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Inspection on 10/02/06 for Lavender Fields (1)

Also see our care home review for Lavender Fields (1) for more information

This inspection was carried out on 10th February 2006.

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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Lavender Fields is clearly run in the best interests of the service users who view the service very much as their home. All four service users at home for this inspection were very positive about the experience of living at Lavender Fields. One service user stated that "this was the best home she had ever lived in". All were positive about the staff and the choices offered to them in maintaining their independence. Staff training is provided and service users can be assured that competent staff are available to meet their needs. A training programme has also been developed for service users to enhance their individual living skills.

What has improved since the last inspection?

The previous requirement for a redecoration plan to be in place has been implemented, as has the requirement for the first aid risk assessment to be reviewed and dated. The recommendation to support service users by offering basic food hygiene training has also been addressed and a series of training dates have been advertised. Although it was noted that the corridors are subjected to heavy use as wheelchairs damage the skirting on-going maintenance/redecoration work does take place. The registered manager has now completed her Registered Managers award (RMA). Training is underway for staff for NVQ level 3. Service users confirmed that they are aware of and involved in the development of their Individual Support Plans (ISP).

What the care home could do better:

The manager stated that the staff group continue to strive to make things better all the time involving service users in the home. One minor error was found on the Medication Administration Records (MAR). Care must be taken to ensure all medication is administered and signed for to ensure the safety of all service users. A requirement has not been made in this instance, as it is evident that this was a slip and not a regular occurrence. Although the views of service users are continuously sought through regular residents meetings and an annual questionnaire it was noted that the quality assurance procedure must be further developed so to involve and obtain the views of all interested stakeholders in Lavender Fields.

CARE HOME ADULTS 18-65 Lavender Fields (1) 1 Lavender Fields Lucas Lane Hitchin Hertfordshire SG5 2JB Lead Inspector Mrs Helen Pettengell Unannounced Inspection 10th February 2006 10:00 Lavender Fields (1) DS0000058611.V277888.R01.S.doc Version 5.1 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 Lavender Fields (1) DS0000058611.V277888.R01.S.doc Version 5.1 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. Lavender Fields (1) DS0000058611.V277888.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lavender Fields (1) Address 1 Lavender Fields Lucas Lane Hitchin Hertfordshire SG5 2JB 01462 452460 01462 440186 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) Leonard Cheshire Elizabeth Turton Care Home 10 Category(ies) of Physical disability (10), Terminally ill (10) registration, with number of places Lavender Fields (1) DS0000058611.V277888.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may only accommodate service users between the ages of 16 and 24. 7th September 2005 Date of last inspection Brief Description of the Service: Number 1 Lavender Fields is a purpose built care home with nursing, registered to provide care and accommodation for up to 10 young physically disabled people between the ages of 16 and 24 years. It is owned and operated by the Leonard Cheshire organisation.The young persons unit is part of a social care complex which sits in its own landscaped grounds close to the town centre of Hitchin, with its shops, transport and social amenities.The home is built on one level and comprises two wings with large bedrooms, each with full en-suite facilities and access to a patio area overlooking the grounds.There is a communal lounge, kitchen and dining room and a large study/activity room that includes an information technology suite.Lavender Fields is intended to provide a transitional service supporting, encouraging and equipping young people to gain the life skills and confidence they need to enable them, where appropriate, to move on to more independent living settings. Lavender Fields (1) DS0000058611.V277888.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the second of the statutory inspections for this service. The focus was on completing core standards not assessed at the previous inspection and talking with service users regarding their experience of the home. Reference should be made to the report of the inspection for 7 September 2005 for comments on standards not inspected on this occasion. A total of 3 inspector hours was allocated to this inspection. All previous regulatory requirements were met as was the recommendation made in the last report. This was a very positive inspection. All service users spoken to were positive about the home. Lavender Fields currently has no service users vacancies. What the service does well: What has improved since the last inspection? The previous requirement for a redecoration plan to be in place has been implemented, as has the requirement for the first aid risk assessment to be reviewed and dated. The recommendation to support service users by offering basic food hygiene training has also been addressed and a series of training dates have been advertised. Although it was noted that the corridors are subjected to heavy use as wheelchairs damage the skirting on-going maintenance/redecoration work does take place. The registered manager has now completed her Registered Managers award (RMA). Training is underway for staff for NVQ level 3. Service users confirmed that they are aware of and involved in the development of their Individual Support Plans (ISP). Lavender Fields (1) DS0000058611.V277888.R01.S.doc Version 5.1 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. Lavender Fields (1) DS0000058611.V277888.R01.S.doc Version 5.1 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 Lavender Fields (1) DS0000058611.V277888.R01.S.doc Version 5.1 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): Not inspected please refer to previous inspection report dated 7 September 2005 for comments. EVIDENCE: Lavender Fields (1) DS0000058611.V277888.R01.S.doc Version 5.1 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): Not inspected please refer to previous inspection report dated 7 September 2005 for comments. EVIDENCE: Lavender Fields (1) DS0000058611.V277888.R01.S.doc Version 5.1 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 the following standard(s): 15 Service users are supported as necessary to maintain appropriate personal relationships. EVIDENCE: Service users confirmed that their relatives and friends could visit and/or stay for meals as they wished. They also confirmed that friends can stay over night as long as there is enough notice for beds to made up for them. Information to maintain healthy appropriate relationships and how to be safe would be provided as required. The manager confirmed that information would be contained in the Individual Support Plan (ISP) as required e.g. on any restrictions on visitors or contraception. Lavender Fields (1) DS0000058611.V277888.R01.S.doc Version 5.1 Page 11 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): 20 Service users are empowered to maintain control of their medication where safe to do so. Appropriate policies and procedures are in place for the safe administration of medication. EVIDENCE: Medication is held in service users own bedrooms and the Medication Administration Records (MAR) are held in the treatment room. One minor error was found on the MAR sheets with one missed signature. Care should be taken to ensure all medication administered is signed for. A requirement has not been made in this instance, as it is evident that this was a slip and not a regular occurrence. Risk assessments are in place for service users who are able to safely self-administer medication. The manager reported that the organisation is quite rightly looking to implement risk assessments for all service users to indicate why it is unsafe for them to maintain their own administration of medication. Coming from the belief that all service users should retain the responsibility for administering medication unless the risk assessment shows otherwise. A contract for the returns of medication is held although the record was not examined on this visit. A medication fridge is available with the temperature checked and records maintained. Lavender Fields (1) DS0000058611.V277888.R01.S.doc Version 5.1 Page 12 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): Not inspected please refer to previous inspection report dated 7 September 2005 for comments. EVIDENCE: All service users spoken to stated that they were aware of how to make a complain, would feel supported to do so if required and are confident that appropriate action would be taken to address any issues. Lavender Fields (1) DS0000058611.V277888.R01.S.doc Version 5.1 Page 13 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): Not inspected please refer to previous inspection report dated 7 September 2005 for comments. EVIDENCE: However, Lavender Fields presented as a homely, clean and safe environment that service users had clearly made home. Lavender Fields (1) DS0000058611.V277888.R01.S.doc Version 5.1 Page 14 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): 35 Service users can be assured that staff are appropriately trained to meet their individual needs. EVIDENCE: A thorough training programme is in place with excellent records (training matrix) maintained to verify training provided or highlight training needs. The training matrix is sent to head office on a quarterly basis for audit purposes. A member of staff has responsibility for coordinating training. Staff confirmed that they had access to training as required. Training can be identified in supervision and all staff have a personal development plan. The manager has completed her RMA and the deputy is soon to start on the same qualification. A number of staff have enrolled in level 3 NVQ and a further 2 are registering in April. 2 staff are completing the A1 (was previously D32/33) NVQ assessors award. Lavender Fields (1) DS0000058611.V277888.R01.S.doc Version 5.1 Page 15 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): 39 Service users are confident that their views are sought and acted upon as appropriate. However, further development of the quality monitoring to include all stakeholders must be undertaken to improve the overall system. EVIDENCE: The current procedure includes an annual questionnaire given to service users. This has just been completed and the questionnaires were examined during the inspection. Further development of the system needs to include all interested stakeholders so that their views can also be sought to bring about improvements if required. The manager stated that the questionnaires are sent to head office who analyse them and produce a report. She also confirmed that the date for the annual internal audit conducted by head office had been set for April. Lavender Fields (1) DS0000058611.V277888.R01.S.doc Version 5.1 Page 16 Service users meetings are held regularly – minutes are maintained and were examined. Service users stated that they feel that they can raise issues as they wish and that they are addressed appropriately. A newsletter for service users and staff is produced and a copy was available on the notice board. Service users confirmed that they have access to advocacy as required. Two service users were very proud that they had put their names forward and been accepted as representatives on the Leonard Cheshire Disabled People’s Forum. Lavender Fields (1) DS0000058611.V277888.R01.S.doc Version 5.1 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 X 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 X 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 x 33 X 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 2 X X X 2 X X X X Lavender Fields (1) DS0000058611.V277888.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? No 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 YA39 Regulation 24(3) Requirement All service users representatives’ views must be sought as part of the quality assurance system. Timescale for action 01/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Lavender Fields (1) DS0000058611.V277888.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Lavender Fields (1) DS0000058611.V277888.R01.S.doc Version 5.1 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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