Inspection on 22/01/09 for Lansdowne Road, 1

This inspection was carried out on 22nd 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

Lansdowne Road, 1 08/11/05

Lansdowne Road, 1 24/05/05

Lansdowne Road, 1 02/03/05

Lansdowne Road, 1 20/08/04

Lansdowne Road, 1 23/12/03

Lansdowne Road, 1 19/05/03

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Extracts from inspection reports are licensed from CQC, this page was updated on 07/08/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Haven Homes 48 Hill Rise Luton Beds LU3 3EE     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: Neil Fernando     Date: 0 6 0 2 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. that people have said are important to them: They reflect the things 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: Haven Homes 48 Hill Rise Luton Beds LU3 3EE 01582513899 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Haven Homes Supported Care Limited Name of registered manager (if applicable) Mr Marlon Bridgeman Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The registered person may provide the following categories of service: Care Home - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - code MD Date of last inspection Brief description of the care home Haven Homes was registered as a residential care home on 29 August 2007. It provides care and support for a maximum of two residents with mental health needs. The accomodation consists of two bedrooms, a good size lounge, dining room and a kitchen. Bathroom and toilet facilities are adequate. The staff office is located on the first floor. A good size garden is available to the rear of the property. The home is located in a residential part of Luton in Bedfordshire. It has easy access to local shops and facilities, with good local public transport links. A copy of the service users guide and the last inspection report is available at the Care Homes for Adults (18-65 years) Page 4 of 28 care home 2 Over 65 0 2 Brief description of the care home home for any residents and visitors to read. The fees for this home is 625 pounds per resident, per week.There are two bedrooms, office, lounge/dining area, kitchen, WC, bathroom and large garden to the rear of the property. Care Homes for Adults (18-65 years) Page 5 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: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. We, the Commission for Social Care Inspection, undertook this unannounced key inspection on 6 February 2009. We spoke with one resident, the manager and one staff. We had a look round the home and viewed a range of records the home must keep. At the time of the visit, there was one resident accommodated with one vacancy. We have received a completed AQAA (Annual Quality Assurance Assessment) a document, which gives the manager the opportunity to tell us how the home is meeting the standards and regulations. We have also received surveys from one Care Homes for Adults (18-65 years) Page 6 of 28 resident and one staff. The manager was present throughout the inspection. The last key inspection was undertaken on 10 January 2008 but there was no resident accommodated yet. What the care home does well: What has improved since the last inspection? What they could do better: 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 prospective resident has their needs assessed and they are able to visit the home, prior to moving in. This ensures that any identified needs could be fully met on admission. Evidence: The AQAA states Full assessments are undertaken by myself (manager) using evidence based tools. The referring agent and an independent advocate (if appropriate) will be present at assessments. The home has admitted its first resident in May 2008 since registration. A copy of the statement of purpose and service users guide has been offered to the resident. The case files for the resident was viewed and it contains a comprehensive pre-admission assessment completed by the manager, prior to an offer of a placement being made. The file provides a detailed profile of the residents identified requirements and the level of support needed. All assessment records were dated and appropriately signed by the manager. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: Information about the prospective resident is also sought from their representative, previous placement and health care coordinator. Evidence shows that the resident and their family had visited the home and met with staff, prior to moving in. I visited the home with my dad to check if I liked this place, said a resident. The manager said that overnight stays could be arranged, if this is required. Care Homes for Adults (18-65 years) Page 11 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 resident is appropriately supported to lead their life in the way they choose, with opportunities to take calculated risks. Evidence: The AQAA indicates Our care plans are formulated with our resident and he signed to show that they reflected what he believes his needs are. The care plan for the resident was examined. It provides a good level of details and clearly identifies how they would like their needs to be met. The care plan is developed with contribution from the resident, their representative, home staff and care coordinator. Issues covered include physical, health, social and recreation, finance, training and employment and culture; these areas are well documented. However, staff should obtain the name and signature of the resident and their representative in the care plan. This would demonstrate their participation and agreement with its content. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: Care plans are being internally reviewed every three months with good contribution from the resident and their representative. The resident also receives a six monthly review undertaken by the the placing authority (Health Authority), involving the resident and their representative and home staff. The staff member interviewed was fully aware of the identified needs of the resident and goals and target. Staff also take time to explain outcomes of reviews, thus ensuring the resident is aware of changes and how they would be met. Regular meetings between staff and the resident to discuss what is happening in the home are held; they are able to raise any issues that matter to them as the manager makes sure things are done. Minutes of these meetings are maintained. The resident was enthusiastic about the support they receive to make decisions and take risks. A comprehensive risk assessment is available and this is being reviewed and updated every three months. Care Homes for Adults (18-65 years) Page 13 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. A good variety of activities are available, both leisure and educational, giving the person living in the home the opportunity to lead a fulfilling life. Evidence: The AQAA indicates We ensure our resident has opportunities to engage in leisure activities and educational pursuits or even employment opportunities that he may be interested in pursuing. The care plan viewed reflects the residents needs, including race, gender identity, age, religion and belief. The staff member spoken with said that residents will be treated equally, whilst recognising the diversity and difference of individual residents. Equally, the recruitment practice and staff induction places serious emphasis on equality and diversity issues. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: The care plan reflects various activities the resident has been involved in. Activities which have occurred regularly include trips to the local library and pubs, eating out, shopping, badminton, cinema, coffee mornings and visiting places of interest. Weekly meetings with the social worker and overnight stays with the family are also taking place, as indicated in the care plan. The resident confirmed their interests and activities are taken seriously, and they could do most things they want to. I can come and go as I please,said the resident. The manager and staff spoken with said that the resident is encouraged to take a full part in the running of the home including cleaning and shopping with staff assistance, where appropriate. The resident said that they take part in the domestic routines of the home and have responsibility for their own room, take part in menu planning, cooking and shopping, with some supervision. A varied and nutritious menu is planned; the resident confirmed how much they enjoy the food and that they had choices of what to eat and drink. The service is proactive in encouraging the involvement of families; documentary evidence is available of regular contact, both with the family visiting the home and people using the service supported to visit their parent. Care Homes for Adults (18-65 years) Page 15 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. Procedures followed by staff ensure that the resident receives good quality personal and health care support; the resident is treated with respect at all times. Evidence: The AQAA states We provide personal and healthcare support in a sensitive and flexible manner, while promoting independence and quality living. The care plan for the resident clearly identifies a range of health issues including mental health and how these are being addressed. Evidence shows that the resident is registered with a general practitioner; they also have access to a range of health professionals including psychiatrist, dentist, optician and community psychiatrist nurse. The resident said that their physical and emotional needs are being well met; they felt in good health and their mental health has improved since moving to Haven Homes. They decide what they do and the daily routines are pretty flexible. Staff help me in a manner that I prefer and they respect me always said the resident. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: The policy and procedure on medication was updated in November 2008 and remains satisfactory. The manager said that all staff receive training on medication before they are allowed to administer medication to any residents. We checked the medication storage and the medication administration records. Staff clearly sign to indicate when they have given medication to the resident. Medication is stored in a metal cabinet, which is kept locked under key. The resident told us that he receives his medicines regularly. A risk assessment is in place and records indicate that it is reviewed as and when required. Care Homes for Adults (18-65 years) Page 17 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 complaints and safeguarding procedures are available; thus ensuring that residents are listened to if dissatisfied with any aspects of the service and they are protected from harm. Evidence: The home has a clear complaints procedure to ensure that any concerns are dealt with and actioned appropriately. The home has not received any complaints since the admission of the first resident in May 2008. The Commission has also not received any complaints regarding this service. The resident told us that they have been given information on how to make a complaint. They echoed confidence in that they would not hesitate in contacting the manager or a staff member, if they had any concerns. I am happy here, reflected the resident in his survey. The home has a policy statement regarding safeguarding adults. Discussion with the manager and a member of staff clearly evidence that they would have no hesitation in reporting any incidents of abuse or neglect to the local safeguarding team. The manager and staff have received training on safeguarding vulnerable adults. There were no safeguarding matters pending at the time of the inspection. During the inspection the manager and a care staff spoke to the resident in a friendly, Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: social and respectful manner. Information gained shows that staff would take swift and appropriate action to protect and promote the welfare of residents. Care Homes for Adults (18-65 years) Page 19 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The accommodation offers a homely and pleasant environment, and is suitable for the needs of the resident accommodated. Evidence: The home is situated in a residential area of Luton and blends well with the properties around it. It is well presented and decorated and furnished to a good standard. There is a good size lounge and a dining room adjacent to it. There are two well decorated and furnished bedrooms. There is shared kitchen, bathroom and a separate toilet facility. The staff spoken with told us that residents would be encouraged to personalise their bedrooms and redecorate them, as they wish. The resident accommodated confirmed that they are able to personalise their bedroom with additional furniture, photographs and other personal effects. Evidence of this was seen in the bedroom occupied by the resident. The resident is able to lock their own bedroom door, which upholds their privacy and security. There is good size garden to the rear of the property which is maintained by the owner/manager. A high standard of cleanliness was evident throughout. There were no Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: health hazards noted. Care Homes for Adults (18-65 years) Page 21 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. Training ensures that staff are competent to deliver good quality care; however, appropriate documentations must be maintained, in order to protect residents from harm. Evidence: The AQAA states We ensure that staff have the necessary skills to meet the needs of residents. We ensure that there is always sufficient staffing numbers to meet the changing needs of residents. This service is registered to accommodate up to two residents. There is currently one person in residence. The home has a small staff team that includes the manager and two of his relatives, all of whom have considerable professional experience in the mental health field. This means the staff have the skills to deliver good quality service for residents. The manager and his wife live next door to the home and they provide on call arrangements between them. There is one staff available during normal office hours and there is no staff in the premises overnight. However, there is an intercom system so that the resident is able to seek assistance, if this is required. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: All staff have completed their mandatory training. They have also received training on a range of subjects including mental capacity act, equality and diversity medication and safeguarding vulnerable adults. Both the manager and his wife hold a registered qualification in mental health nursing and one care staff is currently undertaking an NVQ (National Vocational Qualification) level 2 training. Recruitment files for two staff members show that the required documents including Criminal Records Bureau clearance had been obtained. However, references for one member were not available. Once this shortfall is addressed, this standard would be fully met. The manager has introduced a system of formal supervision for staff. One staff member confirmed that she receives regular recorded supervision once every month. She also said that good management support is available. Care Homes for Adults (18-65 years) Page 23 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. This is a small staff team that is well supported by the manager; this ensures that the resident receives good quality care. Evidence: The AQAA tells us We ensure that the home is well run and that the manager is qualified, competent and experienced to run the home. The owner/manager was registered with the Commission on 29 August 2007. He holds a registered mental nurse qualification and has several years experience working in the mental health field. He is starting his training in Leadership and Management for Care Services in February 2009. The manager is capable of managing the home well. Staff were complimentary regarding the support they received from him. there are effective open lines of communications within Haven Homes Supported Care Ltd, reflected a staff in their survey. The manager has recently undertaken a survey to seek the views and experience of Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: the resident, their representative and visiting professionals regarding the quality of service offered at this home. The manager said that the outcomes together with remedial actions, if any, would be shared with the resident and other people participating in the survey. The manager is aware that a copy of the survey report must be sent to the Commission. A daily record of relevant occurrences is maintained as part of the care plan; this was noted to be in good detail. Other records viewed were in good order. Regular meetings between the resident and staff ensure that views are shared and fire and accident procedures discussed. Health and safety matters are being attended to. Care Homes for Adults (18-65 years) Page 25 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 26 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 34 19 Staff recruitment files must include two references in all cases. This would ensure the protection of residents and staff. 20/03/2009 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 6 Staff should, where appropriate, obtain the name and signature of the resident and their representative in the care plan. This would demonstrate their participation and agreement with its content. 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. 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