Inspection on 24/04/07 for Lanrick Cottage

This inspection was carried out on 24th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lanrick Cottage 31/07/06

Lanrick Cottage 01/01/06

Lanrick Cottage 25/07/05

Lanrick Cottage 05/01/05

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Lanrick Cottage 41 Wolseley Road Rugeley Staffordshire WS15 2QJ Lead Inspector Jane Capron Unannounced Inspection 24th April 2007 09:15 24/04/07 09 Lanrick Cottage DS0000062392.V336338.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 Lanrick Cottage DS0000062392.V336338.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. Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lanrick Cottage Address 41 Wolseley Road Rugeley Staffordshire WS15 2QJ 01889 585262 F/P lanrickcottage@aol.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) Care Services (UK) Ltd Mrs Maureen Holcombe Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31 July 2006 Brief Description of the Service: Lanrick Cottage is a three-bedded care home for residents with autism/severe learning disability who also have specialist communication needs. The home has applied to register a fourth resident having had an ensuite bedroom built on to the accommodation. The home is situated on a main road leading into Rugeley. The home is set back from the road with parking for a number of cars at the front. The home has an attractive garden at the front and a secure garden at the rear providing opportunities for service users to use the garden. The home is completely in keeping with the surrounding residential properties. It is well located to access the town centre resources and public transport. The home has its own transport. The accommodation is well maintained and attractively decorated. The home currently comprises of a lounge, dining room, conservatory, toilet and kitchen and one bedroom with ensuite downstairs and two bedrooms and bathroom upstairs. The home provides residents with the opportunity to undertake a range of independent living tasks such as helping in the house and undertaking shopping. The home has links with local colleges and also provides the residents with a range of leisure activities both in and out of the home. Residents go on holiday and out for day trips. The current fees are £1500 per week. This includes transport, some activities and a contribution towards a holiday. Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This fieldwork part of the inspection took five hours. The home did not know we were coming. Before we went to the home we send some surveys to relatives to get their views about the care provided. Information was also provided by the Speech and Language Therapist and a representative of the Commissioning Service of one of the local authorities funding one of the residents. We also had information from the service. The inspection included talking to the staff on duty and the Care Manager. We observed the people that use the service both alone and being supported by staff. We had lunch with the residents and staff. We looked at some of the papers about the service provided to the residents, at some of the health and safety records and at some staff records. We looked at looked at whether the service was meeting the health and personal care needs and medication needs of the people that used it. We also looked at how the home made sure the people that used the home were safe and how they looked after their money. We looked at the lifestyle that the residents experienced and whether this was based on their choices and supported them to be as independent as possible. We looked round all of the service and looked at all the rooms including the bedrooms. The home had not had any complaints since the last time we went to visit it. What the service does well: The service provided a good service to the residents and was well liked by relatives. Relatives told us: ‘I am very happy with the service provided. The staff compliment is stable and environment is pleasant’ ‘I don’t see any areas for improvement’. ‘I dare to hope that Lanrick Cottage will remain (residents) home for life’. The residents were supported by staff that were qualified, trained and were keen to do a good job. Staff were fully aware of each person’s individual needs and how to meet them. Staff got on well with the people that lived there and wanted to support the people to have a full and varied lifestyle. Relatives spoke highly of the staff. They told us: ‘The staff go the extra mile in catering for my relative’s needs’ Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 6 The home ‘always employed staff who have an understanding of the difficult and varied needs of autistic people’ and ‘The staff have the right skills and experience’. The staff helped people make choices and to independent. The people that used the service had specialist communication needs and staff were fully aware of each persons method of communicating. Staff supported people to make choices by using makaton and symbols and by knowing how each person made their likes and dislikes known. Residents were supported to take part in a range of life skills associated with running of a house including cooking, laying and clearing the table, shopping, doing their laundry and gardening. The service had a range of programmes and procedures in symbols to increase people’s understanding and to help them to take part. The service listened to residents and to relatives and had a complaints procedure in place. This was in symbols to make it easier to understand. Noone had made a complaint but relatives knew about the procedure. One relative said: ‘Have not had need to raise concerns – communication is excellent’ The service was meeting the health and personal care needs of the residents. They were supported to have their personal care needs met in a way that promoted privacy and showed respect and was based on how they liked things to be done. The staff undertook these tasks in a way that promoted the residents’ independence whilst making sure that they did not take too many risks. Staff supported residents to have their health looked after and took them to local and hospital appointments. Medical staff came to the home if residents were not able to go to see them. The service provided residents with a good place to live. It had suitable private and communal rooms. The service was well looked after and was furnished and decorated in a homely and domestic way. The service was well led. The manager has many years experience and has worked at the service since it opened. She has an open management style and staff were well supported. There were systems in place to look at what the service offered and to look at ways of improving it for the people that lived there. The service’s health and safety procedures were safeguarding the people that lived there. What has improved since the last inspection? Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 7 Since the last inspection the service has met the previous requirements we made. These were about the fire precautions and having a better system for checking the quality of the service. The service has been extended to take one more person having had a downstairs ensuite bedroom built. The home was being registered for another person to live there. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 8 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 Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 9 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): 1,2,3,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service provides prospective users of the service and others with the information to know what it offers and whether it can meet their needs. The service has a suitable Statement of Purpose and service user guide and provides a contract outlining the terms and conditions. Staff have the necessary knowledge and training and work effectively with other professionals to meet the needs of people that use the service. EVIDENCE: The home provided suitable information to relatives, professionals and residents to be aware of what services the home offered and whether it could meet prospective residents’ needs. The home had developed a Statement of Purpose and a service user guide, the latter being in a pictorial format. Relatives also felt that they had adequate information over the services the home offered. Although the home had no recent admissions the home had a suitable procedure in place that included visiting prospective residents and doing their own assessment. The assessment process covered education and occupation, health and personal care, communication and family contact. It also included Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 10 looking at a prospective residents’ compatibility with the current residents. All placements were made on a trial period. The home and the funding authorities provided residents and relatives with a contract that outlined the terms of residency and identified the items that were covered by the fees. The home was able to meet the needs of the residents. Information from relatives and health professionals confirmed that the home was meeting the residents’ needs. Comments included: ‘They treat my relative as an individual. They show empathy towards his very unique needs’ and ‘They always employ staff who have an understanding of the difficult and varied needs of autistic people.’ This view was supported by discussions with staff. They were aware of issues relating to autism and had received relevant training including challenging behaviour and communication methods. Staff were aware of residents’ individual needs including their likes and dislikes, their health needs and their preferred routines. The home was working in partnership with specialist health professionals to meet residents’ needs. Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 11 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): 6,7,8,9. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The people that use the service have support plans and risk assessments that outlined their individual needs and showed the support they needed to have their needs met whilst promoting their independence and choices. Support plans were written in a person centred format but these could be further developed to clearly identify people’s spiritual needs and to enable people that use the service to be more included in the process. EVIDENCE: Two residents were case tracked and this included looking at their support plans. Observation showed that satisfactory individual plans had been developed. These covered the areas of health, personal care, family contact, education and life skills. The home also identified and was aware of residents’ spiritual needs but these were not always clearly identified in the support plans. Plans were in place to support any challenging behaviour including any incidents of self-harm. All residents had specialist communication needs and Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 12 this was identified in the support plans. The plans also identified the residents’ individual likes and dislikes. Since the last inspection the home had developed plans that were written in a person centred way placing the resident at the centre of the plan. However the home could develop this further through the use of symbols and pictures. Files contained evidence of being internally reviewed every three months and a full review involving the residents, relatives and the placing authority took place on a yearly basis. A full internal reassessment was undertaken prior to these reviews. Relatives confirmed that they were involved in decisions about their relative’s care and were always informed of any significant changes. Plans showed that the home had developed a range of basic individual risk assessments covering such areas as going out into the community, personal care tasks, use of kitchen and household equipment. These were up to date and had been reviewed. Risk assessments showed that the home was striking a good balance between promoting choice and independence and not placing residents at unreasonable risk. Examination of the risk assessments showed that staff supervision was used as the main method of reducing risk rather than preventing residents undertaking activities. The home promoted residents’ choices, decision-making and participation. Although residents’ verbal communication was limited, the staff were aware of each resident’s method of communicating their preferences. Observation showed staff communicating through makaton signing and through the use of symbols as well as verbally. Discussions with staff confirmed how residents made choices over such areas as what to wear, what drink to have and what they wanted to do. On the day of the inspection staff were supporting one resident to go shopping to buy some new clothes. The home supported residents to choose food to put on the shopping list and to make choices about meals. Staff were also fully aware of each residents’ likes and dislikes. None of the residents were able to manage their own money and the home managed their personal allowance. This was documented in residents’ files. Evidence was seen that staff discussed the spending of large amounts of money with relatives. Recently one resident had bought a piece of furniture for their bedroom and this had been discussed with relatives first. The home had started the process of developing some procedures in pictorial format. These included the complaints process and the fire procedures. The home intends to develop this further. The home had developed programmes in symbol format including how to make a meal and how to make drinks. One resident’s schedule was in symbols to enable them to understand what activities he was undertaking during the day. Observation during the inspection showed that although not actively involved in staff recruitment all prospective staff members meet residents prior to being employed at the home. Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 13 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): 11,12,13,14,15,16,17, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home supports and encourages the residents to make choices about their lifestyle and to take part in activities and to develop their skills. The service provides people that use it with opportunities to take part in a range of activities both in and out of the service however it is recommended that the home look whether there are other activities that the resident who currently chooses not to take part can enjoy EVIDENCE: Observation of residents, talking to staff and the examination of records showed that residents were supported to take part in a range of activities and to develop their life skills. Residents were observed undertaking independent living activities including making breakfast, helping with laying and clearing Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 14 the table, filling the dishwasher, doing their laundry and cleaning and tidying the home. One resident helped to make meals and was able with support to make Spaghetti Bolognese. Residents were supported to maintain and develop their communication skills and the staff. Staff were observed communicating through makaton and through the use of symbols. The home has developed symbol cards to show residents how to do certain household tasks for example making a drink. Two of the residents were identified as having spiritual needs and relatives felt the home supported relatives to meet these. This was done by ensuring that Christian festivals were celebrated and one resident was encouraged to watch a church service on television. The home had links with colleges and one resident was attending college three days a week. He was working on the computer and doing a life skills course. Whilst the other residents were not involved in formal education the home tried to encourage them to take part in activities although residents did not always chose to take part. The staff supported residents to deliver newspapers and all the residents took part to some extent. Looking at records and discussions with staff confirmed that the home provided residents with opportunities to access the community. All the residents went out to a varying degree although one resident found leaving the house very difficult. The other residents went out regularly for walks, to the shops, to a pub, out for meals and out for trips in the car. Two residents went out weekly to a local club where they had a game of pool. One resident went horse riding every week and another went to a local gym twice a week and liked to ride their bike. One resident was working with a staff member to do some decorating. On the day of the inspection one resident was being supported to go clothes shopping. Activities in the home included using the computer, looking at magazines, watching TV and videos, a range of board games, craftwork and gardening. One resident enjoyed playing on their play station and playing draughts with staff and another enjoyed drawing and had made some place mats that were used at meal times. All the residents needed to support to engage in activities. One of the residents found taking part in activities both in and out of the home difficult and the home has found it difficult to find anything that she chooses to take part in. All the residents go on holiday at least once a year and this is paid for by the home and through the money raised from the paper round. The residents were due to go to Wales in the next few weeks. Photos of previous holidays showed that residents enjoyed the experience. Residents were supported to maintain contact with family members through telephone calls, visits and through sending birthday cards. Relatives reported that the home supported their relative to keep in touch and that they were able to visit when they wanted. Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 15 The home’s daily schedules were relaxed but took account of the residents’ need for consistency and choice. Residents got up when they wanted and breakfast was taken individually. One resident chose to eat their meals in the kitchen whilst the others ate in the dining room. All the residents had a weekly schedule based on each resident’s preferences. These were not rigidly kept and changed according to each resident’s choices. The menus were looked at. The residents were provided with a varied menu that was based on their preferences. Breakfast comprised of toast and range of cereals and was taken individually when residents got up. Lunch and the main meal were eaten in the dining room although one resident chose to eat at their own table in the kitchen although in sight of the others. Most residents were supported to make their own breakfast. Lunch was a light meal such as snacks on toast or an omelette. As part of inspection we had lunch with the residents and staff. Lunch was macaroni cheese and it as clear that the residents enjoyed it. The main meal was provided in the early evening. The home provided a supper and there were snacks between meals. Fruit was provided as a sweet and as a snack throughout the day. Residents were observed laying and clearing the table and filling the dishwasher. Residents had the opportunity to take part in deciding on the meals and to put together the shopping list. The latter was completed through using symbols. The home reported that it was to develop the menu in a pictorial format. The home was aware and responded to one resident’s special dietary needs. Records showed and discussions confirmed that resident’s weight was monitored and action taken if there were significant changes. Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 16 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): 18,19,20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The health and personal care needs of the people that use the service were being met and there was evidence of positive multi agency working taking place. Whilst the medication needs of the people that use the service were being met there were some areas of the procedures that needed to be addressed. EVIDENCE: The supports plans identified the health and personal care needs of the residents. Plans showed how residents liked personal care tasks to be undertaken and each resident had an individualised daily routine for personal care. Discussions with staff confirmed that there were aware of these and could fully explain what support each resident needed and how they wanted it to be undertaken. The support provided to residents enabled them to be as independent as possible. For example each resident required some support with bathing but this was kept to a minimum and residents were encouraged to undertake as much of the task themselves as possible whilst ensuring resident’s safety. Staff were promoting residents’ privacy and dignity and Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 17 were able to describe how they did this through for example allowing them privacy with bathing, dressing and always knocking on bedroom doors. Staff supported residents to have their own personality by treating them as individuals. Residents were supported to choose their own clothes and to go shopping for clothes and personal items and to go to the hairdressers where they were able. Residents were able to express preferences over such things as clothes and hairstyle and these were respected. Residents were supported to access health care services. Records confirmed that residents saw the GP, the dentist and the optician and where residents were unable to utilise these services it was recorded. Residents also saw specialist health care services including psychiatric and epilepsy services. Where a resident was unable to access the service the nurse or consultant came to see them. The home had a speech and language therapist that visited monthly to work with the residents and staff to develop communication skills. One resident may benefit from input from behavioural services to work to develop their skills. However although the home has been trying to access this for some time it has been unavailable to them. This issue has now been taken up by the funding authority. Records and discussions with staff confirmed that they were fully aware of residents’ conditions and that these were monitored and any problems addressed. The home’s arrangements for meeting the residents’ medication needs were looked at. The home had a medication procedure but there were areas including home leave arrangements that needed to be further developed. The home had a homely remedies policy that had been signed by the relevant doctors. Medication was stored appropriately in a locked cupboard in a locked room. Each resident’s medication was kept together. The home operated a bottle to person system. Records of each resident’s medication was being kept but this could be presented in a more comprehensive way. The home maintained records of the amount of medication received and running total of medication in the home. An examination of the medication administration records showed that medication was being administered as prescribed and there were no gaps in the records. There was also one handwritten addition to the records and this had not been signed. Discussions with staff confirmed that they were aware of each resident’s medication and the reasons for it. All staff had received training in the administration of medication. Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 18 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): 22,23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The service responds to the views of those that use the service and listens to relatives and has a suitable complaints procedure in place. The staff’s knowledge and the service’s procedures are protecting the people that use the service from abuse. EVIDENCE: The home had a complaints procedure and this was both in a written and pictorial format. No complaints had been received either by the home or by the Commission for Social Care inspection since the last inspection. All relatives reported that they were aware of the procedure but had not needed to make a complaint as the contact between themselves and the home was so good. Any issues or concerns were always discussed and resolved. One relative stated that:‘ any problems that have arisen are easily discussed with the manager and staff. We work together for our relative’s welfare and best interest.’ Residents were not able to verbally make a complaint but were able to express their likes and dislikes. Discussions with staff confirmed they were aware of how each resident showed dislike or unhappiness. The home had a whistleblowing and safeguarding policy and had a copy of the Staffordshire interagency procedures. All staff had received training, and discussions with staff showed them to be aware of signs and symptoms of potential abuse. They were also clear about what action they would take if they suspected abuse. The staff were aware of the challenging behaviour Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 19 including self-harm that residents could exhibit and were aware that it was a means of communicating their needs. Plans were in place to respond to any incidents and these were based on diversion and distraction techniques. Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 20 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): 24, 26,27,28,30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The people that use the service benefit from an environment that is homely and domestic in style and provides them with suitable private and communal accommodation. EVIDENCE: The home is located in a detached property on a main road into Rugeley. It is in keeping with the other residential properties in the area and is indistinguishable as a care home. All the accommodation was looked at during the inspection. The home has recently been extended to provide an additional ensuite bedroom and office on the ground floor. This had not affected the living area for the current residents. The home provided suitable accommodation for the residents. All bedrooms were single. The upstairs bedrooms did not have ensuite facilities. The home had suitable communal rooms – a lounge, dining room, conservatory and kitchen. There was a Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 21 separate toilet downstairs and a bath with shower over and toilet up stairs. This bathroom was quite small and dark and the home would benefit from a proper shower cubicle. Externally there was an enclosed rear garden with a lawn and bushes. There was a sitting area and a small pond in the rear garden. At the front there was a garden and parking area for four cars. The home had a large garage that accommodated the laundry. The home was well maintained. It is furnished and decorated in a homely domestic style. The bathroom was currently in the process of being decorated and the home was due to have new double glazed windows fitted. Bedrooms provided comfortable private accommodation. They were well personalised and reflected the interests and personality of the residents. Seating was provided in bedrooms and they had adequate storage facilities. The home was clean and tidy throughout. The home had cleaning programmes in place. Staff were aware of infection control procedures having recently received training. The home’s laundry was adequate to meet the laundry needs of the residents. Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 22 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): 31,32,32,34,35,36, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people that use the service are supported to have a varied lifestyle based on choice and independence by staff that are trained and supported and in sufficient numbers. The service’s recruitment procedures ensure that the people that use the service are supported by staff that have undergone checks to ensure their safety but the service does need to ensure that information that confirms staff’s identities is kept on file. EVIDENCE: The home provided adequate numbers of staff to meet the needs of the residents. The rosters showed that there was always a minimum of two staff on duty at any time and often there were three although that included the manager who also spent part of her time undertaking support tasks. On the day of the inspection there were two experienced support staff on duty and the manager. Relatives spoke highly of the staff and had good relationships with them. They felt that they understood the residents’ needs and had the necessary skills and experience. They felt that they were caring. Comments included: ‘The staff go the extra mile in catering for relative’s needs’, Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 23 The home ‘always employed staff who have an understanding of the difficult and varied needs of autistic people’ and ‘the staff have the right skills and experience’. This view was supported through discussions with the staff on duty. They were aware of issues relating to people with autism and believed in supporting residents to be as independent as possible and to have a varied lifestyle based on their choices. Residents were fully aware of each resident’s needs. Comments from staff included ‘working here is really rewarding’ and ‘we really know the residents’ ands I believe in giving residents choices’ and ‘we support residents to live a normal everyday life’ All staff had completed NVQ training to at least level 2. Training was also provided in safeguarding adults, medication, communication and challenging behaviour. All new staff undertook the Learning Disability Framework induction programme. Staff stated and records confirmed that they were well supported to undertake their role. They had individual supervision with the manager and team meetings took place where they were kept aware of developments and discussed residents’ progress. The home had a recruitment and selections procedure in place. Two staff files were looked at. This confirmed that all prospective staff completed an application form and had a formal interview. The files confirmed that before staff started work they had satisfactory police checks and two references. Staff completed a health form to confirm that they were fit to undertake the work. The files contained a photograph of staff but did not contain confirmation of identity. The manager reported that these had been seen but not maintained on file. Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 24 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): 37,38,39,42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The people that use the service benefit from a home that is well managed and has procedures in place to review and improve the service. The home’s health and safety procedures safeguard the people that use the service. EVIDENCE: The home is well managed. The manager had worked at the home since it opened and is fully aware of all the residents’ individual needs. She is qualified and has many years of experience of working with residents with a learning disability. She has undertaken recent training to ensure she keeps Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 25 up to date with current practices. She is well respected by the staff and is seen as supportive and as having an open style of management. Staff felt involved and that their views are sought. They felt that they are kept up to date with any developments. Relatives felt that the home is well led. One relative commented ‘I have total confidence in (Mrs Holcombe) to ensure my relative’s health and safety at all times’. The home has made progress in formalising its quality assurance system. The manager regularly undertook a range of audits including medication, health and safety, care plans and policies and procedures. Regular contact with relatives also informed the process. The outcomes of these had led to the development of a plan to improve the service. The home had health and safety procedures in place. Staff records and discussions confirmed that staff had completed the required health and Safety training including first aid, food hygiene and fire safety. The home had a procedure in place for the safe storage of hazardous substances and substances were kept locked away and any use of them by residents was under the close supervision of staff. The home reported that had completed all the necessary safety checks on for example the central heating, the electricity wiring, had a gas safety certificate and water temperature checks for compliance with legionella. The fire records were checked as part of the inspection. The home was undertaking these as required. The home has completed a fire risk assessment and had an evacuation plan in place. The home kept a record of accidents. Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 26 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 3 2 3 3 3 4 X 5 3 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 4 25 X 26 3 27 3 28 3 29 X 30 X STAFFING Standard No Score 31 3 32 4 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 X LIFESTYLES Standard No Score 11 4 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 2 X 4 4 3 X X 3 X Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 27 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 YA6 Regulation 15 Requirement All support plans must clearly identify residents’ spiritual needs to ensure that staff have the information to fully support the people that use the service. The home’s medication policy and procedures must be comprehensive to ensure that the people that use the service are fully protected. Timescale for action 24/05/07 2. YA20 13(20 24/05/07 3. YA20 13(2) 4. YA34 19 Schedule 2 All handwritten additions to MAR 01/05/07 sheets must be signed and doubly checked for accuracy by a second staff member to ensure to ensure that that there can be no errors in the medication provided to people that use the service. The identity of staff working at 08/05/07 the home must be confirmed to fully safeguard the people that use the service. Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 28 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 YA6 Good Practice Recommendations For support plans to be further developed using the principles of person-centred planning to make them more assessable to the people that use the service e.g. use of photos To further develop the systems to increase the involvement of the people that use the service e.g. pictorial menus To look at providing additional activities that may be of interest to the people that use the service To provide the staff with information about medication in a more easily useable format To provide a shower cubicle upstairs to provide a choice of method of washing for the people that use the service. To provide fire drills at varying times through the day to make sure that staff are able to support the people that use the service to exit the property 2. YA9 3. 4. 5. 6. YA14 YA20 YA27 YA42 Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Lanrick Cottage DS0000062392.V336338.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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