CARE HOMES FOR OLDER PEOPLE
Laurel Villas 170/172 Tulketh Rd Ashton Preston PR2 1ER Lead Inspector
Susan Dale Announced 17 May 2005 10:00 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 Older People. 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. Laurel Villas F57 F09 S9834 Laurel Villas V211794 170505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Laurel Villlas Address 170/172 Tulketh Rd, Ashton, Preston, PR2 1ER 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) 01772 720609 Laurel Villas Limited Mrs Susan Hall Care Home 24 Category(ies) of Older People (22), Physical Disabilty (2) registration, with number of places Laurel Villas F57 F09 S9834 Laurel Villas V211794 170505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Not Applicable Date of last inspection 151204 Brief Description of the Service: Laurel Villas is registered as a care home that provides personal care and accommodation for up to 24 persons, both male and female over the age of 65 years. The home is located near to the centre of Preston in a residential area of Ashton close to shops and various local amenities. The home is not purpose built and arranged over two floors with access provided to all parts of the home via a lift. Accommodation is provided in single rooms and certain rooms are available for use as a double room if so required. The accommodation provides a homely atmosphere with plenty of communal space including a large lounge that overlooks a very attractive garden that can be easily accessed by service users. Laurel Villas F57 F09 S9834 Laurel Villas V211794 170505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was announced and during the inspection the inspector was able to speak to 10 service users, 4 care staff, a relative and the registered manager. Comment cards were sent prior to the inspection to service users, relatives/friends and General Practitioners/District Nurses. A response was received from 6 service users, 5 relatives/friends and 2 General Practitioners; all the replies were positive. What the service does well: What has improved since the last inspection?
The staff team has been completely changed from the last inspection. The manager has indicated that the staff are working well as a team and are responsive to changes made to policies and procedures in her efforts to improve and streamline the services. The manager now has a 2nd office where she can go and find some privacy to work on policies and procedures, administrative work and conduct staff supervision etc. This has proved to be most productive and the manager has managed to finalise administrative work that was proving impossible previously.
Laurel Villas F57 F09 S9834 Laurel Villas V211794 170505 Stage 4.doc Version 1.30 Page 6 A new complaints procedure has been implemented called CCI (Complaints, Compliments & Incidents). The manager can now ensure that an outcome has been recorded and whether a complaint is substantiated or not. A review of care plans is now conducted on a monthly basis and a signature is obtained from the service user on the care plan as well as a photo. A record of service users’ weight is now recorded each month. Staff are now receiving regular one to one supervision (appraisal) every 6 weeks. There are several new activities in place including, Orientation, taking service users back to areas they were familiar with such as where they used to live. Shopping with staff (key worker), Karaoke each week, Baking. Several areas of the home have been decorated and had new carpets including the lounges and 4 of the service users bedrooms. 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. Laurel Villas F57 F09 S9834 Laurel Villas V211794 170505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Laurel Villas F57 F09 S9834 Laurel Villas V211794 170505 Stage 4.doc Version 1.30 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3 & 5 Prospective service users are assessed in order to ensure that the services provided meet their needs. Opportunities are provided for prospective service users and their relatives to visit the home prior to admission. EVIDENCE: Each service user has a contract/residents agreement which outlines the terms and conditions of residence. The contract is agreed and signed by the service user and by the registered provider. Service user records were examined and the assessment procedure was seen to be comprehensive and included, general health, mental state, social interests, hobbies and religious and cultural needs. Prospective service users are visited in their own homes or current situation providing an opportunity for discussion about their care needs and personal preferences. The assessment leads to the compilation of a care plan. Information about trial visits is contained within the Statement of Purpose and Service Users’ Guide. Service users are provided with the opportunity to visit the home prior to making a decision to move in on a more permanent basis.
Laurel Villas F57 F09 S9834 Laurel Villas V211794 170505 Stage 4.doc Version 1.30 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 & 10 A care plan is devised and delivered in a way that meets individual service users’ physical, health and emotional needs. EVIDENCE: The initial assessment leads to an individual care plan that covers all physical and emotional requirements. Any risks connected with the care of each individual had been recorded; a record of weight for each service user is now being maintained. The documentation now includes a photo of each service user and the care plans seen had been reviewed on a monthly basis. An inventory is taken of the service users’ possessions. Some of the paperwork seen was incomplete and this seemed to depend on which staff member had completed the details. There was evidence that health professionals had been contacted on behalf of service users and a comment card returned from a General Practitioner (GP) confirmed that the home worked in partnership with them and staff demonstrated a clear understanding of the care needs of service users; the medication was being appropriately managed by the home. The comment card also confirmed that the GP was able to see service users in private.
Laurel Villas F57 F09 S9834 Laurel Villas V211794 170505 Stage 4.doc Version 1.30 Page 10 The medication procedures have recently been improved following some recommendations from a pharmacist inspector. Four staff including the registered manager have received the necessary training and are responsible for the provision of medication. Service users spoken to confirmed that staff are respectful and comment cards returned from service users confirmed that they feel well cared for and privacy is respected. Laurel Villas F57 F09 S9834 Laurel Villas V211794 170505 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 & 14 The home provides activities that meet the expectations and capabilities of the service users and visitors to the home are made to feel welcome at all times. EVIDENCE: There are trips out every Tuesday and on the day of the inspection there was a trip planned to Preston Docks. Some outings are designed to stimulate the memories of service users by visiting places where they used to live. Shopping trips are undertaken with the service user’s key worker and two of the service users have trips to the pub accompanied by a member of staff. Newly established Karaoke takes place each week and has proved to be a success with the service users. Baking sessions have also recently commenced. Clothes parties take place now and again and a professional singer attends the home each month. Service users spoken to were enthusiastic about the activities and confirmed the fact that their families were always made welcome and could visit at any time. One of the service users made the comment: “Its wonderful here”. Comment cards were returned from relatives/visitors who confirmed that as well as being made to feel welcome they are kept informed of any important matters connected with their relative/friend. One of the relatives made a comment: “ Always a warm and friendly atmosphere.” There are many opportunities for informal discussions and individual
Laurel Villas F57 F09 S9834 Laurel Villas V211794 170505 Stage 4.doc Version 1.30 Page 12 discussions and the management ensures that all service users are encouraged to make their views known, with regard to the conduct of the home. Service users maintain responsibility for their own financial affairs for as long as they wish; the home also provides information regarding local advocacy services. Service users are able to bring their own possessions into the home and are encouraged to personalise their rooms. The home has a policy with regard to service users being able to access their personal files. Laurel Villas F57 F09 S9834 Laurel Villas V211794 170505 Stage 4.doc Version 1.30 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 Policies and procedures are in place to ensure that service users are protected from abuse and any complaints/concerns are recognised and acted upon. EVIDENCE: There is a suitable complaints procedure and service users, relatives and any other interested parties are aware of how to raise any concerns. The registered manager has made some changes as to how any concerns are recorded and the action taken following the complaint. Only one complaint had been recorded. The home has suitable policies and procedure in place with regard to Adult Abuse and `whistle blowing’ and staff are provided with information at induction and foundation training. Staff spoken to were aware of the issues surrounding Adult Abuse and are undertaking formal training. Staff policies include a gift policy, which precludes staff from receiving gifts or assisting with any legal documents or benefiting from service user’ wills. Laurel Villas F57 F09 S9834 Laurel Villas V211794 170505 Stage 4.doc Version 1.30 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 26 Service users live in an environment that is clean, safe and well maintained. EVIDENCE: There is a routine maintenance plan for the home and the building complies with the requirements of the local fire service and environmental health department. A programme of refurbishment is in operation and bedrooms are being gradually decorated and provided with new carpets, curtains and duvet covers. The grounds of Laurel Villas are extensive and well kept. All parts of the home are accessible to service users via a passenger lift, which can be used independently by service users. Policies and procedures are in place for the control of infection. Laundry facilities are sited appropriately and do not require to be carried through areas of the home where food is prepared or eaten. The washing machine has the facility to wash soiled clothing etc., at an appropriate temperature. At the time of the inspection the home was warm clean and free from any obvious hazards.
Laurel Villas F57 F09 S9834 Laurel Villas V211794 170505 Stage 4.doc Version 1.30 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 & 30 A suitable recruitment procedure is in operation that ensures the protection of vulnerable people and training is provided to staff that ensures they are competent. EVIDENCE: Since the last inspection a number of staff have left the home and there is now almost a new staff team. There is now a level 1 senior carer and a level 2 senior carer. The staffing rota provides adequate staffing levels and there are 2 new staff commencing shortly who are already qualified to NVQ level 3. The home has a suitable recruitment procedure and the records examined showed that appropriate references had been received including clearance by the Criminal Records Bureau (CRB) and the Protection of Vulnerable Adults Register (POVA). There were a few gaps in the details recorded on application forms and the inspector advised that it was important to ensure that applicants completed each section especially for a declaration such as convictions or health. A recommendation was made that their should be a recruitment matrix that indicates on which date each reference has been received prior to the date of commencement shown on the contract. All staff receive a contract of employment and are expected to abide by the code of conduct set by the General Social Care Council. Staff confirmed that they had received induction training that includes the training requirements set by the National Training Organisation such as the principles of care and safe working practices. Foundation training is also
Laurel Villas F57 F09 S9834 Laurel Villas V211794 170505 Stage 4.doc Version 1.30 Page 16 provided and includes Moving and Handling, Health & Hygiene, Safe handling of Medicines etc. All staff confirmed that they are encouraged to attend NVQ training. There are 19 care staff and 5 staff have achieved NVQ level 2, a further 6 staff are working towards the qualification. Laurel Villas F57 F09 S9834 Laurel Villas V211794 170505 Stage 4.doc Version 1.30 Page 17 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 35, 36 & 38 The service users benefit from the competency and leadership of the manager and are given every opportunity to participate in the running of the home. Staff are supported and appropriately supervised. EVIDENCE: The manager of Laurel Villas has extensive experience in the management of care staff and obtained a qualification at NVQ level 4 in Care and Management. The registered manager is supported by the designated responsible individual and owner of the home; there are clear lines of accountability. Laurel Villas F57 F09 S9834 Laurel Villas V211794 170505 Stage 4.doc Version 1.30 Page 18 The management of the home do not act as an agent for any of the service users and are not aware of any service user subject to Power of Attorney processes. Only the relatives of service users act on behalf of service users with regard to their financial affairs; information about the advocacy service is available for service users who do not have a representative. Secure facilities are available for money or valuables belonging to service users. There was evidence on the staff files that staff are now being provided with one to one supervision (appraisal) every 6 weeks. This provides an opportunity for staff to discuss any issues they may have in the running of the home, service users or any training needs. Regular training opportunities are offered to staff on health and safety topics. Risk assessments have been carried out for all safe working practices; the health and safety of staff and service users is given careful consideration at Laurel Villas. The registered manager provided evidence in the pre inspection questionnaire of compliance with relevant health and safety legislation. An accident book is maintained and staff receive regular updates on health and safety topics. Laurel Villas F57 F09 S9834 Laurel Villas V211794 170505 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x
COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x x 3 3 x 3 Laurel Villas F57 F09 S9834 Laurel Villas V211794 170505 Stage 4.doc Version 1.30 Page 20 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. 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. Refer to Standard 28 29 29 Good Practice Recommendations The training of staff to NVQ level 2 should continue. Any missing gaps on the application form for new staff should be completed. A recruitment matrix should be recorded that indicates on which date each reference has been received prior to the date of commencement shown on the contract. Laurel Villas F57 F09 S9834 Laurel Villas V211794 170505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Unit 1, Tustin Court Portway Preston PR2 2YQ 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 Laurel Villas F57 F09 S9834 Laurel Villas V211794 170505 Stage 4.doc Version 1.30 Page 22 - 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!
