Inspection on 26/06/07 for Laurieston House

This inspection was carried out on 26th June 2007.

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

Laurieston House 20/07/06

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 Denise Bate Unannounced Inspection 26th June 2007 01:30 Laurieston House DS0000062837.V339006.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.V339006.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.V339006.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.V339006.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. 20th July 2006 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. The homes current charges are £355 per week and residents pay for their own hairdressing, chiropody and toiletries. A copy of the last inspection report is kept at the home and made available to residents and/or their advocates on request. Laurieston House DS0000062837.V339006.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place at the home over four hours. Additionally, time was spent in preparation for the inspection, looking at previous reports, the service history and other documents. The manager had completed a pre inspection questionnaire prior to the visit and all residents had sent in a completed questionnaire. Care planning documentation and other records were seen including care planning documentation, policies and procedures, resident meeting minutes, and staff files and training records. A tour of the building was made and discussions took place with one of the proprietors who is also the registered manager. A member of staff was spoken with. The inspector met the current four residents, who were spoken with and some their views about services at the home are reflected within this report. Two residents were case tracked and their care planning documentation looked at in detail. What the service does well: What has improved since the last inspection? A number of requirements made at the last inspection have been complied with. The manager has established staff recruitment procedures to ensure that job application forms are completed and CRB checks carried out. Staff training is taking place and induction records are kept. The manager has put in place a staff supervision procedure and it is anticipated that this will become more detailed and regular as current staff induction training is completed. A resident survey and ‘stakeholder’ survey have been undertaken. Laurieston House DS0000062837.V339006.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Laurieston House DS0000062837.V339006.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.V339006.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. JUDGEMENT – we looked at outcomes for the following standard(s): 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 their needs assessed in an appropriate manner, ensuring that the placement is suitable. EVIDENCE: Two residents were case tracked, and copies of pre placement assessments were seen on their care planning documentation. Some resident’s histories were discussed in detail, and residents had responded to the caring atmosphere within the home. The most recently admitted resident said that ‘I felt nervous before I came but I like it here now’. The resident survey indicated that residents felt they did have sufficient information before they moved into the home, although some residents had limited understanding and relatives had advocated on their behalf. The home has a vacancy at the moment, and the ability of any new resident to fit in with current residents needs will be a consideration in filling the vacancy. Laurieston House DS0000062837.V339006.R01.S.doc Version 5.2 Page 9 Copies of individual contracts are held on individual files. Laurieston House DS0000062837.V339006.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care plans and risk assessments relating to personal and social care needs of residents are generally completed in sufficient detail to direct and inform staff on how individual needs should be met. EVIDENCE: The two care records examined indicated that residents have an individual care plan, which includes aspects of personal and emotional care, and social activities. There were photos, front sheets with basic information, histories and information provided by relatives and professionals, individual care plans, copies of reviews, risk assessments and details of medication and contact with health professionals. Some information was duplicated in different documents, and not all assessments had been dated and signed. Residents had not signed their care planning documentation, although all residents indicated that they Laurieston House DS0000062837.V339006.R01.S.doc Version 5.2 Page 11 were very satisfied with the standards of care provided. Most residents were able and required ‘prompting’ rather than the direct provision of personal care. Most also help about the home which they enjoy as they feel they are making a meaningful contribution. One resident took in the washing, and another resident said she kept her room tidy. All residents spoken with said they were happy at the home and they appeared relaxed, confident and friendly. They indicated that they liked living at the home and they got on well together. They were observed interacting with the proprietor and member of staff in a relaxed and friendly manner. All residents were eager to talk about the activities that had taken place during the day at their day centres. Laurieston House DS0000062837.V339006.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides outings, activities and individual and group support which enhance the quality of life of residents. EVIDENCE: Information on care plans and discussion with the manager demonstrated that residents’ emotional welfare was monitored, with the support of specialist resources such as staff from Ash Green Hospital. The manager also stated that she generally received good ongoing support from specialist sources, such as the C.P.N. and social services, in terms of any care and risk strategies. From discussions with staff and residents together with care plan records it was clear that residents have a wide range of recreational opportunities in accordance with their interests and wishes. Residents are involved with local Laurieston House DS0000062837.V339006.R01.S.doc Version 5.2 Page 13 day care facilities to varying degrees, including day centre resources. Local shops and pubs are accessed as well as the town centre. Within the home there are communal TV and music facilities and most residents also have a television and/or music centre in their bedrooms. Residents often go out together, particularly at weekends. Examples were given of the range of activities which take place within the home which include bingo, baking and board games. There is a very pleasant garden which is enjoyed and residents help with garden maintenance. Staff spoken to emphasised that residents have choice in their daily life and are consulted about how their care is provided. Comments included; ‘residents have a good qualify of life with lots of variety’, ‘standards are good here’, ‘people get individual attention, they have different needs’. As already mentioned, interaction between staff and residents was relaxed and spontaneous. Residents comments included; ‘I like living here’, ‘the house is nice’, ‘I like to keep busy’. All the residents said they got on well together and they were friends. Some residents mentioned that there had been difficulties with a former resident who has recently left. The manager and staff said that visitors are always welcome, but only one resident has a relative who visits regularly. The manager said that information about advocacy services was available in the home, but that no resident wanted to access these services at the present time. Following the resident survey a meeting was held to review the menus and some changes were made. The residents told the inspector that they liked the food they were offered and that they enjoyed their meals. Laurieston House DS0000062837.V339006.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Healthcare records are documented and the home is pro-active in seeking help with health concerns ensuring that service users health needs are met. EVIDENCE: Reference to residents’ health, personal and social care needs are made on care planning documentation and were seen by the inspector. Residents spoken to indicated that care is provided in a way that is appropriate and acceptable to them. Personal care needs are minimal amongst the resident group and usually only a degree of prompting is required. Discussions with the manager and staff member indicated that these matters were dealt with sensitively. Laurieston House DS0000062837.V339006.R01.S.doc Version 5.2 Page 15 Residents are generally in good general physical health and there are records on care plans of any appointments with community health resources such as G.P., optician and dentist. As mentioned previously, the home received good support from Ash Green Hospital, C.P.N.s, and other health and social care professionals when appropriate. Several examples of working together were given to the inspector. Only one resident is in receipt of regular medication, which was stored securely and records of administration are maintained. The layout of the home is not suitable for people with physical disabilities as the corridors are narrow and most of the bedrooms are upstairs. Laurieston House DS0000062837.V339006.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clear and accessible complaints and safeguarding adults procedures are in place to ensure residents can be confident that any issues raised would be acted on effectively and promptly. EVIDENCE: The Home has the required policies and procedures for complaints. The home is small, residents see the manager/proprietor on a day to day basis, and any problems are dealt with as they arise. Information provided in the pre inspection questionnaire that there have 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 issues and these are held on a regular basis and records kept. The manager has attended local interagency training run by the social services department regarding safeguarding adults and the home have relevant policy and procedural information in their policies and procedures manual. Recently appointed care staff have received training in ‘adult protection’ issues and this was confirmed by a member of staff, who was aware of safeguarding adults issues and took her responsibilities very seriously. She talked about her commitment to maintaining residents safety on a routine basis, e.g. when taking residents on outings, and also protecting the residents from potential Laurieston House DS0000062837.V339006.R01.S.doc Version 5.2 Page 17 situations where they might be vulnerable. Risk assessments had been undertaken which provided advice to staff on identified risks. No issues regarding safeguarding adults have been raised with the CSCI. Laurieston House DS0000062837.V339006.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well appointed and maintained providing a high standard of accommodation in both individual and communal areas enhancing the quality of life for residents. EVIDENCE: The home is run on domestic lines and was homely and clean with fixtures and fittings of a good standard. Communal areas, including the dining area within the kitchen are also well maintained and the home continues to be suitably decorated and furbished throughout. The residents showed the inspector their bedrooms. All bedrooms were comfortably furnished and personalised by each resident with photos, Laurieston House DS0000062837.V339006.R01.S.doc Version 5.2 Page 19 calendars, pictures and momentoes. One resident’s room is below current size standards but it is his choice to remain in that room. Externally, the home is similar to surrounding properties and convenient for local shops and transport. There is a good sized, attractively maintained garden with sitting areas for resident use, and a greenhouse. There is domestic sized laundry equipment and clothes are laundered daily or as necessary. Standards of cleanliness and hygiene are good and the residents were all well dressed in clean and appropriate clothing. As mentioned previously the layout of the home is such that it would not be suitable for residents with physical disabilities. Laurieston House DS0000062837.V339006.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35, 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Competent staff meet the dependency needs of residents currently accommodated within the home. Residents’ interests would be served by having a higher proportion of current staff trained to NVQ level 2. EVIDENCE: There have been several staff changes since the last inspection. Several of the NVQ trained staff have left. The manager has taken on three new care staff since January 2007, one of whom is still within their three month probationary period. Rotas were seen and generally matched the needs of residents with shift patterns but the manager is currently taking on most of the ‘day to day’ caring responsibilities for residents and is doing the majority of the ‘sleep ins’. The manager and member of staff spoken to are mindful of their responsibilities as there is sometimes only one member of staff on duty. Laurieston House DS0000062837.V339006.R01.S.doc Version 5.2 Page 21 Two staff files were examined. These had job application forms covering previous employment details. Written references were taken up, though the reference forms provided by the home are very brief and give little space for referees to put comments. Criminal Records Checks had been obtained and evidence of this was on staff files. There was a clear induction record that had been completed by staff and the manager. Staff contracts and relevant training records were on staff files. A clear system for the individual supervision of staff was in place. Staff supervision was not taking place at the recommended frequency of six times per year so it is envisaged that staff supervision and appraisal could take place on a more regular basis when NVQ2 and other training has been completed. The home are in contact with ‘Skills for Care’, and hope to benefit from staff undertaking NVQ2 training in the near future. At present one of the four members of staff has a nursing qualification, and another member of staff is due to start NVQ2 training in the near future. Other staff have undertaken mandatory training, some of which is in house, and training records were seen on staff files. However, at present the home does not meet the standard of having 50 of staff trained to NVQ2 standard and there have been a lot of staff changes this year. Laurieston House DS0000062837.V339006.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is an experienced manager in post and residents are able to express their views, thus ensuring the home is run in the best interests of residents. EVIDENCE: The manager is experienced and has a caring and responsible attitude towards every aspect of running the home. The requirements made at the last inspection have been met. At present she is still in the process of completing the NVQ4 registered managers award. As well as supporting staff and carrying Laurieston House DS0000062837.V339006.R01.S.doc Version 5.2 Page 23 out other management responsibilities she currently spends a lot of time providing day to day care to residents. Residents indicated that she was very approachable and they were observed having a natural and supportive relationship with her. Staff said that the manager was supportive, was prepared to listen to staff suggestions and provides training opportunities. Discussions with residents confirmed that they were consulted about the running of the home and they were quite happy to express their opinions. A survey of residents views was held last year which indicated that residents were very satisfied with the care provided. Residents had been helped by staff to fill in the questionnaire. Consideration may be given in the future for an independent person, possibly an advocate, to help residents complete questionnaires. A ‘stakeholder’ survey was also done which covered an employee, health and social care professionals, and relatives, which also indicated a high level of satisfaction with services provided by the home. 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.V339006.R01.S.doc Version 5.2 Page 24 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 X 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 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 2 34 3 35 2 36 x 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 3 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 3 3 X X 3 x Laurieston House DS0000062837.V339006.R01.S.doc Version 5.2 Page 25 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. 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 Refer to Standard YA6 Good Practice Recommendations Care planning documentation should be consolidated and care taken to sign and date all documents. Residents should sign their care planning documents to indicate that their care plans have been discussed with them. The home should have 50 of staff trained to NVQ level 2 to ensure residents are cared for by appropriately qualified staff. Supervision should be detailed, cover all areas of carer responsibilities, and take place six time per year to ensure that staff get the support and supervision they need to provide appropriate care for residents. The manager should complete her NVQ registered managers award to obtain the recognised qualification. Regular fire drills should take place. DS0000062837.V339006.R01.S.doc Version 5.2 Page 26 2 3 YA32 YA36 4 5 YA38 YA42 Laurieston House Laurieston House DS0000062837.V339006.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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.V339006.R01.S.doc Version 5.2 Page 28 - 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!