Inspection on 05/10/07 for Larchpine

This inspection was carried out on 5th October 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Larchpine 21/03/07

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Larchpine Kenley Road Headley Down Nr Liphook Hampshire GU35 8EJ Lead Inspector Nick Morrison Key Unannounced Inspection 5th October 2007 09:00 Larchpine DS0000068502.V347532.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 Larchpine DS0000068502.V347532.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. Larchpine DS0000068502.V347532.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Larchpine Address Kenley Road Headley Down Nr Liphook Hampshire GU35 8EJ 01428 713307 F/P 01428 713307 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) Omega Elifar Ltd Louisa Shiner Care Home 5 Category(ies) of Learning disability (0) registration, with number of places Larchpine DS0000068502.V347532.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to te home are within the following categories: Learning disabilities (LD) 2. The maximum number of service users to be accommodated is 5. 21st March 2007 Date of last inspection Brief Description of the Service: Larchpine is situated in a quiet residential area of Headley Down and the village post office and local shop is situated close by. The village of Greyshot is approximately 3 miles away and the towns of Haselemere and Petersfield are a 10 minute drive away. The home has a minibus that is equipped to provide transport for physically disabled service users. The home is a converted bungalow and all bedrooms and communal areas are fully wheelchair accessible. The home is operated by Omega Elifar Limited and provides support and accommodation for up to 5 service users who have a learning disability. Fees at the home are £1000 per week and service users are responsible for paying for their own toiletries and items of a personal or luxury nature. The home is registered to provide a service to five people, but at the time of inspection there were only three people living there. Larchpine DS0000068502.V347532.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report represents a review of all the evidence and information gathered about the service since the previous inspection. This included a site visit that occurred on 5th October 2007 and lasted four hours. During this time the Inspector looked in all the rooms in the house including the kitchen/dining room, lounge, all bedrooms and both bathrooms, looked at the files of all three service users and observed the service people were receiving. The Inspector also met with the Manager, spoke with two members of staff and observed interaction between staff and service users. All records and relevant documentation referred to in the report was seen on the day of the inspection visit. We also referred to service’s own self-assessment of the home and spoke with two relatives of service users. What the service does well: What has improved since the last inspection? What they could do better: There were no requirements or recommendations made as a result of this inspection. Larchpine DS0000068502.V347532.R01.S.doc Version 5.2 Page 6 The home has good processes in place for identifying necessary improvements to the service and implements plans accordingly. There are plans to purchase new equipment to improve the service. This includes a new vehicle and new furniture and beds specifically for the individual needs of people living in the home. 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. Larchpine DS0000068502.V347532.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Larchpine DS0000068502.V347532.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users benefit from having their needs and aspirations assessed prior to moving into the home. EVIDENCE: The home requires a full care management assessment for each person before they move into the home. In addition to this, the home does it’s own comprehensive assessment. Records showed that all assessments were in place prior to the person moving in and that the Manager of the home had met with people at their previous residence and involved their relatives to carry out the home’s assessment. Larchpine DS0000068502.V347532.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users benefit from having clear care plans and risk assessments in place and from being supported to make their own decisions. EVIDENCE: Individual care plans were in place for each person living in the home and were clearly related to the initial assessment and the ongoing information the home had gathered on each person over time. The plans were well written and explained not only what staff needed to do in order to support people well, but also the reasons why. Staff spoken with were clear about individual care plans and had all signed to say they had read and understood them. Relatives spoken with said they were involved in the care planning process and that the home kept them informed of changes to the plans as they occurred. Each person had a review once or twice a year and parents and Care Managers were involved in these and were able to contribute to the care planning process. Larchpine DS0000068502.V347532.R01.S.doc Version 5.2 Page 10 Each person living in the home had a ‘Getting To Know Me’ file that provided guidance for staff in how to support them and listed their individual preferences, how they liked to be supported and what things were important to them. The religious preferences of people were recorded on admission and people were supported with these as far as they wanted to be. Each person in the home had a review annually. These involved service users and their families and Care Managers where appropriate. The review documents were well-presented and made use of photographs in order to make them more interesting and accessible to service users. Most people living in the home have limited communication skills. This is recognised within care plans and there was information about the way each person communicated, what things were important to them and how they needed to be supported to make decisions for themselves. There had been input from speech and language therapists. Staff spoken with were clear about each person’s communication methods and the importance of enabling people to make decisions for themselves. Staff training supported this and emphasised the need for people to be in control of their own lives as far as possible. The service used pictures, symbols and photographs to support people to make decisions for themselves. Risk assessments were clearly written and reviewed on a regular basis. Staff spoken with were clear about risk assessments for each person and the importance of supporting people in line with the risk assessments. Risk assessments were used to promote independence and support people living in the home to be involved safely in the activities they wanted to do. Larchpine DS0000068502.V347532.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users benefit from having their rights respected and from balanced and nutritious meals. They also benefit from having the opportunity to engage in a wide range of activities both inside and outside of the home. EVIDENCE: People living in the home each have a timetable of activities which, from observation throughout the inspection visit, were followed. Staff support was managed so that each person had the necessary support to do the activities they wanted to do. From observation it was also clear that people were able to choose whether or not to take part in the activities offered to them. Activities available to people living in the home included hydrotherapy, use of a Multi Sensory Room, beauty therapy and use of day services. People also used local clubs and went to discos. There was also a weekly trip for people living in the home and they were involved in choosing where to go. Trips have included visits to farms, Larchpine DS0000068502.V347532.R01.S.doc Version 5.2 Page 12 cathedrals, pleasure parks, museums, garden centres, ice-skating, aquariums and shopping centres. There were risk assessments and behavioural guidelines so that staff knew how to support people effectively and safely in their activities. There was a lot of support for people living in the home to maintain contact with their families. The visiting policy promoted and encouraged visitors. People living in the home were supported to telephone their families whenever they wanted to and were able to do this private. Staff in the home did arrange transport for some people to be able to go and visit their families. Records showed that people had regular contact with their families and family members spoken with confirmed this. The home is working closely and sensitively with one service user in reestablishing contact with family members. Food in the home was of good quality and people spoken with during the inspection visit said they enjoyed their meals. The menu’s showed that the diet was varied and nutritious. People living in the home were able to choose alternatives to the set menu on a daily basis. Records were kept of individual food intake. Food was well stored and food stocks showed that fresh fruit and vegetables were well used in the home. Individual preferences were recorded so that people did not have food they didn’t like. The home has a dining area in the large kitchen. There was sufficient staff support at mealtimes and staff ensured that mealtimes were an enjoyable time for people living in the home. Larchpine DS0000068502.V347532.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users benefit from having their healthcare needs met and are protected by the home’s medication policies and practices. EVIDENCE: There had been a requirement from the previous inspection that the manager must ensure that clear records are kept of the amount of medication given on each occasion it is administered. This requirement had now been addressed. The system for administering medication in the home was clear and was stated in the home’s policies. Staff who were involved in administering medication had received good training and demonstrated that they had a good understanding of medication issues. Medication records were clear and up-todate and all medication was stored appropriately and safely. There were clear guidelines in place for medication that was prescribed on an ‘as required’ basis. Care plans contained information on how people preferred to be supported with their personal care. The files of people living in the home demonstrated Larchpine DS0000068502.V347532.R01.S.doc Version 5.2 Page 14 that healthcare needs were monitored and that people were supported to use healthcare services as necessary. There were comprehensive records relating to each person’s health. All identified areas of health needs were monitored and recorded on a regular basis. Where people had used healthcare services there were records detailing the time and date, the reason why they attended and any outcomes as a result of the consultation. Staff in the home liaised closely with healthcare professionals in the interests of people living in the home. The home had been very active in addressing healthcare needs and there was evidence that they had organised multi-disciplinary investigations into health issues for people and pursued these in the interest of service users. Larchpine DS0000068502.V347532.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The policies and practices of the home protect service users and promote their involvement in the running of the home. EVIDENCE: The home had relevant policies and procedures in place regarding the protection of vulnerable adults. Good procedures were in place to ensure that service users’ finances were dealt with appropriately and clear records were kept of all transactions where staff supported service users to manage their money, or managed it on their behalf. The home’s policy was clear that the starting point was that everyone had the right to manage their own money, subject to an assessment of the risk. The Manager was very clear that service users’ money was not used to subsidise staff who were supporting them with activities. There was a clear complaints procedure in place that was given to each service user prior to them using the service and was available throughout the home in an accessible format. There had been no complaints in the previous twelve months. The home had a non-aversive approach to any challenging behaviour displayed by people living in the home. Clear support plans were in place and, from observation, it was clear that staff followed them. People living in the home were supported to have their own advocates in addition to input from their families. Larchpine DS0000068502.V347532.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a clean, comfortable and safe environment. EVIDENCE: The home is a bungalow and provides a stimulating, safe and comfortable environment for people. The garden area is well designed and is safe and accessible. The service has a plan in place to deal with ongoing maintenance and the appearance of the building shows that this is effective. The company has a maintenance department that responds quickly to maintenance issues. There were two bathrooms in the home and one was used by the two women living there and the other was used by the man living there. Bathrooms were equipped for the needs of the people living in the home. The service aims to maintain a homely feeling in the house and the furniture and fittings are modern, domestic and comfortable. There had been a new plasma screen television put into the lounge and service users were very appreciative of this. Larchpine DS0000068502.V347532.R01.S.doc Version 5.2 Page 17 The home was kept clean throughout. Clear infection control policies were in place and staff spoken with were aware of these and of the need to maintain a comfortable and appealing environment for people living in the home. Liquid soap and paper towels were provided throughout the building and staff had access to adequate protective clothing. The laundry area was well managed and clean. Larchpine DS0000068502.V347532.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users benefit from being supported by adequate numbers of welltrained staff and are protected by the home’s recruitment policies and practices. EVIDENCE: Staff training records showed that people working in the home received a wide range of training opportunities relevant to their work. Sixty-seven per cent of the staff have an NVQ2 or equivalent. Training courses covered a range of areas such as risk assessment, abuse, equality and diversity, food hygiene, health and safety, and health and manual handling as well as specific training for the particular needs of people living in the home. The induction programme for new staff was very comprehensive. Staff spoken with were knowledgeable and demonstrated skills and understanding in working with people who have a learning disability. Training needs were formally identified with the line manager and staff were also supported to attend other courses that came up which they had a particular Larchpine DS0000068502.V347532.R01.S.doc Version 5.2 Page 19 interest in. The home has a training plan in place and all training is well monitored. Rota’s showed that there were sufficient staff on duty at all times. There were two members of staff on each shift and the Manager worked during the week and at weekends. At night there was one person sleeping-in and one person awake. There were also additional staff for people to receive one-to-one support at different points during the week. There was also clear evidence that staffing was arranged around the needs and the activities of people living in the home. Staff spoken with and observed during the inspection visit were conscientious, enthusiastic, skilled and focussed on the needs of people living in the home. Recruitment records demonstrated that staff are not employed in the home without all necessary checks being in place, including references, Criminal Records Bureau check and POVA First check. The staff files were well kept and included equal opportunities monitoring for all staff. Larchpine DS0000068502.V347532.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a well managed home that is safe and responsive to their needs. EVIDENCE: The Manager of the home is registered and has demonstrated that she has the skills, knowledge and training to manage the service. Service users and relatives spoken with during the inspection process spoke highly of the Manager saying that she was supportive and responded to issues well. In discussion the Manager was able to demonstrate that she has a clear understanding of the issues within the home and is able to manage them effectively. She also has developmental plans in place for the home. The home has effective quality assurance processes in place that are focussed on the needs and views of people living in the home. These include internal Larchpine DS0000068502.V347532.R01.S.doc Version 5.2 Page 21 audits, questionnaires for people who live in the home and their representatives, staff involvement and monthly Provider reports. The views of people living in the home were represented in local management meetings and staff meetings also focussed on the needs and views of people living in the home. Health and safety is well managed in the home. All equipment is serviced and checked regularly, maintenance issues are dealt with in a timely manner, incidents and accidents are recorded and regularly audited and good workplace risk assessments were in place. There were no outstanding health and safety issues in the home at the time of the inspection. Incident and accident records were kept and were regularly monitored and reviewed. All servicing records were up-to-date. Fire records were up-to-date and service users were involved in practice evacuations. The Manager had also produced guidance that was kept at the entrance to the home and detailed the individual support each person in the home might need from the Fire Brigade in the event of a fire. Larchpine DS0000068502.V347532.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Larchpine DS0000068502.V347532.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 Larchpine DS0000068502.V347532.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Larchpine DS0000068502.V347532.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!