Inspection on 27/01/09 for Lancaster Place

This inspection was carried out on 27th January 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lancaster Place 30/01/07

Lancaster Place 09/11/05

Lancaster Place 27/06/05

Lancaster Place 12/02/05

Lancaster Place 17/08/04

Extracts from inspection reports are licensed from CQC, this page was updated on 20/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Lancaster Place 5-11 Lancaster Place Leicester LE1 7HB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Fiona Stephenson     Date: 2 1 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Lancaster Place 5-11 Lancaster Place Leicester LE1 7HB 01162558649 01162558649 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Prime Life Ltd care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: No additional conditions of registration apply. Date of last inspection Brief description of the care home Lancaster Place is a residential home for up to 12 people with mental health needs. It is situated in a residential area near New Walk in the city of Leicester. The home consists of two adjoining buildings converted from four semi-detached houses. There are two kitchens, two lounge/dining rooms, and 12 single bedrooms. To the rear of the home are gardens with lawn areas and garden furniture. 12 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection included a visit to the service. We (the CSCI) visited Lancaster Place on Tuesday 27th January 2009. The registered manager, Mark Raynor, staff and people who live at Lancaster Place helped us during the visit. We arrived at 9.15am and finished at 4.30pm. The main method of inspection we used was case tracking. This means looking at the care given to people in different ways. We did this by, - talking to the people who live in Lancaster Place, - talking to staff and management, Care Homes for Adults (18-65 years) Page 5 of 28 - watching how people are being given support, looking at records. We looked at the Annual Quality Assurance Assessment (AQAA). This is a document the Provider (the person who owns the service) sends to us at the CSCI, and it tells us what the provider thinks about the service they deliver to people who live at Lancaster Place. We also looked at the surveys called Have your Say about.. which are sent out to people who live and work at Lancaster Place, and to health care professionals who support the health care of people who live in the home. (these comments will be filled in before the final report is published - they have not yet been received). We spoke with the other member of staff on duty at the time of the visit, and at length to three people who live at the home. We also spoke with a visiting health care professional. People living at Lancaster Place told us: Mark is a good manager - hes the best. He manages the place well, you can approach him and he listens to what you have to say My bedroom is the way I want it, and if I want it changed, staff will move things around for me Its fine here, I have my independence. The food is off and on - theres always enough. We checked all the standards that the CSCI has decided are key standards during this inspection. The information below is based only on what we checked in this inspection. We have kept details about individual people out of the report to respect their confidences. What the care home does well: What has improved since the last inspection? What they could do better: The contact telephone number and address of the CSCI should be changed on the Statement of Purpose to the one currently in use, so that people know where to contact if they wish to tell us about the service. The medication care plan should also include information about why the medication has been prescribed and the effects the medication may have on the person. The manager should ensure that people who have expressed a wish about what they want doing in the event of their death, have signed and dated the record. This record should also be reviewed and checked with the service user that their wishes remain the same. The manager should ensure the menus show all the food provided, and not just the main part of the meal. e.g.. if sausages are being given, the record should show what vegetables and other accompaniments are provided also. Medicines requiring refrigeration must not be kept in a fridge alongside food stuffs. The manager should ensure all staff have received training, or are scheduled to receive training on Safeguarding Adults. The provider should assess the shower and bathing facilities at Lancaster Place to determine whether they would benefit from upgrading. This would improve the quality of life for people living at Lancaster Place. The cleanliness of the bathrooms should also be improved. Care Homes for Adults (18-65 years) Page 7 of 28 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs of people who come to live at Lancaster Place are well considered prior to them moving in. Evidence: We looked at the information (Statement of Purpose) given to people who are considering moving into Lancaster Place and found that it accurately showed what service was being provided to people who live in the home. The Statement of Purpose had not been up dated to inform people living at Lancaster Place of the new address and telephone number of the CSCI. We looked at the records of a person who had been admitted to Lancaster Place in the last few months. We found these were detailed, and gave staff a good understanding of the needs of the person who had come to live in the home. Care Homes for Adults (18-65 years) Page 10 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The individual needs and choices of people living at the home are supported well. Evidence: People living at Lancaster Place told us they are involved in the care planning process, and are encouraged to make their own decisions and choices. Care plans have been revised to become more person centred. They provide a good level of information about what needs the person has, and how those needs can be supported. We were told by people living in the home that they are involved in the reviews of their care plan. The care plans inform of the medication people are taking, but not why they are taking it, and the effects it may have on them. We saw that each care record had risk assessments which showed that staff had looked at what risks there might be for each person, and how staff could support the person in reducing the chance of risk occurring. Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: The manager is open to suggestions from people living at Lancaster Place and consults with them on a formal and informal basis to improve their quality of life. Care Homes for Adults (18-65 years) Page 12 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Lancaster Place live the lifestyle they choose. Evidence: We were told that people have the opportunity to take part in activities, education and training, and some have taken up the opportunity to attend a day centre. We saw that management have encouraged people living in the home to use local community facilities. We saw that people who live at Lancaster Place have the opportunity of going on a day trip using the Prime Life transport once a month. We were told by people living in the home that they are in the main able to do what they want to do, and if there are restrictions they understand and agree to them. We were told by people who live at Lancaster Place that they are able to see visitors, and keep links with their family members. Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: We spoke to people living at Lancaster Place about meals and mealtimes. There were mixed opinions about the food on offer, and the availability of food. This was discussed with the manager, who showed that he was moving towards providing a more balanced and nutritious diet for people living at the home, not just with the main meal, but for snacks and tea times also. Care Homes for Adults (18-65 years) Page 14 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Lancaster Place are provided with with good health care and personal support. Evidence: We checked the records, spoke with staff and people who live at the home and saw that people living at Lancaster Place were receiving or given the opportunity to receive health care support, from a range of professionals, including GPs, CPNs, social workers, psychologists, psychiatrists, dentists and opticians. We observed that people living at Lancaster Place were able to determine their daily routines such as getting up, showering, and when to have their breakfast. We saw that the service has good records relating to the giving of medication to people who live at Lancaster Place. We saw that people who give people medication, have been trained to do so, and we observed staff giving medication to people safely. We saw that the service does not have a medication cabinet which complies to the new requirements relating to the safe custody of controlled drugs, but were told that one Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: was on order. We also saw medication that needed to be stored in a fridge, was being stored alongside food. We saw that one person had not signed or dated their wishes concerning what they would like to happen in the event of them dying. This record had been in the file for sometime and it had also not been checked to see if the person still had the same wishes. Care Homes for Adults (18-65 years) Page 16 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has good procedures in place for responding to concerns and complaints, and for ensuring people living at Lancaster Place are safe from abuse. Evidence: People living at Lancaster Place feel able to express their views and opinions to the manager and his staff. There is a complaints procedure, and we were told by one person living at the home that their complaint was dealt with quickly. We saw records to show action that had been taken as a result of a person complaining. There have been no complaints to the CSCI about the service provided at Lancaster Place. The manager has a good understanding of how to ensure people living at Lancaster Place are kept safe from abuse. The AQAA states that our staff are fully trained with regard to abuse, what may constitute abuse, how to observe and how to report. We spoke with one member of staff who knew to report an incident or allegation, but we did not see evidence of training in relation to Safeguarding Adults in two of the staff files we looked at. We at the CSCI have received information from the manager about two incidents in the home that needed to be reported to us. We were satisfied that the manager had taken the right action on both occasions. Care Homes for Adults (18-65 years) Page 17 of 28 Care Homes for Adults (18-65 years) Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home generally meets the needs of people who live there, but the bathrooms could benefit from upgrading and better hygiene control. Evidence: People who live at Lancaster Place have their own rooms which they personalise. We were given permission by one person living at Lancaster Place to look at their room and found that their room had been decorated to their taste, and had their personal possessions and ornaments in there. There are a number of smokers who live at Lancaster Place, and the service has a designated smokers lounge and a non smoking lounge. We saw people living at the home respect the designated areas. The communal sitting and dining areas are comfortable and clean, and meet the needs of people who live at Lancaster Place. We looked at the bathrooms and found that some were less clean, and in need of repair. The ground floor disabled toilet and shower room was also being used as a storage facility for the pool table and for shelving. Two of the baths seen looked poorly cleaned (one might require reenameling), these were not from someone just using the bath, but looked like they Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: required a more thorough cleaning. The shower in a ground floor bathroom is not used, and we were told this is because it is too high for people living at the home to step up and down from. Care Homes for Adults (18-65 years) Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is sufficient staffing to support the needs of people living at Lancaster Place. Evidence: Lancaster Place operates with two staff on duty during the day (including the manager), and one member of staff on duty at night and another on-call. The manager, staff member spoken with, and people living at Lancaster Place all thought there were enough staff on duty to support the needs of people who live in the home. We checked staff records, and saw that Prime Life have made the right checks on staff to make sure they are safe to working with people who live at Lancaster Place, before they start working in the home. We saw by looking at the records, and by talking to the manager and staff, that staff have had been provided with sufficient training to help them meet the needs of people living at Lancaster Place. We also saw that staff are receiving regular formal supervision from their manager, have the opportunity to attend staff meetings, and appraisal systems are in place. We were told by staff that the manager is approachable, and that staff can speak freely to him, and he will act upon what you say, if he can. Care Homes for Adults (18-65 years) Page 21 of 28 Care Homes for Adults (18-65 years) Page 22 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered manager is working well to support the needs of people living at Lancaster Place. Evidence: Mark Raynor is the registered manager at Lancaster Place. He has many years experience as a manager, and has managed different homes in the Prime Life company. Through the care planning process and through discussions with him about people who live at the home, Mark Raynor demonstrated a good understanding of the needs of the people who live at Lancaster Place. Both staff and people living at the home said he was approachable and listened to what they had to say. The manager holds residents meetings to listen to what people have to say, and was also observed to listen to peoples views during the inspection. The Prime Life company has a formal quality assurance process however a service user survey has not been completed at Lancaster Place for over a year. Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: Through looking at a selection of records, we saw that the registered manager takes good responsibility for safe working practices. We checked fire records, risk assessments, accident and incident records and Regulation 37 reporting and found records were being regularly checked and updated, and where appropriate the CSCI was being informed. Care Homes for Adults (18-65 years) Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 Medicines requiring refrigeration must not be kept in a fridge alongside food stuffs. To comply with the Royal Pharmaceutical guidance on the Handling of Medicines in Social Care. 11/02/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 1 6 The contact telephone number and address of the CSCI should be up dated on the Statement of Purpose. The care plans should include information about why the medication has been prescribed to each service user, and the effects the medication may have on the person. The manager should ensure the menus show all the food provided, and not just the main part of the meal. eg. if sausages are being given, the record should show what vegetables and other accompaniments are provided also. The manager should ensure all staff have recieved training, or are scheduled to recieve training on Safeguarding Adults. 3 17 4 23 Care Homes for Adults (18-65 years) Page 26 of 28 5 24 The provider should assess the shower and bathing facilities at Lancaster Place to determine whether they would benefit from upgrading, as indicated in the AQAA. This would improve the quality of life at Lancaster Place. The manager should ensure that bathrooms are cleaned to a higher standard. The provider could improve the managers access to information external to Prime Life Ltd, and related to Prime Life Ltd by providing the manager with access to the internet and e-mail. 6 7 30 37 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!