Inspection on 25/01/08 for Lampton Court

This inspection was carried out on 25th January 2008.

CSCI found this care home to be providing an Good service.

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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lampton Court 05/03/09

Lampton Court 12/09/07

Lampton Court 07/06/06

Lampton Court 16/02/06

Lampton Court 21/12/05

Lampton Court 08/03/05

Lampton Court 23/07/04

Lampton Court 05/01/04

Similar services:

Clouds House

Closereach

Westcliffe House

Hilldales

Longreach

Chandos House

Cherry Orchards Camphill Community Ltd

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

CARE HOME ADULTS 18-65 Lampton Court Lampton Court Littleham Bideford North Devon EX39 5HT Lead Inspector Adele Adams Unannounced Inspection 25th January 2008 10:00 Lampton Court DS0000026736.V357449.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 Lampton Court DS0000026736.V357449.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. Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lampton Court Address Lampton Court Littleham Bideford North Devon EX39 5HT 01237 470280 01237 425040 admissions@lamptoncourt.com 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) Health & Care Partnership Limited Vacancy Care Home 19 Category(ies) of Past or present alcohol dependence (19), Past or registration, with number present drug dependence (19) of places Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of care only: Care home providing personal care- Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Past or present alcohol dependence- Code A 2. Past or present drug dependence- Code D The maximum number of service users who can be accommodated is 19. 12th September 2007 Date of last inspection Brief Description of the Service: Lampton Court provides 24-hour care for 19 younger adults aged 18 to 65 years with past or present alcohol and/or drug dependencies. The home is registered as a care home. The service is run in a large detached house standing in its own extensive landscaped grounds and is a short drive away from the North Devon town of Bideford. There are 5 single bedrooms and 5 bedrooms are shared. There is a swimming pool on site. The service runs a programme that provides group work, and an activity programme. The programme also provides an experience of community living and day programme. The fees charged can be obtained by contacting the service; all basic provisions such as basic toiletries are provided; additional charges are made for personal items such as toiletries, magazines and newspapers. Copies of previous inspection reports are available in the office at Lampton Court. Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The Commission for Social Care Inspection has introduced ‘Key Standards’ to be inspected over each inspection year. Therefore, unless it is felt necessary by the inspector, some standards will not be inspected. This inspection was unannounced and took place over one day; it began at 10:00 and ended at 14:20. The Regional Lead Pharmacist also took part in this inspection. The purpose for this inspection was to find out what progress had been made by the service following the last inspection in September 2007 and to inspect the key standards. The key standards include: information; health and social care; leisure activities, complaints and protection; environment; recruitment; management and health & safety. The Regional Lead Pharmacist focused on the service’s medication practices. To do this, we spoke with people that use the service, and read records, policies and procedures. We also spoke to staff during the inspection. Surveys were not sent to people using the service or health and social care professionals on this occasion. During this inspection people were visiting to see what service is provided at Lampton Court. Information in the form of an Annual Quality Assurance Assessment (AQAA) was received before the last inspection in September 2007. As this inspection has taken place within a year of the last inspection, the same AQAA provided us with important information that supported this inspection. Information about the fees for this service can be obtained by contacting Lampton Court. What the service does well: Everyone using the service provided at Lampton Court has been through a thorough pre admission process, which makes sure that the service can meet the needs of that person. People wishing to find out about the service provided at Lampton Court can now access an informative newsletter and DVD in addition to visiting the service if they are able to. Each person at Lampton Court has a key worker. Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 6 People told us that this helps to makes sure that their needs are met in a way that is best for them. People are encouraged to be fully involved in planning and reviewing their care and place value on this. People told us ‘we are treated with respect and receive support.’ People using the services provided at Lampton Court continue to benefit from the excellent approach to personal development. This includes opportunities to take part in many activities that are purposely designed to be both fun and personally challenging. People told us that they really appreciate the activities that they are involved in and can see the purpose and value of them. In addition, as part of their personal development, people get involved with the preparation of food, learn the importance of eating a well balanced diet and can learn new skills in meal preparation. People told us that they had done a food safety course and were really pleased with their achievement. There are some restrictions in place at Lampton Court, for example, with regard to relationships and freedom of movement outside of the home. People using the service told us that this is both positive and acceptable as this is part of the support they need to help them not to return to behaviours associated with substance addiction. People told us that they are able to raise concerns and openly discuss matters with each other and the staff. They said they felt confident that if they had to make a complaint or had a concern the staff would treat it seriously and act upon it. What has improved since the last inspection? Lampton Court’s Statement of Purpose (which is the document containing all of the information about the service) has been improved and provides up to date and accurate information about how the service is run and what is offered. This improved information will help people to confidently make decisions about the service and whether it will suit their individual before they move to the home. The service has begun to improve the care records of people using the service by showing that people using the service are involved in planning and reviewing their care. Some individual care records have been improved to contain up to date signed and dated risk assessments. This now shows when a risk assessment has been carried out and whether or not it should be reviewed. The service has changed and improved the systems in place for the management of medicines and medicines are now managed more safely. Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 7 The information in the Complaints procedure has been improved by updating and entering the correct contact details of the Commission for Social Care Inspection so that people using the service can contact us should they need to. The service’s policies and procedures have been improved by being updated, this will help to ensure people using the service receive up to date appropriate care. Improvements in health and safety checks have begun and staff have all received first aid training and fire training has been organised. What they could do better: The address of the service provider Health and Care Partnerships Limited should be included in the updated and improved Statement of Purpose. Arrangements must be made to provide safe storage for medicines that are looked after by people living in the home. Arrangements must be made to ensure that a record is made of all receipts and disposals of medicines. All staff working at Lampton Court should have a training plan in place. This is to ensure that they have the skills and knowledge to meet the needs of the people using the service. It would also assist in identifying in advance when training should to be organised. Staff should have regularly planned one to one supervision, to ensure that they have ‘protected time’ when they can receive support and discuss their own development needs. This will enable them to work effectively with people using the service. A report detailing finding of quality assurance systems such as questionnaires should be made available to people using the service and the Commission for Social Care Inspection. The service does not have a Registered Manager; this must be improved by ensuring that a suitably qualified and experienced person is registered with the Commission for Social Care Inspection. Essential health and safety checks such as the recommended testing for Legionella in water stored at the home and the testing of the emergency lighting system are carried out; records to show this should be kept. This is to make sure that risks to people using the service are minimised. Please contact the provider for advice of actions taken in response to this Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 8 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 9 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 Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The service’s performance was assessed against Key standard 2 and Standard 1. People who may use the service at Lampton Court undergo a thorough assessment process to determine whether Lampton Court can meet their needs and have access to up to date information about the service which helps them to make informed decisions about whether the service can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service provided a completed AQAA (Annual Quality Assurance Assessment) which described how the service selects people through assessing their individual needs and that clients also have the opportunity to visit the unit prior to admittance to test drive it for a day unless they come directly from custody when this is not possible. The AQAA also advised that the admissions procedure at Lampton Court consists of a three-stage process which includes a telephone assessment followed by a more in depth face to face assessment at Lampton Court and then a care planning meeting to decide whether the applicant is ‘right for us Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 11 and us for them.’ The service also asks the referrer for information about the applicant which helps in making their decision. We spoke to two people using the service who told us about their own assessment before admission in detail. In addition, the reading of two people’s records showed the amount and quality of the information that is gathered during the assessment process that enables the service to make their decision about whether or not they can meet a person’s needs. This information confirmed what had been stated in the AQAA. Following the last inspection findings the Statement of Purpose has been updated and was provided to us. We read this and found that the information has been updated and that only one piece of information needs to be added to this. Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 12 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The service’s performance was assessed against Key standards 6, 7 and 9. People using the service at Lampton Court are involved in decisions about their lives, and play an active role in planning the care and support they receive. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service provided a completed AQAA (Annual Quality Assurance Assessment), which informs us that each person has a key worker with whom he/she discusses all aspects of care in weekly (often twice weekly) one to one sessions. This personal approach to individual care allows for the needs of the individual to be monitored continually and adapted as necessary with the agreement of both parties. The AQAA identified that the service is looking at ways of improving the current paper record system that is in use. Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 13 Two people using the service told us about the key worker system that is in place at Lampton Court. They told us that they each have their own records and talk with their key worker in the one to one sessions that take place regularly. We were also told of some of the opportunities that people have and how these are enjoyed and appreciated. In addition, we read two people’s records; these showed that individual records are kept for each person at Lampton Court. These records include risk assessments; we saw that risk assessments are being improved and are now being dated when carried out. The two records read by us all contained evidence of being regularly reviewed. The written content showed us that this is done with the involvement of the person using the service and it was encouraging to see that the sections of the records that are available for the person to sign to show their involvement have started to be used. The records we read held appropriate information. This information confirmed what had been clearly communicated in the AQAA. Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. The service’s performance was assessed against Key standards 12, 13,15,16 and 17. People who use the services at Lampton Court are able to make safe choices about their life style, and are supported to develop their life skills. Social, educational, cultural and recreational activities meet and sometimes exceed expectations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service provided a completed AQAA (Annual Quality Assurance Assessment), which in relation to the above standards told us that: “The whole ethos of Lampton Court is about personal development and developing lifestyle choices away from drugs and alcohol. There are some restrictions which are in place to ensure the safety of clients. These Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 15 restrictions are of benefit to the programme and service user and are designed to allow clients time away from the pressures of having to face external challenges before they are well and strong enough to do so. The holistic curriculum includes many outdoor activities which are designed to broaden the clients thinking and be fun. Service users are positively encouraged to review relationships and to examine whether they are healthy. Parents, partners and children are encouraged to visit Lampton Court and after a period of time service users can go off site with visitors. We have a chef tutor who as well as providing tasty and nutritious food also instructs service users on cooking for themselves and nutritional, healthy eating and dietry options.” We spoke to two people using the service who told us of the improvement in their lives in the short time they have been at Lampton Court and explained this to us. They explained that this had been due to being supported to develop through education, leisure pursuits and daily routines. People told us that they couldn’t believe some of the things they have been able to take part in and achieve while being at Lampton Court and were looking forward to the activities of the following day which included abseiling. People told us that there are some restrictions are in place with regard to relationships and freedom of movement outside of the home and these are acceptable because they are designed to support them from returning to behaviours associated with substance addiction. People also described how they are supported to maintain healthy meaningful relationships and maintain contact and re establish contact with meaningful others including their family. Staff and people using the service told us that the service employs two doctors who visit regularly and support the people using the service, this information is made clear in the statement of purpose. On site, we observed and were told by people that the house is situated in approximately eight acres of land and there are areas for sports such as football and swimming and we were told of some of the pursuits that have been enjoyed such as horse riding. Gym equipment is available for use and computers are available for personal use – ‘rules’ are in place to ensure appropriate use of equipment and facilities provided. The kitchen was seen form a distance on this occasion and the chef tutor was present, we did not join people for lunch on this inspection but people told us what they had and we observed the menu and discussed the catering arrangements with people who told us these remain outstanding. The menus continue to be planned, and people using the service continue to be involved in kitchen duties and food preparation. Each person has the opportunity to gain Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 16 a food hygiene qualification and the two people we spoke this were extremely pleased they had taken part and successfully achieved their certificate. All we observed read and spoke with people about confirmed what had been stated in the AQAA. Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 17 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The service’s performance was assessed against Key standards 18,19 and 20. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Medication systems and the management of medicines are improving. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service provided a completed AQAA (Annual Quality Assurance Assessment), which in relation to the above standards told us that: ‘The programme is designed to promote emotional and physical health; which is reviewed individually through care planning with the person concerned. The service has a private contract with two GPs who hold surgeries on Mondays and Fridays at Lampton Court. People are perscribed the medicines that they need and these are recorded in a MARS chart. All medicines are stored safely in a locked meds cupboard within the locked staff office. It is unlikely that Standard 21( the aging illness and death of a service user ) would apply to us, but we understand and accept the value of this.’ Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 18 We spoke to two people using the service who told us how their personal, physical and emotional and medication needs are met at Lampton Court. They told us that they manage their own personal independently care and that care is taken to ensure that their privacy and dignity is respected. Two people that use the service told us that a doctor visits the service twice a week on a Monday and Friday and told us that their health needs are met. The statement of purpose shows that 2 doctors are part of the staffing compliment at Lampton Court. There is a letter that the Commission has seen that shows that it is difficult for people using services at Lampton Court to register with local doctors. We found that the medicines are stored securely and it was possible to identify the member of staff responsible for the administration of medicines and they held the keys securely. We found that apart from an instance where a person had left the service following a disciplinary meeting and the quantity of medicine they had taken with them had not been recorded and neither had the quantities returned to the service following re-admission been recorded, all other receipts and disposals were recorded correctly. We found that when people are looking after any of their own medicines that a record is made that they have been given the medicine but the date of supply is not recorded. Also no provision is made for the safe storage of these medicines, as people are not provided with a lockable space. Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The service’s performance was assessed against Key standards 22 and 23. People who use the service are able to express their concerns, and have access to an effective complaints procedure, and are protected from abuse, and have their rights protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service provided a completed AQAA (Annual Quality Assurance Assessment), which informed us: ‘There is a good system for listening to the views of service users and that all service users are protected from abuse, neglect and self harm through understanding their individual needs. All staff are currently undergoing POVA training, many have already undertaken this training and the remainder are booked to do it at North Devon College on the 24th July 2007. The complaints procedure is displayed on the service users notice board, staff are approperatly trained and are aware what they need to be looking for. We have feedback sheets and questionaires about clients views of activities and value verbal feedback through open meetings and forums.’ People we spoke with told us that they are able to raise concerns and discuss matters openly with each other and the staff and said they felt confident that if they had to make a complaint the staff would treat it seriously and act upon it. Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 20 The Responsible individual for the service advised us that the complaints procedure had been updated to include the correct contact details for the Commission. We received a faxed communication that demonstrated this. The Responsible individual for the service advised and showed us information that shows that staff have recently attended suitable training in the protection of vulnerable adults. We spoke with 4 staff that told us they had attended this training and found it useful. Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The service’s performance was assessed against Key standards 24, 27 and 30. Lampton Court provides an environment suitable to the needs of those who reside there, and encourages independence. This judgement has been made using available evidence including a visit to this service EVIDENCE: The service provided a completed AQAA (Annual Quality Assurance Assessment) which informs us that: ‘Lampton Court is a delightful Victorian house set in 8.5 acres of gardens over 3 miles from the nearest town. Service users safety, both from risk within the home and from challenges outside the home, are of paramount importance as the feeling of safety and care has a huge effect on the service users recovery. We have a range of different accomodation from single to three bedded rooms. This is so service users can be accommodated in the correct environment for themselves and their recovery. Female residents share an ensuite room for Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 22 privacy and safety. All are encouraged to personalise their rooms with pictures or items with sentimental value. All bedroom doors can be locked for privacy. Each bedroom has its own laundry day and service users who have not used them before are helped to use the washing and drying machines, developing further independent living skills. There is a large comfortable residents lounge which is used outside curriculum time for relaxation and TV. We also have an exception to the new anti smoking law so that clients can smoke in this room. Lampton has a House Keeper and each service user is, each week, given a theraputic duty (TD) to do. The service users TD changes weekly and is supervised by the House Keeper and head resident. This develops a sence of belonging within the house and also keeps the house clean and hygienic. The general feeling of the house is comfortable and homely whilst accepting that it is a temporary residence not a permanent home.’ The AQAA also informs us that over the next 12 months plans for improvement include : We aim to continue decoration the house internallyand have plans to develop another 11 beds in a rebuild of the west wing to increase the unit to 30 beds.” A tour of the home took place at the last unannounced inspection 4 months ago and we were advised that there had been no major changes since the last inspection and therefore did not see all of the building and grounds on this occasion. We spoke with two people that use the service and with staff they told us that they think the accommodation provided is good. They also described what ‘T.D’s’ (therapeutic duties) are and explained how the rotas in place work – for example the laundry rota. The laundry area was viewed and is by the courtyard and next to the kitchen. The laundry can be accessed without going through areas where food is prepared or eaten the Responsible Individual for the service advised that new appliances had recently been bought for the laundry. The service’s statement of purpose states that the provision of bathrooms and toilets complies with the National Treatment Agency guidelines for short-term drug and rehabilitation units the people we spoke with during this inspection said that the number of bathrooms and toilets was satisfactory. Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The service’s performance was assessed against Key standards 31,32,34,35 and 36. The staff in the home are in sufficient numbers to support the people who use the service. The staff that are in post are enthusiastic, dedicated and strongly believe in the work they do, there is still however a lack of a Registered Manager. This judgement has been made using available evidence including a visit to this service EVIDENCE: The service provided a completed AQAA (Annual Quality Assurance Assessment), which tells us: ‘That the staff team at Lampton Court are all highly trained and that each member of staff is clear about their role, the responsibility within that role and how that role works as part of the overall staffing team. The AQAA also states that of the 8 permanent staff 6 have NVQ Level 2 or above. The AQAA also informs us that there had been problems with inappropriate recruitment and a very relaxed attitude to CRB checks, references etc. and that in the last 12 Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 24 months all staff have undergone POVA and CRB checks, references have been taken up and the lack of care in recruitment has been corrected.” We spoke with two people using the service, they told us that they have confidence in the skills of the staff employed at Lampton Court and they understand the different positions held by staff in the home. They also told us that there are always enough staff on duty. Staffing levels were discussed with staff. The Responsible Individual for the service told us that the service has recently successfully recruited people to work with the service and that this has had positive results. Staff also told us that the numbers of staff have increased which has been very positive for the service and that shifts are always covered. Training was discussed with staff in the absence of any training and development plan. Staff spoken with told us of the training they had done or are involved in doing – for example NVQ courses. Staff told us that they had done first aid training and fire training has been organised and we also saw written records that showed this. The Responsible Individual for the service discussed the current lack of training and development plans with us and advised that this would be attended to. The staff we spoke with told us that one to one supervision had been organised and was to start soon which will also provide staff with an opportunity to discuss individual training and development needs. Staff did tell us that they do attend a weekly staff meeting, which is of benefit, and that minutes of these meetings are kept, we were also informed that there is good staff communication between shifts. The staff spoken with told us that they are familiar with the General Social Care Council standards of conduct and practice and these were seen on the notice board in the office. 2 members of staff have started the Registered Managers Award, another member of staff confirmed they have achieved their NVQ Level 2 in Care. We were advised when we asked staff about roles and responsibilities that general management systems that addressed essential areas such as training were improving. We were also told that there more clarity now about how or who should take responsibility for certain duties. We have also been advised in writing that the service is trying to recruit a Registered Manager. The Responsible Individual for the service and staff told us that interviews for a Registered Manager have taken place in place. We discussed the services recruitment practice with a recently appointed member of staff – this showed us that all of the correct procedures and checks Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 25 had taken place. We were also told by a member of staff of the induction they had received, which they felt had been useful. Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 26 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The service’s performance was assessed against Key standards 37,39,40 and 42. The service is currently without a qualified registered manager but is managing in the interim period. A meaningful quality assurance system is in place but the outcomes are not openly available, health and safety practices have and continue to improve. This judgement has been made using available evidence including a visit to this service EVIDENCE: The service provided a completed AQAA (Annual Quality Assurance Assessment) however changes have taken place since the AQQA was supplied to us that effect the information originally supplied. Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 27 The AQAA originally informed us that a new centre manager had been recruited and that an application to register this person with the Commission for Social Care Inspection was to be made. Unfortunately decisions have been taken not to continue with this. However we were informed both in writing and during this inspection that interviews for a new Registered Manager have taken place. We have been advised in writing of the management arrangements that are in place while the new Registered Manager is being recruited. There has also been a change in the staffing structure within the service that has enabled a senior member of care staff to move forward with some management issues. We spoke with two people that use the service about how the home is run. They told us who they feel are the staff that have greater responsibility in the running of the service and that they have confidence in these people. We were also told that people give feedback to staff on a daily basis and know that what they say is listened to and understood by staff and that if any action needs to be taken they know that staff will do so. The Responsible Individual for the home told us that people using services at Lampton Court are able to take part in quality assurance processes even though their stay is relatively short – this is in the form of a quality assurance questionnaire. This information is also in the Statement of Purpose. At present the results are not available in a report, however we were told that this could be done and supplied to the Commission. We spoke with staff and they told us that although there is no registered manager currently in post, the day to day running of the home has improved and that this is because a senior member of staff has been given more management responsibility and that this has been positive for the service. The AQAA gave clear us details about when maintenance checks were performed at the home, a fire risk assessment dated 5/1/08 was in place, a new alarm had been installed in December 2007, we also saw records that the fire alarm was regularly checked, that a fire maintenance check had been carried out in December 2007 and that a fire inspection and service had taken place in October 2007. There had been some lapses in he recording of the emergency lighting checks – we were told that this would be given immediate attention. We were told that Fire training for staff has been arranged. Staff have undertaken first aid training since the last inspection – this means that there is someone that is a qualified first aider working on each shift. A risk assessment was provided to us that showed that the service has assessed the need for lifting and handling people that use services at Lampton Court. This shows that there is currently no need for lifting and handling equipment or training. Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 28 The Responsible Individual told us that they had looked into the testing of water for Legionella. We were told that the service provider tests the hot water temperatures at regular intervals – this is not recorded, we advised that a record of this must be kept. Following the previous inspection when we found that there were comprehensive policies and procedures available but they had not been reviewed and contained out of date information we were provided with information and told by the Responsible Individual and staff that we spoke with that up to date policies and procedures have been obtained and are to be put into place. Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 29 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 3 25 X 26 X 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 X 34 3 35 2 36 2 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 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 2 X 3 X Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 30 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 YA20 Regulation 13(2) Requirement Arrangements must be made to provide safe storage for medicines that are looked after by people living in the home. Arrangements must be made to ensure that a record is made of all receipts and disposals of medicines. Timescale for action 25/04/08 2. YA20 13(20 25/04/08 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 YA1 YA7 Good Practice Recommendations The Statement of Purpose must include the Service Providers address. This is to ensure that all details of the business are accessible. The signature of the person using the service should be included in the spaces available in all care records. This will clearly show that all people are involved in their reviews, care planning and goal setting. All Risk assessments should be dated to show when they have been carried out. This is to make sure that information in all risk DS0000026736.V357449.R01.S.doc Version 5.2 Page 31 3. YA9 Lampton Court 4. YA35 5. YA36 6. 7. 8. YA39 YA40 YA42 assessments is up to date and can be used to identify when a risk assessment should be reviewed - especially if the needs of the person using the service have changed. People working in a service should receive suitable training and training plans must be in place to support this. This is to make sure that they are able to carry out their work effectively and can safely and confidently support people using the service. Staff should receive regular supervision and there should be a record of this. This is to make sure and show that staff have the protected time to receive the support they need to work effectively with people using the service. A report showing the outcome of quality assurance processes for the service should be produced and made available to people using the service and the Commission. The service must put its new policies and procedures in place and ensure that staff understand and follow these. Clear up to date records should be in place to show that essential health and safety checks such as testing the emergency lighting and the hot water temperatures do take place. This is to make sure that risks to people using the service are minimised. Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Lampton Court DS0000026736.V357449.R01.S.doc Version 5.2 Page 33 - 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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