Inspection on 01/08/05 for Laurieston House

This inspection was carried out on 1st August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Laurieston House 26/06/07

Laurieston House 20/07/06

Laurieston House 09/12/05

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Laurieston House 118 Hady Hill Chesterfield Derbyshire S41 0EF Lead Inspector Ray Coonan Unannounced 1 August 2005 13:00 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 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. Laurieston House C52 C02 S62837 Laurieston House V242403 010805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Laurieston House Address 118 Hady Hill, Chesterfield, Derbyshire, S41 0EF 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) 01246 629389 Dr Bolegowda Narayana Swamy Nanda Swamy Nanda Swamy Care Home (CRH) 3 Category(ies) of Learning disability (LD) 3 registration, with number of places Laurieston House C52 C02 S62837 Laurieston House V242403 010805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Responsible Individual must attend a recognized training course concerning Multi Agency Adult Protection Procedures in Derbyshire within six months of his registration. 2. The Registered Manager must enroll on a NVQ Level 4 course in Management and Care before the end of 2005. 3. Bedroom 3 will not be used as service user accommodation once the present occupant has vacated the room. Date of last inspection 2/12/04 Brief Description of the Service: The Home is a detached corner house, located in a residential area just outside the centre of Chesterfield, and close to a wide range of local amenities and facilities. There are attractive garden and sitting areas accessible to the residents. The Home is run on family domestic lines and each resident has their own bedroom. There are 2 lounge areas in use and suitable bathroom and toilet facilities available. The manager and proprietor live on the premises and share the Home’s facilities with residents, who also attend local day care centres during the week. Laurieston House C52 C02 S62837 Laurieston House V242403 010805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first inspection since the current proprietors took over the running of the Home in May. The visit took place over a period of three and a half hours on the 1st August 2005. The manager/ proprietor, Mrs. Swamy, was present throughout the inspection and there was also the opportunity to talk to the deputy manager and the two residents during the course of the visit. All parts of the premises were viewed and a variety of documentation was seen. These included care plans, maintenance records and policies and procedures. What the service does well: What has improved since the last inspection? Relevant policies and procedures have been reviewed and updated as necessary. Laurieston House C52 C02 S62837 Laurieston House V242403 010805 Stage 4.doc Version 1.40 Page 6 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. Laurieston House C52 C02 S62837 Laurieston House V242403 010805 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 Laurieston House C52 C02 S62837 Laurieston House V242403 010805 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 and 5. Clear and comprehensive information on services at the Home is readily available. EVIDENCE: The new owners have satisfactorily updated the Home’s Statement of Purpose, which details the services available. The service user guide was also seen and was developed in a format accessible to residents. Clear admission ad assessment procedures were in place. Both residents have been at the Home some 18 years and whilst there is one vacancy a further placement was not imminent. Discussions with the manager indicated that she was aware of the need for thorough assessments prior to any placement offers. Each resident had a copy of their contract on their individual file. Laurieston House C52 C02 S62837 Laurieston House V242403 010805 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, 8 and 9. Residents’ care needs were assessed in a competent manner and their individual wishes and preferences were appropriately established and respected. Individual care plans were generally well maintained but needed some streamlining. EVIDENCE: Residents’ individual care plan files were examined and these were detailed, comprehensive and gave a good sense of each resident’s preferences, capabilities, needs and interests. Minutes from resident meetings were also seen and demonstrated that residents were consulted in such areas as social activities and meals and the general ongoing life of the Home. There was satisfactory guidance for meeting care needs and appropriate risk assessment information evident on care plans, which covered the physical and social/developmental welfare of each resident. There were also copies of reviews with Care Manager and Day Centre input. Although care plans were generally well organised there was a lot of old, out of date information kept on the files. There was not clear evidence that the plans were being monitored on an ongoing basis. Laurieston House C52 C02 S62837 Laurieston House V242403 010805 Stage 4.doc Version 1.40 Page 10 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) 16, and 17. 11, 13, 14, 15, Each resident had a full and active lifestyle that supported their overall developmental needs and expressed social interests. Residents were also provided with meals that satisfactorily took into account individual preferences and any dietary needs. EVIDENCE: Care plan files showed that each resident’s day centre activities were reviewed and linked to their overall personal development. It was also clear that they have a wide range of leisure activities throughout the week, which includes use of local amenities such as shops and pubs, and also regular outings from the Home at weekends. One resident also attends a luncheon club each week. Residents chatted quite happily about their general social life and interests and it was clear that their preferences were taken into account. Activities were less structured within the Home, though residents had their own television and music facilities and some games and craft materials were available. Residents were observed as using the various parts of the Home as they wished. The manager said that the residents helped around the house up to a point and that one particularly liked to help in the garden. Laurieston House C52 C02 S62837 Laurieston House V242403 010805 Stage 4.doc Version 1.40 Page 11 Neither resident had any family, though they were well known in the neighbourhood and had local visitors. It was stated that neither had any particular friendships amongst their peer group. Catering was discussed with the residents and they indicated they were quite satisfied with the meals they received at the Home and sometimes helped with the food shopping. Menus were seen and these were suitably varied. One resident had specific dietary needs due to a diabetic condition and this was appropriately considered and monitored. Laurieston House C52 C02 S62837 Laurieston House V242403 010805 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 and 20 Residents had their general health care needs suitably promoted and monitored. EVIDENCE: Both residents were seen to be in good general physical health and there were records on care plans of any appointments with community health resources such as G.P., optician and dentist. Plans would also monitor general behavioural, and social issues relevant to each individual’s emotional wellbeing. Any personal care needs were identified and reviewed on care plans and these were minimal. Discussions with the manager indicated this was dealt with in a sensitive manner. There was only one resident with prescribed medication and he did not manage this himself. The medication was stored securely and records of administration were satisfactorily maintained. The manager administered insulin injections on a daily basis and stated that instruction had been provided through the practice nurse at the local surgery, though there was no written evidence of this. The Home has recently changed to Boots pharmacy and regular audits of the Home’s arrangements for the handling of medicines will be undertaken. Laurieston House C52 C02 S62837 Laurieston House V242403 010805 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 and 23 The general safety and protection of residents was satisfactorily considered though there remained some shortfall in related training. EVIDENCE: The Home had complaints policies and procedures in place, including a version accessible for residents. However, information on the Commission was not included. It was stated that there had been no complaints received since the last inspection. There was a full range of relevant information and guidance concerning the protection of vulnerable adults. The manager/proprietor had received training on local multi agency protocols though the other proprietor, who also lives on the premises and is included on the staffing rota, was still waiting to attend an appropriate course. However, it was stated that this was arranged for next month. Laurieston House C52 C02 S62837 Laurieston House V242403 010805 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, 25, 26, 27, 28, 29 and 30. Residents enjoy a comfortable and homely environment that is maintained to a high standard. EVIDENCE: All parts of the Home were viewed and general fixtures and fittings, furnishings and décor was of a high standard. The Home was run on domestic lines and was well maintained with residents consulted on any redecoration plans. Bedrooms were comfortably furnished and suitably personalised. One resident’s room was slightly below size requirements but it was his own choice to remain in that room and the two lounge areas in use compensated for this shortfall. All communal areas, apart from the bathroom were shared with the owners who also live on the premises. Both residents were of good mobility and no aids or adaptations were required The Home was observed to be clean and hygienic and the bathroom and toilet facilities were accessible and suitably equipped and maintained. Laurieston House C52 C02 S62837 Laurieston House V242403 010805 Stage 4.doc Version 1.40 Page 15 Externally, the Home is congruent with surrounding properties and convenient for local shops and transport. There were good sized, attractively maintained garden and sitting areas for resident use, which included a greenhouse. Laurieston House C52 C02 S62837 Laurieston House V242403 010805 Stage 4.doc Version 1.40 Page 16 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) 31, 32, 33, 34, 35 and 36. Staff at the Home are committed to the welfare of the residents and work flexibly in their interests. However, there were some areas of training to be further developed and aspects of recruitment practice to be improved. EVIDENCE: Since the last inspection the proprietors have appointed a deputy manager to assist them in the running of the Home. No other staff employed at this stage. Recruitment and selection processed were examined and these were generally satisfactory with written references obtained. However, an up to date Criminal Records Bureau had not been obtained. There were clear job descriptions in place and discussions with the manager and deputy indicated they had a wide range of experience in care provision and a commitment to the welfare of the residents. Staffing rotas were seen and were satisfactory with supports flexibly arranged around residents’ activities. The manager and deputy met regularly and there were some records of their meetings to identify priorities for the running of the Home. The manager has NVQ level 2 and is waiting for an interview in order to proceed to NVQ level 4 in care and management. Relevant mandatory care Laurieston House C52 C02 S62837 Laurieston House V242403 010805 Stage 4.doc Version 1.40 Page 17 courses have been taken up. There had been no input regarding training specifically related to working with people with learning difficulties. Laurieston House C52 C02 S62837 Laurieston House V242403 010805 Stage 4.doc Version 1.40 Page 18 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, 38, 39, 40, and 42 The Home is run on an informal and family basis with residents’ interests and general welfare met through an underlying, effectively organised service. EVIDENCE: Residents were observed to be comfortable and relaxed with the manager who stated that they had adjusted generally well to recent changes. Although the Home now had new proprietors the general routines and style of running of the Home was not perceptibly different and the owners and residents shared the Home much as any family. Consultation with residents was said to be ongoing and there were recorded formal meetings available. The manager had an annual plan and established priorities for the running of the Home and policies and procedures had been reviewed and expanded with the assistance of the deputy manager. Laurieston House C52 C02 S62837 Laurieston House V242403 010805 Stage 4.doc Version 1.40 Page 19 Health and Safety policies were in place and up to date utility and servicing records were seen. Fire Safety records were examined and these were suitably maintained. Laurieston House C52 C02 S62837 Laurieston House V242403 010805 Stage 4.doc Version 1.40 Page 20 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 3 Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 x 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 2 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Laurieston House Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 x 3 x C52 C02 S62837 Laurieston House V242403 010805 Stage 4.doc Version 1.40 Page 21 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. 2. Standard 22 23 Regulation 22 13 Requirement Full contact details for The Commission must be included in the complaints policy. All staff must receive training in local multi agency procedures for the protection of vulnerable adults. Up to date CRB checks must be obtained for all staff. The manager must enrol on NVQ 4 training in care and management Timescale for action 30th September 2005 30th September 2005 30 September 2005 31 December 2005 3. 4. 34 37 Schedule 2 9 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 6 20 35 Good Practice Recommendations The manager should ensure that there is evidence that care plans are monitored on a regular basis and that these plans are streamlined. Written confirmation of satisfactory training to administer insulin should be obtained from the practice nurse. The manager should explore opportunities for training related to working with people with learning disabilities. C52 C02 S62837 Laurieston House V242403 010805 Stage 4.doc Version 1.40 Page 22 Laurieston House Commission for Social Care Inspection South Point Cardinal Square Nottingham Road Derby, DE1 3QT 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. 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