Inspection on 20/07/06 for Laurieston House

This inspection was carried out on 20th July 2006.

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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Laurieston House 26/06/07

Laurieston House 09/12/05

Laurieston House 01/08/05

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 Inspection 20th July 2006 2:00 Laurieston House DS0000062837.V300582.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Laurieston House DS0000062837.V300582.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Laurieston House DS0000062837.V300582.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Laurieston House Address 118 Hady Hill Chesterfield Derbyshire S41 0EF 01246 238213 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Dr Bolegowda Narayana Swamy Nanda Swamy Nanda Swamy Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Laurieston House DS0000062837.V300582.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Bedroom 3 will not be used as Service User accommodation once the present occupant has vacated the room. 9th December 2005 Date of last inspection 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. Two of the bedrooms have en suite facilities. There is a lounge area and suitable bathroom and toilet facilities available. Residents link in with specialist community health and social support services as required. Laurieston House DS0000062837.V300582.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a period of nearly four hours on the 20th July. The owner/manager, Mrs. Nanda Swamy, was present throughout the visit and there was the opportunity to meet with one of the care staff on duty at the time. There was also the opportunity to meet with all the residents when they returned from their daytime activities. Most parts of the premises were viewed and a range of documentation such as care plans, staff files, health and safety records and other relevant policies and procedures were examined. What the service does well: What has improved since the last inspection? What they could do better: Now that occupancy and staffing levels have increased at the Home the manager needs to develop a more systematic approach to the recruitment, training and appraisal of staff. Laurieston House DS0000062837.V300582.R01.S.doc Version 5.2 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. Laurieston House DS0000062837.V300582.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Laurieston House DS0000062837.V300582.R01.S.doc Version 5.2 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 the following standard(s): 1 and 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents have the needs assessed in a purposeful manner. EVIDENCE: The Home’s statement of purpose reflected the new occupancy levels but not staffing arrangements and qualifications. All individual care plans were examined, including that of a resident who had arrived at the home six weeks previously. These demonstrated that appropriate needs assessments were undertaken, including physical, behavioural, social and emotional needs, at the time of a proposed placement. A full range of relevant information was obtained and initial care plans were formally reviewed with the resident during the first few weeks of the placement. Laurieston House DS0000062837.V300582.R01.S.doc Version 5.2 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 the following standard(s): 6, 7, and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents had their individual care planned in a way that took into account their individual interests, preferences and capabilities but also understood any limitations or vulnerability. EVIDENCE: The care plans for all four residents were examined during the visit and these were comprehensive, well organised and accessible with a sense of each resident’s preferences, capabilities, needs and interests. There was evidence that residents’ views were sought, though they were not given information about independent advocacy services. Risk assessments were included on the plans and were developed with input from specialist community health services if relevant. The care plans contained detailed guidance and instructions for addressing individual needs and the manager stated that she received good ongoing support from specialist sources, such as the C.P.N, in terms of any care and risk strategies. Laurieston House DS0000062837.V300582.R01.S.doc Version 5.2 Page 10 The files were appropriately maintained and up to date with clear daily records kept. Any community health contacts were recorded and reviews were timely and included other agencies such as the social services care manager and day centre workers. Laurieston House DS0000062837.V300582.R01.S.doc Version 5.2 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 the following standard(s): 12, 13, 14, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoyed an active lifestyle, which complemented their overall developmental needs as well as expressed interests and preferences. 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 and three residents attended a specialist social club one night per week. Residents chatted quite happily about their general social life and interests and it was clear that their preferences were taken into account in the Home. Minutes from residents meetings were seen and demonstrated that they were consulted about social activities and menus. Activities were less structured Laurieston House DS0000062837.V300582.R01.S.doc Version 5.2 Page 12 within the Home, though residents had their own television and music facilities and some games and craft materials were available. Residents were observed using the various parts of the Home as they wished and there was no undue emphasis on routines evident. The manager said that the residents helped around the house up to a point with various domestic chores and one resident particularly liked to help in the garden and used the greenhouse for growing plants. Only one resident had any significant family contact, which was facilitated by the Home in line with agreed plans. The two longstanding residents were well known in the neighbourhood and had local visitors though neither had any particular friendships amongst their peer group. All residents said they enjoyed their food at the Home and menus seen were suitable in terms of nutrition and variety. One resident had some specific dietary needs, which were monitored appropriately. Residents confirmed that they also have a full meal at their day centre on weekdays. Laurieston House DS0000062837.V300582.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The general health needs of residents were satisfactorily promoted and any specific individual needs were monitored appropriately with the support of specialist community health services. EVIDENCE: Personal care needs were minimal amongst the resident group and mostly a degree of prompting was just required. Discussions with the manager and staff member indicated that these matters were dealt with sensitively. 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. Strategies to deal with specific behavioural patterns had been developed and the manager stated that she felt confident in following agreed plans and had good ongoing support and advice from the community team working from Ash Green hospital for people with learning disabilities. All Laurieston House DS0000062837.V300582.R01.S.doc Version 5.2 Page 14 residents were in contact with Ash Green for regular reviews and relevant records were maintained. Two of the residents were in receipt of regular medication, which 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, and there was now written evidence of this. Medication levels were reviewed regularly at Ash Green. Laurieston House DS0000062837.V300582.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have opportunities to express their views and any concerns. Their interests would be further enhanced through all staff having specific training in the protection of vulnerable adults. EVIDENCE: The Home has the required policies and procedures for complaints. It was stated that there had been no formal complaints since the last inspection and none have been made to The Commission. Residents have opportunities at house meetings to air any issued and these are held on a regular basis. Both the registered responsible individual and the manager have attended local interagency training run by the social services department regarding protection and abuse and have relevant policy and procedural information to hand. However, the recently appointed care staff have yet to receive specific input in this area. Laurieston House DS0000062837.V300582.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy a comfortable and homely environment that suits their needs and is well maintained. EVIDENCE: Most areas of the Home were viewed. Since the last inspection there has been some alterations in order to accommodate increased occupancy. One of the downstairs lounges has been converted to a bedroom with en suite shower and toilet. This was seen and was suitably furnished and decorated with the new resident having already personalised the space. Communal areas, including the dining area within the kitchen were also well maintained and the Home continues to be suitably decorated and furbished throughout. The Home is run on domestic lines and was homely and clean with fixtures and fittings of a good standard. All bedrooms were comfortably furnished and very much personalised by each resident. One resident’s room is below size requirements but it was his own choice to remain in that room. The proprietors’ bedroom with en suite facilities Laurieston House DS0000062837.V300582.R01.S.doc Version 5.2 Page 17 is also now registered for resident use and they plan to move out as soon as any further referral is made. Externally, the Home is similar in type to 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 DS0000062837.V300582.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ interests would be better served through more thorough recruitment practices and the development of a structured training programme for staff. EVIDENCE: Since the last inspection the manager has taken on two new care staff who are still within their three month probationary period. The assistant manager has now changed to an administrative role without any direct care involvement. Rotas were seen and generally matched the needs of residents with shift patterns flexible to incorporate any social activities. However, the rotas did not always clearly detail the exact hours worked by individual staff. Staff files were examined. These did not have full job application forms covering previous employment details. Written references were taken up though one member had started employment (under supervision) without POVA references or a Criminal Records Check having been obtained. There were no clear induction records on file though the manager is starting to use the training framework produced by ‘Skills for Care’. Staff contracts were on file and relevant training records, though clear systems for the individual supervision of staff, appraisals, skills analysis and ongoing training plans were Laurieston House DS0000062837.V300582.R01.S.doc Version 5.2 Page 19 not yet developed. One new recruit already has NVQ qualifications and the manager is continuing her NVQ course in care and management. Laurieston House DS0000062837.V300582.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 40 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from an open atmosphere and safe environment at the Home, which is generally effectively managed. EVIDENCE: The Home has a relaxed and open atmosphere with residents very much at ease around the premises using their rooms and lounge areas as they wanted and comfortable with each other. Both residents who have come to the Home in the past few months stated they had settled in well and liked living there. Discussions with residents confirmed that they were consulted about the running of the Home and they were quite happy to express their opinions. However, the Home does not have formal aims and objectives or quality monitoring systems. Laurieston House DS0000062837.V300582.R01.S.doc Version 5.2 Page 21 The manager has developed a comprehensive range of policies, including relevant Health and Safety procedures. Checks and servicing records for utilities were up to date with the five year electrical certificate to be renewed shortly. Fire safety measures were in place and the Fire Officer had been satisfied with these at his inspection earlier in the year at the time of the Home’s change in registration. However, Fire drills had not taken place though the alarm was tested regularly. Laurieston House DS0000062837.V300582.R01.S.doc Version 5.2 Page 22 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 Standard No Score 1 2 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 1 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 3 X 3 X Laurieston House DS0000062837.V300582.R01.S.doc Version 5.2 Page 23 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 YA34 Regulation 19 Requirement The manager must establish clear staff recruitment procedures that ensure full job application forms, CRB checks and induction records are in place. The manager must develop a structured training programme for staff. The manager must establish clear processes for the individual supervision and appraisal of staff. Timescale for action 31/08/06 2. 3. YA35 YA36 18 18 30/09/06 30/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA1 YA7 YA16 Good Practice Recommendations The Home’s statement of purpose should reflect staffing arrangements and qualifications. Residents should be given clear information on the availability of independent advocacy services. Residents should be given the option of having their own bedroom key. DS0000062837.V300582.R01.S.doc Version 5.2 Page 24 Laurieston House 4. 5. 6. YA23 YA39 YA42 All staff should have specific training in protection and abuse. More systematic quality assurance processes should be developed. Regular fire drills should take place. Laurieston House DS0000062837.V300582.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office 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. Extracts may not be used or reproduced without the express permission of CSCI Laurieston House DS0000062837.V300582.R01.S.doc Version 5.2 Page 26 - 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!