Inspection on 13/01/09 for Laura House

This inspection was carried out on 13th January 2009.

CSCI found this care home to be providing an Good service.

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

Laura House 03/10/06

Laura House 16/02/06

Laura House 06/10/05

Laura House 02/02/05

Laura House 23/09/04

Laura House 18/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Laura House Belmont Terrace Totnes Devon TQ9 5QB two star good service The quality rating for this care home is: 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: Judy Hill Date: 1 3 0 1 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. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Audience Further copies from Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright 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 Information about the care home Name of care home: Address: Laura House Belmont Terrace Totnes Devon TQ9 5QB 01803866541 01803866679 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Robert Owen Communities Name of registered manager (if applicable) Mrs Therese Annette Timberlake Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 16 16 0 0 care home 16 learning disability physical disability Additional conditions: Date of last inspection A bit about Laura House Up to 16 people can live at Laura House but as the home is divided into three houses people only have to share their home with three to five other people. All of the people who live at Laura House need help because they have a learning disability. Some people use wheelchairs and the home is well equipped to help them get around. Laura House is in Totnes. There are a lot of interesting shops, cafes and pubs in the town. There is also a train station and bus service. The people who live at Laura House each have their own bedroom. And their own toilet and bathroom or shower room. Lots of staff are around to help people. And everyone has their own special member of staff, who is called a key worker. The manager is called Terese Timberlake and she makes sure things run smoothly. 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 How we did our inspection: This is what the inspector did when they were at the care home This key inspection was completed with an unannounced site visit that was carried out on Tuesday 13th January 2009 by one inspector. During the site visit we carried out a physical inspection of the premises, spoke to residents and staff and looked at some of the homes records, including residents care needs assessments and care plans and staff recruitment and training records. Additional information about the service was gained from the homes Guide to Service Provision and an Annual Quality Assurance Assessment that had been completed by the registered manager and surveys completed and returned to the Commission by some of the people who live Laura House and by some of the staff. Information from the last inspection report, notifications of events and complaints, concerns or allegations may also be referred to in this report. What the care home does well The quality of the individual needs assessment, reviews of the residents needs and the care planning practices are excellent and this has enabled the delivery of the service provided to be tailored to each of the residents personal and individual needs. The residents are actively encouraged to lead active lives and a lot of effort is put into finding activities and pastimes that they will enjoy. Continued family contact is actively encouraged and the residents and their relatives are involved in the individual care planning process. The staff have a good understanding of the dietary needs of the residents and the residents are actively involved in menu planning. The residents are given the support they need to maintain their personal hygiene and their mental and physical health is monitored. The registered manager lets the Commission know about incidents that occur that could have a negative impact on the people who live at the home and has demonstrated that she will deal appropriately with any concerns, complaints and allegations. The premises have been designed to accommodate people with physical disabilities and the house is well equipped with aids to mobility so that the staff can assist the residents safely. The separation of the home into three separate houses enables the people who use the service to live in an environment that is domestic and homely in scale. The home is well decorated, suitably furnished and well maintained. Safe practices are used to recruit staff and the staffing levels are maintained at a level that meets the needs of the people who use the service. What has got better from the last inspection What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Judy Hill 33 Greycoat Street London SW1P 2QF 02079792000 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 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 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The people who use the service and their representatives have the information they need to choose a home that will meet their needs. Evidence: During the site visit we obtained a copy of A Guide to Service Provision at Laura House, looked at initial assessment records and spoke to a senior member of staff about the process used for admitting new residents. We were told that an following the receipt of an initial needs assessment from Social Services or a Care Trust the prospective residents and his or her family would be contacted and arrangements would be made to meet them to discuss what Laura House could offer and to begin the process of building upon an initial needs assessment. Records showed us that the homes assessment procedures and practices are very thorough and well documented and that the prospective residents and their families are fully involved. As part of the period of assessment and consultation the prospective resident will be invited to visit the home for short visits, which may include overnight stays. 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 . Individuals are involved in making decisions about their lives and play an active role in planning the care and support they receive. Evidence: During the site visit we looked at a sample of care planning records. The care plans were seen to be comprehensive and well documented. Care had been taken to ensure that the residents individual needs are central throughout the care planning and review practices by making good use of a key worker system, daily records, consultation with the residents and consultation with the residents families and professional representatives. Most of the people who use the service find it difficult to communicate verbally and the Annual Quality Assurance Assessment tells us that the service providers are seeking to build upon and improve the staffs ability to communicate with the residents by making better use of information technology and digital photography. We were also told that some of the staff had attended courses on Total Communications and that further courses were planned. Although the service providers acknowledge that improvements could be made to help the staff and residents to communicate with each other, there was plenty of evidence to show that the residents are able to express their likes and dislikes and that they are encouraged to make decisions for themselves. This was evident in the presentation of their bedrooms and in their daily activities. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who use the service are able to make choices about their lifestyles and are supported to develop their social skills and to participate in social and recreational activities both in their own home and in the community. Evidence: During the site visit we looked at activity boards that were displayed in the lounges to remind the residents about the activities that they had planned for the coming week. A lot of the pre-planned activities take place outside the home and these include swimming, hydrotherapy and horse riding, as well as computer, music, drama and arts and craft classes. The staff told us that they try to ensure that each of the residents spends part of each day out of their home. Residents meetings are held once a week to decide what activities will be arranged for weekends and to plan meals. The planned lunch and evening meal is displayed in the dining areas in written and picture form. Each of the residents has a choice of meals at breakfast time. This choice is either communicated on the day or determined by understanding the individual likes and dislikes of the residents, which we were told could sometimes vary from day to day. Some of the residents need their food to be liquidised or pureed and the staff spoken with had a clear understanding about what individual residents could and could not eat. Evidence: Relaxation therapists visit the residents in their own home and provide massages and reflexology sessions and several of the bedrooms had been fitted with sensory lights to help people to relax. One of the residents showed us the certificate she had received from South Devon College and told us that she was still attending college to gain further qualifications and skills, which she could use in her part-time work at the companies head office. We were told that all of the residents have maintained contact with their families and the records of care planning identified that the home is proactive in encouraging the residents and their families to remain in close contact with each other. 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 . The personal and health care needs of residents are well met with evidence of good multi-disciplinary working taking place on a regular basis. Evidence: We looked at Care Plans and these told us that the personal and healthcare needs of the residents had been assessed and that arrangements had been made through the care planning process to identify and meet the personal care needs of the residents and to monitor their health. Very positive feedback was received from relatives and residents about the quality of the care provided. The home has established good working relationships with the National Health Service and Social Service specialist support teams. The residents are all registered with local doctors and timely referrals are being made to the primary health care services as and when necessary. The contracting authorities have reviewed all of the people they are funding within the last year. The Annual Quality Assurance Assessment told us that fourteen of the fifteen people who are currently living at Laura House have physical disabilities as well as learning disabilities. During the site visit we saw that the design of the home and the mobility equipment provided should ensure that the staff are able to assist the residents safely. The residents medication is administered by the support staff and an inspection of the Evidence: medication administration records showed that the staff administering the medication are not always signing the record or using a coding system to indicate why an item of medication has not been administered. Information is kept with the medication administration records to identify each item of medication that is administered, what it is used for and to enable the support staff to identify possible side effects. New cabinets had recently been purchased to store medicines in, these have a built in facility to store controlled medication. 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 . Help is given to enable the residents make their concerns and complaints known. Policies and procedures are in place to safeguard the residents from the threat of abuse. Evidence: The home has a complaints procedure and one of the residents told us that she has a copy of this in her room. As many of the residents may have difficulties in presenting a formal complaint, their relatives are also told how to make a complaint and regular key worker meetings are held to ensure that concerns can be raised. The registered manager has dealt with concerns, complaints and allegations responsibly and has involved outside agencies as and when necessary. All of the recommended policies and procedures for safeguarding vulnerable people are kept at the home and these are included in staff handbooks. The staff receive training in issues relating to abuse and adult protection. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The physical design and layout of the home enables residents to live in a safe and comfortable environment. Evidence: Laura House is a modern home that has been carefully designed for use by people with physical disabilities. The home is divided into three separate units or houses. To the front of the house there is off road parking spaces for four cars and two minibuses, however, this may not be enough space to accommodate staff, residents and visitors cars and the road to the front of the home has single line parking restrictions. There is a public car park about five minutes walk from the home. Laura House has been built on a hill so from the outside it looks like a single storey building, however the accommodation is arranged on three floors and a passenger lift is provided to enable the residents to access all parts of the home. Each of the three houses provides the residents who live in them with a single bedroom, and a shared lounge and dining area, a kitchen, suitable bathrooms and wet rooms. Each of the houses also has a private patio so that the residents have access to a safe and level outdoor space. All of the rooms occupied or used by the residents were seen during the site visit and found to be light, spacious, clean and well equipped. Two of the bathrooms have baths that are designed for use by people who have physical disabilities and the provision of wet rooms ensures that people have a choice of taking a bath or a shower. Evidence: Suitable hoists are provided where necessary. All of the residents bedrooms were spacious enough to enable the staff to provide assistance from both sides of the bed. Where necessary beds that are designed for use by people with physical disabilities are provided. All of the bedrooms were seen to have good natural lighting and some had been fitted with sensory lights to help the residents to relax. Care had been taken to ensure that each of the bedrooms reflects the interests of individual whose room it is. This was particularly noticeable in one of the bedrooms, which had been very artistically decorated by a member of staff for a resident who likes Dr Who. The managers office is off the main entrance hall and easily accessible to the residents and visitors to the home. The laundry facilities meet the needs of the residents but there are plans to relocate the laundry room and provide additional toilet facilities. 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 . The staff are trained, skilled and employed in sufficient numbers to support the people who are living in the home. Evidence: The staff recruitment records and feedback from surveys completed by the staff told us that safe recruitment practices are used to ensure that unsuitable people are not employed to care for the residents. We spoke to some of the staff and looked at staff training records which showed us that new staff are given induction training and that on-going training is provided for all of the staff. The training undertaken by each member of staff is recorded on a graph so that the staffs training needs and achievements can be easily identified. There were some gaps in the training provision and some of the staff told us that they would like to attend more specialist training courses to give them a better understanding of the needs of individual residents. The company employs a National Vocational Qualification assessor. A number of staff have completed their NVQ Levels 2, 3 and 4 in Care and more staff are currently working towards gaining this qualification The staff told us that they felt well supported by the organisation, management and their colleagues and that they receive formal one to one supervision, annual work appraisals and attend staff and house meetings regularly. 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 . The management and administration of the home is based on openness and respect and has effective quality assurance systems. The home is maintained safely and safe working practices are used to protect the people living and working at the home. Evidence: The Registered Manager Mrs Theresa Timberlake is a qualified nurse and has completed the Registered Managers award. She was on leave at the time of the site visit and good arrangements were in place to ensure that the home was well managed in her absence. Positive feedback was gained from the staff about the registered manager, who we were told was very supportive, both on a professional and personal level. She also works well with the Commission by keeping us informed any events that occur at Laura House, which may have a negative impact on the residents. A quality assurance programme is in place to gain feedback from the people who use the service and their representatives. The outcome is recorded on graphs that easily identify areas of the service that are perceived to be excellent or good and areas where improvements could be made. The Annual Quality Assurance Assessment tells us that the servicing of equipment and appliances is up to date. The staff are given a handbook that contains some of the homes policies and procedures. Other policies and procedures were seen in the individual houses and in files that are accessible to the staff in the managers office. Are there any outstanding requirements from the last inspection? Yes  No  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 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 Description 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 1 Standard 20 Regulation 13 Description Timescale for action The registered providers 27/02/2009 must ensure that the staff who administer medicines to the residents sign the medication administration records sheet as they do so. To ensure that accurate records are kept to provide evidence that medicines are being administered as prescribed. 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 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. - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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