Inspection on 19/09/06 for Lancastria

This inspection was carried out on 19th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Lancastria 03/10/05

Lancastria 20/05/05

Lancastria 26/01/05

Lancastria 20/07/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Lancastria 138 Elwick Road Hartlepool TS26 9PF Lead Inspector Stephen Willcock Unannounced Inspection 19th September 2006 10:30 Lancastria DS0000021751.V311000.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 Lancastria DS0000021751.V311000.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. Lancastria DS0000021751.V311000.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lancastria Address 138 Elwick Road Hartlepool TS26 9PF 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) 01429 235207 londonroad@tiscali.co.uk Milbury Care Services Limited Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Lancastria DS0000021751.V311000.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd October 2005 Brief Description of the Service: Lancastria is a detached house located in a residential area of Hartlepool within easy walking distance of a variety of community facilities. There is a large garden at the rear of the property providing a private recreational area for service users, and a car parking area to the front of the house. The home is registered to provide care and accommodation for up to six persons with a learning disability. The cost of living at the home is currently around £1100 per week and does not include the cost of chiropody, hairdressing and toiletries. Lancastria DS0000021751.V311000.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on 19th September 2006 over a period of 3 hours and time was spent with service users and talking to staff members. The manager was not present during the inspection. Due to the nature of the service users’ disabilities, communication between service users and the Inspector was not always possible. However one service user was keen to show me their bedroom and appeared happy and contented with life at Lancastria. It was seen that a good relationship had developed between service users and staff members and that social events played a large part of life at the home. There had been a lot of improvements to the home recently especially the fitting of double-glazing and a complete rewire of the electrical circuits. New bathing equipment had also been installed. The home was well decorated and pleasantly furnished. What the service does well: What has improved since the last inspection? What they could do better: Further improvements could be made at the home. The repair of a broken toilet and the renewal of the lounge sofa are needed. There has been a longstanding issue of space in the dining area, especially when all of the service users and staff members have their meals. Consideration should be given to increasing the space available in the dining area. Lancastria DS0000021751.V311000.R01.S.doc Version 5.2 Page 6 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. Lancastria DS0000021751.V311000.R01.S.doc Version 5.2 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 Lancastria DS0000021751.V311000.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Assessment of service user needs is carried out prior to admission to the home and regularly reviewed. EVIDENCE: A number of service users’ individual care plans and assessment records were looked at and seen to contain good detail. The records showed when the service user moved into the home and what their needs would be and how the home would be able to meet those needs. The home had recently introduced a new file format following the person centred approach and service user files were being rearranged. The files looked at contained assessments form social workers and psychiatry reports and had evidence that the files had been prepared with service users and their families’ agreement. It was also noted that a picture format was used to assist service users to understand the content of the files and regular review of the assessments took place. Lancastria DS0000021751.V311000.R01.S.doc Version 5.2 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): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users’ changing care needs and personal goals are reflected in their care plan. Staff members assist service users to make decisions about their lifestyles and provide support to carry out the choices they have made. Where risk has been identified in a service user’s chosen lifestyle or decision, an assessment is carried out and reviewed. EVIDENCE: Care planning is carried out on a regular basis with the service user and their representative if possible. Care plans are detailed and cover all aspects of personal and social support needed and were based upon original care plans provided by social workers and nursing staff. Where necessary, the plan includes details about how staff can communicate effectively with service users Lancastria DS0000021751.V311000.R01.S.doc Version 5.2 Page 10 who have limited verbal communication skills by using a set of communication descriptions. One relative commenting about the approach the home took towards the care of their relative, described it as “holistic” and “second to none”. It was seen that service users were supported to make decisions about their lifestyles, including planning for future events such as holidays and trips outside of the home. Service users’ likes and dislikes were recorded within the care plans and regularly reviewed. Risk assessments had been completed for each service user and cover many aspects of their daily lives. The assessments were regularly reviewed, updated and linked to the main care plan. New risk assessments were developed when any new activities were introduced or an element of risk was identified. Lancastria DS0000021751.V311000.R01.S.doc Version 5.2 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): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users have opportunities to take part in appropriate activities at the home, and within the local community. Links with family and friends are encouraged and service users’ rights are respected. Meals and mealtimes are arranged to meet service users’ preferences. EVIDENCE: Currently none of the service users were engaged in educational placements or employment but there was a high level of developing daily living skills within the home, dependent upon the ability of the individual service user. One service user had recently given up a work placement due to ill health and staff members were seeking a day centre placement for another service user. There were opportunities to take part in fulfilling activities within the home environment. Lancastria DS0000021751.V311000.R01.S.doc Version 5.2 Page 12 The home has developed good links with the local community. Service users often go to the town for shopping or use the local shops. Regular outings and meetings with other service users at various social events take place and service users are well supported by staff members. Family and friends of service users are welcomed to the home at any time. Service users take part in social activities, including events at local pubs, and trips to the cinema and the local disco. These provided good opportunities to meet friends and to develop social skills. On the day of the inspection, service users were keen to go out bowling for the day on a trip organised by staff to the local bowling centre. Service users take part in the daily routines of the home and are encouraged to be as independent as possible and to take care of their environment to their individual ability. Staff members were seen to engage service users in everyday domestic tasks and to give assistance when needed. Mealtimes at the home are flexible and menus dependent upon service users likes and dislikes. A structured menu has been prepared but service users often choose to eat something different or to go out for lunch. Lancastria DS0000021751.V311000.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Personal care is given to service users depending on their preference. Health and personal care is maintained. Medication is administered and recorded accurately. EVIDENCE: Staff at the home provide personal care and support to service users, respecting the way each service user wants to receive their care. In discussion, staff members demonstrated a good knowledge of each service user’s needs and referred to the individual care plans and made good use of the communication descriptions. There is regular contact with local doctors and other healthcare professionals either through a visit to the surgery or at the home. District nursing services and community psychiatric services are also involved in the service users care and maintain a regular link with the home. Special adaptations have been Lancastria DS0000021751.V311000.R01.S.doc Version 5.2 Page 14 made to home to meet service users’ assessed needs including the fitting of hoists and bathing aids. Currently no service user was controlling their own medication but a process and policy was available should the need arise. Medication records were accurately held and medication was administered according to the home’s policy and procedures. Lancastria DS0000021751.V311000.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home has an effective complaints procedure. Staff members are trained to respond appropriately to adult protection issues. EVIDENCE: The Milbury organisation’s corporate complaints procedure is available at the home and details how a complaint can be made and what response can be expected. During the last 12 months, there have been some concerns recorded that were raised by members of the local community but these were resolved immediately. It was noted that the complaints policy was available in a picture format. The home has a policy and procedure to follow in the event of an adult protection issue and there is an ongoing programme of training in the Protection of Vulnerable Adults and abuse awareness. Lancastria DS0000021751.V311000.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home has had major improvements carried out but requires some general maintenance. The home is clean and tidy. EVIDENCE: The home has recently been rewired and had double-glazing installed. The new windows have made a big improvement to the home and comfort of the service users. A shower room has been refurbished with a walk in shower and a new bath suite fitted. However, a toilet was out of order and needed repair and a staff member said the heating system had also been giving problems. The home was light and airy and comfortable although the sofa in the lounge was in need of repair or replacement. The dining area at the home continues to be rather cramped especially when all of the service users, with assistance from staff members, take their meals. Lancastria DS0000021751.V311000.R01.S.doc Version 5.2 Page 17 Staff and service users at the home ensure as far as possible, that the home is maintained in a clean and hygienic manner and it was noted that the home was clean, tidy and free from odour. Lancastria DS0000021751.V311000.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Qualified and competent staff members support service users. An appropriate recruitment procedure and training is in place to meet the needs of service users EVIDENCE: Staff members regularly take part in further training provided by Milbury, the home’s owners, to meet the needs of service users. Some of the staff members have been in their present post a number of years and have developed a good understanding of individual service users needs. In discussion, a staff member said training was readily available and a training plan had been developed. Most staff members had achieved the qualification of NVQ 2 and 3 in care and two staff members had nearly completed the course. The home’s recruitment policies followed the Milbury organisations procedures. All staff employed at the home has a Criminal Records Bureau check, provide references and take part in Induction and Foundation training. Service users had been invited to take part in the recruitment process and had gained good experience. Lancastria DS0000021751.V311000.R01.S.doc Version 5.2 Page 19 The home has a training plan in place and training is carried out using the organisations trainers or specialised trainers from a training agency. Mandatory courses including Fire Safety, Health and Safety and First Aid have been carried out and more specialised courses in Learning Disability, Autism and Challenging Behaviour are undertaken. Lancastria DS0000021751.V311000.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home is well managed by a capable manager. The home’s performance is regularly reviewed. The health and safety of service users are promoted and protected. EVIDENCE: The home has recently undergone a number of changes in management, some lasting only a few weeks. The present manager has recently undertaken the position and has experience with a similar client group to draw upon. The manager was not present on the day of the inspection but staff members said the home was running well and staff members had confidence in the new manager. The manager should ensure that she holds qualifications as stated in the National Minimum Standards. Lancastria DS0000021751.V311000.R01.S.doc Version 5.2 Page 21 Staff members said service users were enabled to express their views on how the service is run and how their needs were met but a number of service users had limited verbal communication skills. Knowledge of individual service users gestures and body language played a large part in understanding what opinion they held about the care they received. Relatives were often consulted about the way the home was performing and about the care their family member received. A senior manager from Milbury visited the home every month to conduct a review of the service and to carry out quality assurance checks. Regular checks were conducted at the home to ensure fire safety and general maintenance was carried out to remedy any defects, as they occurred to ensure the safety of service users, staff and visitors to the home. Lancastria DS0000021751.V311000.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X 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 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 X Lancastria DS0000021751.V311000.R01.S.doc Version 5.2 Page 23 No 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 YA24 Regulation 23 Requirement The registered person must ensure the broken toilet is repaired. Timescale for action 19/10/06 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 YA24 Good Practice Recommendations The manager should ensure the heating system is examined and the sofa in the lounge is repaired or renewed. The provider should consider ways to provide an enlarged dining area. The manager should achieve qualifications at NVQ4 in care and management. 2. 3. 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