Inspection on 06/10/05 for Laura House

This inspection was carried out on 6th October 2005.

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

Laura House 13/01/09

Laura House 03/10/06

Laura House 16/02/06

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 09/07/2008.

CARE HOME ADULTS 18-65 Laura House Belmont Terrace Totnes Devon TQ9 5QB Lead Inspector Margaret Crowley Announced 6 October 2005 th 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 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 Stationary 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. Laura House D54-D07 S3739 Laura House V237122 061005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Laura House Address Belmont Terrace, Totnes, Devon, TQ9 5QB Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01803 866541 01803 847771 admin@roc-uk.org Robert Owen Communities Mrs Therese Annette Timberlake Care Home 16 Category(ies) of Learning disability (16), Physical disability (16) registration, with number of places Laura House D54-D07 S3739 Laura House V237122 061005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 02/02/2005 Brief Description of the Service: Laura House is a care home registered to provide care for sixteen service users with a learning disability who may also have a physical disability. It is situated close to the centre of Totnes, which is reached via steep roads.The premises are a detached, modern purpose- built building, divided into three separate ‘flats’ or “houses”. Houses One and Two accommodate service users with higher levels of needs and/or a physical disability. These are on one floor, with a full passenger lift to access other areas. House Three is a semi-independent unit for four people with accommodation on two floors, and its own external entrance. Service users are accommodated in single rooms. Each “house” has it’s own lounge, dining room, kitchen and adapted bathing facilities. Fifteen people only now live in Laura House, as two bedrooms have been converted to one to provide more spacious accommodation for a wheelchair user.Outside there are two enclosed lower ground floor patio areas at the rear, accessed from Houses Two and Three. The premises are built on a sloping site and access to the grassed area below the patios is via a steep ramp. There is limited parking at the front of the building Laura House D54-D07 S3739 Laura House V237122 061005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and took place on the 6thth October 2005 over one day. A tour of the premises took place and records were inspected. Most of the service users who live at Laura House were seen and several were spoken with. Staff were seen and spoken with in the course of their daily duties. Discussions took place with Therese Timberlake registered manager who was present in the home during the inspection. What the service does well: What has improved since the last inspection? What they could do better: Service user daily records held in their “houses” should be stored securely. Medicinces should be stored according to the recommendations of the Royal Pharmaceutical Society The Administration and Control of Medicines in Care Homes (2003). Laura House D54-D07 S3739 Laura House V237122 061005 Stage 4.doc Version 1.40 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. Laura House D54-D07 S3739 Laura House V237122 061005 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Laura House D54-D07 S3739 Laura House V237122 061005 Stage 4.doc Version 1.40 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 standard(s) 1,2 Prospective service users and their families have good information regarding the services and facilities at Laura House. EVIDENCE: The service user guide is available in forms which are accessible to service users. This includes a video made involving service users currently living there. There is a statement of purpose that is reviewed regularly. This should include the room dimensions and information concerning staff currently employed, including their qualifications. There have been no new service users admitted since the last inspection. From records inspected it was evident that there are comprehensive initial assessments undertaken and clear admission procedures. Laura House D54-D07 S3739 Laura House V237122 061005 Stage 4.doc Version 1.40 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 standard(s) 6,7,9,10 Service users have care plans and risk assessments which are reviewed, and ensure that their changing needs are met. EVIDENCE: Service users have both care plans and person centred plans. Evidence was seen of care plans, which are retained by service users themselves. These are available in accessible formats using photographs and symbols. One service user demonstrated her person centred plan, which has been made with her by staff using video. Daily diaries are kept for all service users and showed evidence of choices made. Records inspected demonstrated that comprehensive assessments, risk assessments and care plans are available and reviewed regularly, with the service users fully involved in the processes. There are systems in place for managing service users monies. All service users have their own bank accounts. Clear records were seen of incoming and outgoing payments. Service users main records are stored in a locked cabinet in the office. Daily records are held in unlocked trolleys in the “houses”. It is recommended that a locked cabinet be provided. Laura House D54-D07 S3739 Laura House V237122 061005 Stage 4.doc Version 1.40 Page 10 Laura House D54-D07 S3739 Laura House V237122 061005 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,17 Service users are consulted and provided with a choice of activities within Laura House and in the community. EVIDENCE: Service users are encouraged to make choices and to be as independent as their disability allows. All service users have daily activity plans and enjoy a range of day opportunities. These include attending college, or day care centres, and using facilities provided by the Robert Owen Foundation including working at the farm on the outskirts of Totnes. Service users were seen enjoying creative activities within the home. Good use is made of community facilities within the local environment. An allotment has recently been acquired nearby to enable service users to persue their interests in growing herbs and vegetables. Meals are provided separately in each house and are tailored to service users tastes and dietary requirements. Special diets and textures are catered for. Each house purchases its own food and service users are encouraged to participate as far as possible in menu planning, shopping and preparing meals. Menus are varied and show good attention to healthy eating principles. Laura House D54-D07 S3739 Laura House V237122 061005 Stage 4.doc Version 1.40 Page 12 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 standard(s) 18,19,20 Service users can be confident that their personal and health care needs will be met at Laura House. EVIDENCE: Service users health care needs are assessed and medication is reviewed regularly. Some service users have profound physical, learning and communication disabilities. Moving and handling plans and risk assessments were seen. There are designated key workers to provide continuity of support. Staff showed a good awareness of service users’ needs and their preferences about how they like their support to be delivered. Consideration is given, when possible, to the gender of staff providing intimate personal care. The district nursing service and specialist nursing services provide support as appropriate. Medicines are stored separately in each house in a locked cupboard in the kitchen due to lack of storage space. A monitored dosage blister pack system is used for most medication. The keys to the medicines cupboards must be held securely. Medicines are not stored in a locked container in the refrigerators. The home does not have a medicines refrigerator. There are processes for the administration of medicines. The management must ensure that the storage and procedures comply with those recommended by the Royal Pharmaceutical Society The Administration and Control of Medicines in Care Homes (2003). Laura House D54-D07 S3739 Laura House V237122 061005 Stage 4.doc Version 1.40 Page 13 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 standard(s) 22,23 Procedures are in place to enable service users to complain and to protect them from abuse. EVIDENCE: There have been no complaints since the last inspection. There is a complaints procedure an accessible format for service users, and issued to each service user. There is an adult protection procedure and the locally issued Alerter’s guide for staff reference. Some staff have received training in adult protection. It is recommended that information regarding the home’s whistle blowing policy is included in the staff handbook. Laura House D54-D07 S3739 Laura House V237122 061005 Stage 4.doc Version 1.40 Page 14 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 standard(s) 24,30 Service users are provided with accommodation that is comfortable, safe and clean. EVIDENCE: The premises are purpose- built to cater for service users with a range of needs from those who are semi independent to those with profound physical, learning and communication disabilities. The three separate units, each with their own lounge dining and kitchen facilities, were clean, comfortable, and well furnished. There are two patio areas, but outside space is limited. Service users have use of a room on the lower ground floor area for recreation purposes. Service user rooms are personalised and adapted to their needs. Suitable equipment is provided for service users with physical disabilities including adapted bathing facilities, overhead-tracking hoists, mobile hoists and slings and lifts. The premises are satisfactorily maintained with attention given to service users safety. There was a damp patch in House 3, which has been identified for remedial work. The property was clean throughout and efforts are made to keep the environment hygienic and odour free. Laura House D54-D07 S3739 Laura House V237122 061005 Stage 4.doc Version 1.40 Page 15 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,35,36 Sufficient skilled staff are employed to meet the high level of needs of the service users. EVIDENCE: The three “houses” have separate staff groups. The registered manager said that there are sufficient staff employed to meet service users needs by day and by night. Staffing levels are kept under review dependent on the needs of the service users. There were 4 vacant posts at the time of the inspection and agency staff are employed when necessary. The staffing rota was available for inspection. There is a staff training plan. Only 12 of care staff currently hold NVQ2 or above, but 19 staff are currently undertaking the training. The LDAF framework is used within the home. The managements’ commitment to training was confirmed by the NVQ assessor and care staff. Staff interviewed were positive about their work and said they receive good support from the registered manager and senior staff. Evidence of staff induction and supervision systems was seen. Records were inspected of staff recently employed and provided satisfactory evidence of the recruitment processes. Laura House D54-D07 S3739 Laura House V237122 061005 Stage 4.doc Version 1.40 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,39,42 Laura House is well managed. Service users live in an environment where health and safety standards are met and maintained. EVIDENCE: The Registered Manager is a qualified nurse and is completing the registered managers award. There are comprehensive systems for health and safety management, record keeping and policies and procedures Evidence was seen of the quality assurance system and an annual development plan. . There are risk assessments of the environment and monitoring processes. Fire safety records and accident records were available for inspection. Staff receive mandatory training in fire safety and first aid and safe working practices. Laura House D54-D07 S3739 Laura House V237122 061005 Stage 4.doc Version 1.40 Page 17 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 3 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x x x 3 Standard No 31 32 33 34 35 36 Score x 2 x x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Laura House Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 3 x D54-D07 S3739 Laura House V237122 061005 Stage 4.doc Version 1.40 Page 18 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. 1. 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. 1. 2. 3. 4. Refer to Standard YA1 YA10 YA23 YA20 Good Practice Recommendations The statement of purpose should include the room dimensions and information concerning staff currently employed including their qualifications. Service user records held in the houses should be kept in locked cabinets. It is recommended that information regarding the home’s whistle blowing policy is included in the staff handbook. Medicinces should be stored according to the recommendations of the Royal Pharmaceutical Society The Administration and Control of Medicines in Care Homes (2003). Laura House D54-D07 S3739 Laura House V237122 061005 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 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 Laura House D54-D07 S3739 Laura House V237122 061005 Stage 4.doc Version 1.40 Page 20 - 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. 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