CARE HOME ADULTS 18-65
Lansdowne Road, 1 Bedford Bedfordshire MK40 2BY Lead Inspector
Katrina Derbyshire Unannounced Inspection 8th November 2005 13:50 Lansdowne Road, 1 DS0000014924.V265285.R01.S.doc Version 5.0 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 Lansdowne Road, 1 DS0000014924.V265285.R01.S.doc Version 5.0 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. Lansdowne Road, 1 DS0000014924.V265285.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Lansdowne Road, 1 Address Bedford Bedfordshire MK40 2BY 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) 01234 357339 01234 350606 info@lansdowncare.com Lansdowne Care Services Miss Elizabeth Lynes Care Home 14 Category(ies) of Learning disability (14), Physical disability (14) registration, with number of places Lansdowne Road, 1 DS0000014924.V265285.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The manager must complete an NVQ 4 in care by 31st December 2005. Date of last inspection Brief Description of the Service: 1 Lansdowne Road is a large three-storey house in a residential area of Bedford. The registered provider is Lansdowne Care Services. The home is within walking distance of the town centre and all the amenities on offer, these include shops, pubs, and places of worship, parks and clubs. Access to bus and rail services is also within walking distance of the home. Care and support can be offered to fourteen young adults with a learning disability. The aim is to provide service users with the support and environment to promote their independence. Accommodation is provided across three floors. Thirteen rooms offering individual accommodation is available within the main building, alongside a self contained one bedroom flat at the rear of the home. In addition the home provides a lounge, dining room, quiet room and games room. Lansdowne Road, 1 DS0000014924.V265285.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 8th November 2005. The Acting Manager, Ms Liz Lynes was present throughout. During the inspection several areas of the home were visited and the inspector spent time with many of the residents in the lounge and other communal areas in the home. The care of one resident was examined in depth by looking at their records and interviewing the residents and staff who look after them. What the service does well: What has improved since the last inspection? What they could do better:
The areas examined at this inspection did not identify any areas of required improvement on this occasion. Lansdowne Road, 1 DS0000014924.V265285.R01.S.doc Version 5.0 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. Lansdowne Road, 1 DS0000014924.V265285.R01.S.doc Version 5.0 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 Lansdowne Road, 1 DS0000014924.V265285.R01.S.doc Version 5.0 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): EVIDENCE: These standards were not assessed at this inspection. Lansdowne Road, 1 DS0000014924.V265285.R01.S.doc Version 5.0 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): 9 Systems in place for the management of risk are good and protect the residents whilst maintaining their independence. EVIDENCE: Written records were seen within resident files that evidenced that the home had approached the management of risk in a systematic way. Areas of the residents’ life had been reviewed and any risk identified with that activity had been explored with the resident and safety measures put in place to protect the resident. Those safety measures put in place were noted not to restrict the residents rights so ensuring the resident could remain as independent as possible. One example explained by a resident was that they enjoyed going into Town or the pub, the home never prevented them from doing so however the safety measure in place was an agreement between the resident and the home that the resident would always advise them of where they were going. Lansdowne Road, 1 DS0000014924.V265285.R01.S.doc Version 5.0 Page 10 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): 15 & 16 Support offered to the residents in maintaining important relationships in their lives are good so resident’s benefit from the emotional and psychological gain associated with close relationships. EVIDENCE: Records examined showed the home had a system in place to ensure the birthdays of those close to residents were kept within their individual care notes. In addition records showed that the home had on an ongoing basis supported residents in maintaining relationships with their friends and family, through supported visits, telephone calls and social activities. Residents confirmed that their friends and families often visited them in the home and they too spent time away visiting them. Several residents described their personal rights and all were very clear in their knowledge of how staff should treat them and if unhappy what they could do about it. Residents also described their own individual responsibilities as they lived together in the home and how their behaviour can affect other residents and they all knew the expectations of the homes staff in this area.
Lansdowne Road, 1 DS0000014924.V265285.R01.S.doc Version 5.0 Page 11 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): 20 The medication in the home is well managed promoting good health. EVIDENCE: Medication taken by residents were detailed within the individual care records, these gave guidance to staff on all prescription medication that should be given. In addition individual medication administration sheets were maintained and these were noted to match all other records. Medication was kept in a locked storage area and was seen to be secure. Staff training records showed that all staff had received appropriate and up to date training in the administration of medication and this included the administration of rectal diazepam. Lansdowne Road, 1 DS0000014924.V265285.R01.S.doc Version 5.0 Page 12 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): 23 Systems in place regarding adult protection are sufficient to protect the residents from harm. EVIDENCE: The home was seen to have the local policy on the protection of vulnerable adults in place and this alongside their own guidance, gave clear instructions to staff on all the required areas in this subject. Types of abuse were explained and included examples of physical, sexual and financial abuse in addition the protocol to be followed in the reporting of any alleged abuse was correct. Staff records also showed that training had taken place in this subject and staff were able to accurately describe how they should act in this area. Lansdowne Road, 1 DS0000014924.V265285.R01.S.doc Version 5.0 Page 13 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): 30 The home is well maintained and very clean this provides a pleasant environment for the residents to live in. EVIDENCE: Several areas of the home were visited during this inspection and all were noted to be very clean and tidy. Staff were also noted to undertake the necessary hygienic practices in the kitchen area when carrying out food preparation. Disposal of waste products were under contract for their removal and facilities for hand washing were in place throughout the home. Staff commented and this was supported by staff training records that they had undertaken a variety of training and this had included, infection control and food hygiene. Lansdowne Road, 1 DS0000014924.V265285.R01.S.doc Version 5.0 Page 14 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): 35 The approach and organisation of staff training in the home is good so residents are cared for by competent and knowledgeable staff. EVIDENCE: Training of staff is organised through the head office of the home in consultation with the manager. All statutory training and additional training is detailed on individual records and then entries are made to show if the staff member has undertaken this, and the date that they did so. Staff spoke of the training available to them and reported that they viewed this as a benefit of working at the home as the home “seem to be so organised with their training, it’s always been good”. Training undertaken by staff included fire safety training, epilepsy, and assessment of need and adult abuse. Lansdowne Road, 1 DS0000014924.V265285.R01.S.doc Version 5.0 Page 15 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): EVIDENCE: These standards were not assessed at this inspection. Lansdowne Road, 1 DS0000014924.V265285.R01.S.doc Version 5.0 Page 16 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X 4 X Standard No 24 25 26 27 28 29 30
STAFFING Score X X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 4 17 Standard No 31 32 33 34 35 36 Score X X X X 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Lansdowne Road, 1 Score X X 3 X Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000014924.V265285.R01.S.doc Version 5.0 Page 17 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Lansdowne Road, 1 DS0000014924.V265285.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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