspection was carried out on 21st February 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 13 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 19/06/05

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 21st February 2006 10:00 Laglin House DS0000022801.V268849.R01.S.doc Version 5.1 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 Laglin House DS0000022801.V268849.R01.S.doc Version 5.1 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. Laglin House DS0000022801.V268849.R01.S.doc Version 5.1 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) 020 8769 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 Laglin House DS0000022801.V268849.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 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. Laglin House DS0000022801.V268849.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector undertook this unannounced inspection one afternoon. It lasted for two hours. The registered provider and the manager were present. The home has one service user. She is preparing to move to supported housing following a recent review prompted by the manager. She was not present for the inspection as she was attending a community activity. Records were seen relating to the service user and the premises. No other members of staff are currently employed. The premises are undergoing refurbishment. What the service does well: What has improved since the last inspection? What they could do better: The premises are undergoing refurbishment. For the past three years only two service users have lived at the home although it is registered for three people. Plans are in place to extend the number of service users accommodated to four. A variation request will need to be completed for this. The inspector will visit the home to assess the premises following refurbishment. To meet the needs of proposed increase to service user numbers it will be necessary to recruit and appoint an effective staff team that are competent and trained. Laglin House DS0000022801.V268849.R01.S.doc Version 5.1 Page 6 There is no staff training and development programme in place; it also lacks the presence of a staff induction training and foundation programme. A training and development programme that includes induction training an foundation is needed for staff at the home. The registered manager is dedicated and knowledgeable. However she needs to continue to keep her management skills updated and develop an awareness of changes to legislation, policies and procedures. 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. Laglin House DS0000022801.V268849.R01.S.doc Version 5.1 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 Laglin House DS0000022801.V268849.R01.S.doc Version 5.1 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): 14 The home has provided a supportive environment enabling service users develop the confidence and the ability to move to more independent living. EVIDENCE: Currently the registered provider and his wife occupy the ground floor of the home. He spoke of the changes proposed that include using the home to accommodate service users only. This will free up bedrooms and the home plans to increase bed occupancy and apply for a variation to agree this. Work was underway on vacant bedrooms. The statement of purpose and service user’s guide needs to be updated to reflect the changes proposed. Following referral by the registered manager a local authority review was held for the current service user. She has lived at the home for five years and made steady progress. At the previous inspections she had reported favourably on the support she received at the home and was looking forward to developing more independence. She was assessed at the recent placement review as ready to move to supported housing. Suitable housing had been found and arrangements were in place to help her relocate to her new address. The registered manager demonstrates a commitment to supporting this service user until she has settled in her new home. Refurbishment is taking place at the home. During this period prospective service users will not visit to view the home. Laglin House DS0000022801.V268849.R01.S.doc Version 5.1 Page 9 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): 679 Service users benefit from living in a small homely environment. Service users with mental health difficulties find that in this setting they receive the necessary support to help them achieve their goals. EVIDENCE: The support arrangements in place for the current service user have made a significant difference to her development. She had experienced mental health related problems prior to admission to the home. With the support and encouragement of staff at the home she has managed to overcome many obstacles and achieve her goals. During her stay restrictions and limitations on choice were necessary following assessments during the earlier period. As progress was made the assessments were ongoing with restrictions reduced to reflect this. It was recognised that the service user was ready to move to supported housing. The registered manager made a referral to the care management team in order to review the service user’s needs. The outcome has been that the service users is recommended for supported housing within her placement authority. A flat has been secured in Dulwich to which she will move in the next two weeks. The registered manager is supporting the lady with her move in order that it is as least traumatic as possible. The inspector was impressed with the care and Laglin House DS0000022801.V268849.R01.S.doc Version 5.1 Page 10 sensitivity demonstrated by the manager. it was evident that she cares deeply about service users and is sensitive to their vulnerability especially the support needs to move on. Laglin House DS0000022801.V268849.R01.S.doc Version 5.1 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 13 16 Service users lead meaningful lives and have opportunities for personal development. As the home is small service users like to participate in a wide range of activities in the community. EVIDENCE: It was found at the last inspection that service users were given the opportunities to achieve their goals and to lead fulfilling lives outside as well within the home. Service users are encouraged and supported to develop confidence and self esteem. Two service users have developed the skills necessary to move to more independent living in the past two years. The support given helps them overcome many obstacles that they have previously experienced due to mental health related issues. The rights of service users are respected at the home. Service users are issued with keys to bedrooms. Bathrooms have internal locks to ensure privacy. The current service user was attending an activity in the local community. The registered manager spoke of how much the service user looked forward to the prospects of moving on the supported housing. Laglin House DS0000022801.V268849.R01.S.doc Version 5.1 Page 12 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): 19 20 The physical and emotional conditions of service users are closely monitored. Prompt action is taken to address any issues of concern identified and to prevent relapse. EVIDENCE: Service users attend outpatient’s clinics for appointments. When service users have appointments such as psychiatric reviews staff ensure that these are kept. It is evident that progress is recorded to reflect response to medication and support networks. Records of individual’s progress are held on care files. There were occasions when indicators were recorded of relapses and that necessitated consultation with psychiatric services. All this information is used in the assessment process to determine the extent of the independent living skills developed. These records are essential and were used in a recent review for a service user to assess her suitability in moving to housing that is more independent. The service user lived at the home for five years. During this time the home has enabled the service user to successfully overcome and deal positively with a number of issues relating to her mental health. The home has medication policies and procedures in place that enable service users to control and administer their own medication where appropriate. Laglin House DS0000022801.V268849.R01.S.doc Version 5.1 Page 13 The current service user has been successfully supported to administer and control her own medication following assessment. Laglin House DS0000022801.V268849.R01.S.doc Version 5.1 Page 14 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 While the home has policies and procedures in place to safeguard people from abuse or neglect these need to be updated. EVIDENCE: There is a complaints procedure in place at the home. No complaints were recorded since the last inspection. The home should ensure that a copy of the complaints procedure is supplied to new service users admitted together with the user’s guide. The adult protection policies and procedures of the home do not reflect changes in current local authority procedures recently revised. These must be updated to reflect changes to current local authority procedures. Management and staff must receive refresher training on the adult protection policies and procedures. Laglin House DS0000022801.V268849.R01.S.doc Version 5.1 Page 15 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 27 30 The home is undergoing a refurbishment programme. As the number of service users proposed will increase from three to four the premises will be viewed before this variation is agreed. EVIDENCE: The home was clean and hygienic. Since the last inspection two bedrooms have been totally refurbished, all to a high standard. A`new lock has been fitted to the bathroom door. Service user bedrooms (three) and a lounge are located on the first and second floor. The kitchen includes a large dining table. Service users and staff currently use this to share meals. There are plans for the remaining bedroom and the rooms occupied on the ground floor on the ground floor to undergo refurbishment when they are not occupied. The proprietor and his wife the registered manager live on the ground floor. They plan to move out of the home and release these rooms for service users. This will increase numbers accommodated from three to four. When work is completed the inspector will return to view the premises before a variation application is processed. A requirement was made regarding the refurbishment of the premises. Laglin House DS0000022801.V268849.R01.S.doc Version 5.1 Page 16 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 34 35 Increases proposed in service user numbers will impact on the staffing numbers. The home needs to have a competent and skilled staff team if it is to meet the needs of new service users in the future. EVIDENCE: The registered manager is the main staff member for one service user. Her husband the proprietor supports her. Since the last inspection the manager has undergone distance training in risk assessment, fire safety, health and safety food and hygiene. Plans were in place for further training in administering medication, coping with aggression. The home does not have a staff team but in the proposals to increase the capacity of the home a staff team will need to be in place. 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. It is the subject of a requirement that a staff team be recruited and selected for the home, and that it reflects the assessed needs of service users. At previous inspections two requirements were stated relating to training and development programme and induction and foundation training for staff. While the registered manager and the proprietor have undergone training no induction and foundation training or development programme is in place for staff at the home. Both of these requirements have been restated. Laglin House DS0000022801.V268849.R01.S.doc Version 5.1 Page 17 Supervision notes were viewed for the manager. This was provided by an external source. Laglin House DS0000022801.V268849.R01.S.doc Version 5.1 Page 18 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 40 42 The experience of the manager as well as her caring and sympathetic approach enables service users relate well to her to. They feel secure and confident that the manager will respond positively when they have trouble or relapse. EVIDENCE: The registered manager has many years experience in the mental health field. She has undergone areas of training since the last inspection. Positive outcomes have been achieved by service users that directly reflect her dedication and commitment. However, she needs to continue with her professional development and keep her skills and competencies updated. While the home has been successful in supporting vulnerable service users that experience mental health difficulties to move towards independence there are areas highlighted for development. The home has not established a system to effectively monitor the quality of services delivered or how successful it is in achieving its aims and objectives. This requirement is restated. A selection of the home’s written policies and procedures were viewed. A number had been reviewed recently. This was the subject of a requirement at Laglin House DS0000022801.V268849.R01.S.doc Version 5.1 Page 19 the last inspection. It is restated as a requirement with extended timescales for achievement. The registered person must ensure that all the policies and procedures of the home are reviewed and reflect current legislation. The premises are well presented and maintained. Ongoing work takes place to maintain high standards. This demonstrates the interest and pride taken by the proprietor and his wife. Smoke detectors are in place. A recent inspection was undertaken by the fire prevention officer who made a number of recommendations. The home has responded positively to these and the majority have been attended to including the fitting of fire doors. One recommendation outstanding is the erection of fire exit notices. It has not been possible to complete this while the refurbishment programme is ongoing. This is the subject of a requirement. Currently the proprietor and the manager live on the premises are constantly viewing the premises to ensure that all safety legislation is adhered to. They identify and swiftly address any areas that require attention in relation to safety or repairs. The manager explained the visual checks that are ongoing. With the proposed changes that will include additional staff members it is recommended that changes be introduced with health and safety audits. Laglin House DS0000022801.V268849.R01.S.doc Version 5.1 Page 20 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 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 x 26 3 27 3 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 2 34 2 35 2 36 3 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 3 12 x 13 3 14 x 15 x 16 3 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 3 x x 2 x 2 x 2 x Laglin House DS0000022801.V268849.R01.S.doc Version 5.1 Page 21 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 YA1 Regulation 6 Requirement The registered person must ensure that the statement of purpose and the user’s guide is updated to reflect services offered. The registered person must ensure that management and staff receive refresher training on adult protection policies and procedures. The registered person must ensure that adult protection policies and procedures of the home be updated to reflect changes to current local authority procedures. The registered person must ensure that the inspector is notified when the refurbishment programme for the home is completed. The premises must be viewed before a variation to increase numbers is processed. Timescale may be adapted according to progress in refurbishment. The registered person must ensure that an effective staff team be recruited and selected for the home, and that the team DS0000022801.V268849.R01.S.doc Timescale for action 30/06/06 1 YA23 13 (6) 30/06/06 2 YA23 13 (6) 30/06/06 3 YA24 13 (4) a c 23 (1) a 30/05/06 4 YA33YA34 18 (1) a b c 30/06/06 Laglin House Version 5.1 Page 22 5 YA35 18 (1) a, c are trained and competent to meet the assessed needs of service users 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. The registered person must develop an induction and foundation-training programme that meet Skills for care requirements on all safe working practices. The registered person must ensure that the registered manager undertakes periodic training to keep her skills and knowledge updated. Has received distance learning but this will need to be linked to management role and be ongoing. 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. (Not met in agreed timescales of 30/12/05) The registered person must ensure that recommendations made by the fire prevention officer are addressed when the refurbishment programme is complete. (fire exit signs to be erected) DS0000022801.V268849.R01.S.doc 30/12/05 6 YA42YA35 18 (1) a, b, c 30/06/06 7 YA37 9 (2) b 30/09/06 8 YA39 24 (1) a, b, c Appendix 2 30/06/06 9 YA40 30/06/06 10 YA42 23 (4) a b 30/04/06 Laglin House Version 5.1 Page 23 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 YA22 Good Practice Recommendations The registered person should ensure that a copy of the complaints procedure is supplied to service users with the user’s guide. The registered person should ensure that health and safety audits (in writing) are introduced for staff to monitor the safety of the premises. 2 YA42 Laglin House DS0000022801.V268849.R01.S.doc Version 5.1 Page 24 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 Laglin House DS0000022801.V268849.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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