CARE HOME ADULTS 18-65
Larwood Fullbrook Lane South Ockendon Essex RM15 5JY Lead Inspector
Sarah Axam Unannounced Inspection 7th March 2006 07:30 Larwood DS0000018114.V264806.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 Larwood DS0000018114.V264806.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. Larwood DS0000018114.V264806.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Larwood Address Fullbrook Lane South Ockendon Essex RM15 5JY 01708 857354 01708 857354 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) Redbridge Community Housing Limited [RCHL] Mrs Freda Lee Care Home 8 Category(ies) of Learning disability (4), Physical disability (4) registration, with number of places Larwood DS0000018114.V264806.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. Care to be provided to four (4) adults with learning disabilitys Care to be provided to four (4) adults with a physical disability The Home to be used as a Care Home only. Date of last inspection 7th August 2005 Brief Description of the Service: Larwood is a two-storey purpose built care home in south ockendon. It has a large secluded garden and has off road parking. It provides accommodation for eight younger adults with severe or profound learning disabilities and also caters for those with additional mobility or physical differences. All residents’ rooms have washing facilities and are spacious enough to accommodate mobility equipment and personal items. Larwood DS0000018114.V264806.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and took 6 hours to complete. Through the inspection the manager and deputy manager were present. All requirements from the last inspection have been met. What the service does well: What has improved since the last inspection? 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. Larwood DS0000018114.V264806.R01.S.doc Version 5.0 Page 6 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 Larwood DS0000018114.V264806.R01.S.doc Version 5.0 Page 7 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): 1&2 New residents into Larwood have access to a service users guide. Larwood has thorough assessments in place. They are reviewed for all residents EVIDENCE: The service user guide sampled was not in a format in which all residents may be able to understand fully or updated, the home plans to develop this further and have consultation with residents over this. The assessments sampled in resident’s folders were to a high standard and covered all aspects of an individual’s life that you would expect to see. Professional as well as the ‘home’ assessments was in place. Assessments covered areas such as speech, communication, hearing, vision and language. Nutrition, religious requirements and weight gain or loss. Family and social contact, physical and mental health. Meaningful education or occupation and any ‘specific’ individual needs were all included. Family and service users views are evidenced and that consultation had been sort by being recorded within the assessment process. Each assessment had a box to tick to indicate if a specific support plan had been written from issues raised within this assessments process. All aspects of assessments are reviewed on a regular basis. Larwood DS0000018114.V264806.R01.S.doc Version 5.0 Page 8 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 Residents are to be consulted with when reviewing Care Plans. The residents are encouraged to participate in the running of the home. The residents have a choice of lifestyle they chose. EVIDENCE: Residents care plans sampled evidenced that individuals were actively encouraged to participate in the day-to-day running of the home. The plans recorded day-to-day activities individuals participated in and what their skill levels are. There is a social activities book which daily records activities undertaken and comments about this. However in some care plans resident’s views were not always recorded or signed for as evidence that consultation had gone ahead. The home has a good procedure on risk assessments and indicates where high risk is apparent and instructs the staff team in how to minimise these risks. Prior to residents moving into the home professional risk assessments are in place. Larwood DS0000018114.V264806.R01.S.doc Version 5.0 Page 9 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): 16 Residents are treated with respect and have opportunities to be as independent as possible within the home environment. EVIDENCE: During the inspection it was observed good interaction between staff and residents was in practice. Staff knocked on bedroom and bathroom doors and spoke appropriately to each resident. Picture cards and consultation with specialist services are sought if this is how an individual chooses to communicate. The home manager informed me that all residents have the right to hold their own door keys if appropriate, this is recorded within their individual files. Residents are actively encouraged to join in duties within the home and are evidenced through daily notes and care plans what they are involved in. A new gardening project has been set up to encourage residents to take an interest in their home environment. Larwood DS0000018114.V264806.R01.S.doc Version 5.0 Page 10 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): 19 Larwood has health care plans in place. They are reviewed for all residents EVIDENCE: Recorded clearly within resident’s files are any healthcare visits or specialist service involved within their care plans. Every 6 months each individual’s health care needs are reviewed. Each individual review is in place alongside an action plan of what is to be achieved. Resident’s health care needs are monitored on a daily basis and reviews take place sooner than the 6-month period if need be. All visits by health service within the home are held in private. Larwood DS0000018114.V264806.R01.S.doc Version 5.0 Page 11 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 The residents have regular opportunity to be consulted with regarding all aspects of their life and that these views are recorded. EVIDENCE: Within the service users guide and the statement of purpose is clear guidelines on how to complain. There have been no complaints recorded on this inspection. If a complaint is received then there is a process where as the complaint is responded to within the 28-day period. All complaints correspondence and responses and action plans are kept together. Outcomes are recorded and signed off by the manager or senior manager of the organisation. Alongside this procedure is a quality assurance monitoring system, which is given out to relatives, residents and other professionals. This system tracks what people who use and are in contact with the service think about the home and if they want to raise any issues they can do so through this process. When information is gathered an action plan is put together with the final outcomes recorded. Larwood DS0000018114.V264806.R01.S.doc Version 5.0 Page 12 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 environment is well maintained and generally odour free. EVIDENCE: The premise is clean, fresh and provides a homely environment. In the communal areas or individuals rooms there are no odours. There is a separate laundry room with appropriate facilities needed to control any spread of infection and to keep hygiene to the expected standard required. Larwood DS0000018114.V264806.R01.S.doc Version 5.0 Page 13 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): Not inspected on this occasion EVIDENCE: Larwood DS0000018114.V264806.R01.S.doc Version 5.0 Page 14 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): 42 Larwood has safe working practices in place. EVIDENCE: Larwood provides a good system of training of staff that includes all mandatory requirements and the specific needs of anyone resident. There is a good system in place for the recording of any incidents or accidents of both staff and residents and a system of reporting of them to the commission for social care inspection. Regular monthly visits by the registered provider are undertaken and the registered manager ensures that all relevant legislation is complied with. All certificates relating to legislation and the health and safety of residents and staff were inspected and found to be of a good standard. Larwood DS0000018114.V264806.R01.S.doc Version 5.0 Page 15 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 2 3 X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 3 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 X 16 3 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Larwood Score X 3 N/A X Standard No 37 38 39 40 41 42 43 Score X X X X X 3 X DS0000018114.V264806.R01.S.doc Version 5.0 Page 16 Are there any outstanding requirements from the last inspection? NO 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 YA6 2 Standard YA1 Regulation Reg 5(2) Reg 6(a) Reg 24 (2)(3) Requirement The registered person must ensure the service users guide is in a choice of formats suitable to the individual. The registered person must ensure Service users reviews include evidence of their consultation by means of including views and signatures by the service users themselves or representative when appropriate. Timescale for action 30/06/06 30/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 YA8 2 Refer to Standard YA7 Good Practice Recommendations The registered person must ensure staff record service users daily, weekly and monthly choices and how these have been met. The registered person must ensure that service users are offered consultation either on a 1-1 basis, advocacy or by means of residents meetings and issues raised by service users are actioned and feedback given on progress.
DS0000018114.V264806.R01.S.doc Version 5.0 Page 17 Larwood Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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