CARE HOME ADULTS 18-65
Laverneo Pennywell Road Nookside Sunderland SR4 9HZ Lead Inspector
Elsie Allnutt Announced Friday, 12 August 2005 : 10:00
th 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. Laverneo B52-B02 S15745 Laverneo V219406 12 Aug 05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Laverneo Address Pennywell Road, Nookside, Sunderland SR4 9HZ 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) 0191 528 6908 0191 242 1648 SCOPE Ms Elaine Douglass PC care home only 4 Category(ies) of 4 x LD; 3 x PD; 1 x LD(E) registration, with number of places Laverneo B52-B02 S15745 Laverneo V219406 12 Aug 05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 24 February 2005 Brief Description of the Service: Laverneo is a purpose built detached bungalow in the Pennywell area of Sunderland. It is situated in a residential area, close to bus routes and other local amenities.The staff provide personal care for four service users who have a learning disability. The age range of the service users, who are all female ranges from 41 to 72 years.The home comprises of a lounge, kitchen/dining room, four single bedrooms, two toilets, a bathroom and a shower room. An office/sleep in room is provided for staff who share communal areas within the service users.Externally there is an easily accessible garden, parking facilities are available and there is a separate garage.The home has it’s own transport. Laverneo B52-B02 S15745 Laverneo V219406 12 Aug 05 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This announced inspection took 7 hours over one day in August 2005. The views of four service users and four members of staff were sought. Service users’ satisfaction of the service provided not only relied on verbal communication but it was also interpreted through observations of body language, interaction with staff, discussions with staff and the examination of records. This process demonstrated that all were satisfied with the service and the care and support given by staff. Two relatives of the service users also gave positive feedback in relation to the satisfaction of the service provided via surveys carried out prior to the inspection. As part of the inspection process a sample of service users’ care files and the homes records were also examined. What the service does well: What has improved since the last inspection?
Laverneo B52-B02 S15745 Laverneo V219406 12 Aug 05 Stage 4.doc Version 1.40 Page 6 In order that the environment is kept to a good quality standard a redecorating programme has been put into action since the last inspection. All of the service users bedrooms have been redecorated, and with the addition of small furnishings that coordinate with the colours, attractive areas for the service users to enjoy and relax in have been developed. Much work has been carried out by the home to develop a system to monitor the quality of the service that is being delivered. In addition to the monitoring work carried out by the manager and staff, service users, staff and other people involved in the service have received questionnaires to complete. The manager explained that the outcomes of the questionnaires were analysed and used in developing the service further. 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. Laverneo B52-B02 S15745 Laverneo V219406 12 Aug 05 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 Laverneo B52-B02 S15745 Laverneo V219406 12 Aug 05 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) 5 Service users are aware of the terms and conditions of their Contracts and understand their rights as well as what is expected of them, however the Contract does not include the full costs of their fees or who is responsible for the paying them. EVIDENCE: Each service user has a signed contract that clearly states the terms and conditions of their stay at the home. This is also available on video in an attempt to make it easier to understand by the service users. However the contract does not inform the service user of the cost of living at the home nor how this is paid. In discussion with the service users they confirmed that they were aware of the content of the contract and the conditions of their stay. Laverneo B52-B02 S15745 Laverneo V219406 12 Aug 05 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) 6,9 Service users assessed needs are reflected within their individual plans of care. These provide guidance for staffs’ care practice. Service users are supported to take risks within a risk management framework. This helps to ensure they remain safe and that their independence is promoted. EVIDENCE: When reading through the care files it was evident that each service user has a care plan that is service user led and which includes appropriate detailed information in relation to their needs, goals and aspirations. Risk assessments and clear risk management plans that include guidelines for staff to follow are an integral part of the care plans. This provides consistency in the delivery of care and protection for the service user. One care plan described one service user’s needs in relation to how much assistance they needed when getting dressed, while at the same time maintaining and promoting their independence. The service user confirmed this
Laverneo B52-B02 S15745 Laverneo V219406 12 Aug 05 Stage 4.doc Version 1.40 Page 10 and described how they chose their own clothing each day and how their choice is respected. Another service user described how they and staff address their occasional challenging behaviour and records in the care plan confirmed this action. Staff confirmed that they had attended training in relation to challenging behaviour and when needed specialist advice was sought for guidance. Records showed that the outcome of individual goals in the care plan is recorded monthly and the care plan itself is reviewed 6 monthly. The local authority carry out annual reviews via a mail questionnaire system, but the manager confirmed that if necessary a member of social services is invited to the home’s review. Laverneo B52-B02 S15745 Laverneo V219406 12 Aug 05 Stage 4.doc Version 1.40 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 standard(s) 12,13,14,15,17 Service users are assisted to lead active and fulfilling lifestyles by having a regular community presence and by accessing a range of community facilities, while also maintaining links with family members. A healthy and nutritious diet is also encouraged and offered. EVIDENCE: Service users discussed a variety of activities they enjoyed including, visiting the theatre, going to local places of interest, line dancing, 10 pin bowling and gardening. Two service users discussed how they enjoyed going to the day centre while another discussed their involvement in integrated activities at the local neighbourhood centre, where they enjoyed gardening and craft sessions. All described how they enjoyed using the local community facilities for example going to the pub for Sunday dinner. Service users and staff confirmed that different venues are offered for holidays away, taking into consideration individual preferences and choices. Two service users discussed with enthusiasm their planned trip abroad, while another two,
Laverneo B52-B02 S15745 Laverneo V219406 12 Aug 05 Stage 4.doc Version 1.40 Page 12 supported by staff, discussed their recent break to London to see Phantom of the Opera, and a planned trip to Edinburgh to see the Edinburgh Tattoo. Service users discussed their family members pointing them out in different photographs in their individual rooms. Staff confirmed that service users are encouraged to maintain contact with families through visits and telephone calls. Although the staff and service uses confirmed that there are set weekly menus, these are flexible and if service users change there mind about what they wish to eat, this is accommodated. However staff confirmed that they support service users to eat a balanced and healthy diet that is also monitored by regular visits from a dietician. Laverneo B52-B02 S15745 Laverneo V219406 12 Aug 05 Stage 4.doc Version 1.40 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 standard(s) 18,19 Service users receive appropriate support from staff to ensure that their personal, physical and emotional health needs are met with the aim of allowing service users to take the lead. However some of the technical aids available could be improved to promote safer practices and independence. EVIDENCE: The manager and staff stated that they support service users to address their individual healthcare needs by assisting them to visit local GPs and attend hospital appointments. Service users confirmed this, and member of staff was observed escorting a service user to a doctor’s appointment. The outcomes of such visits are recorded in the care plans. Service users confirmed that they are assisted with personal tasks in a way that they prefer, while at the same time they are encouraged to be as independent as possible, despite at times the task taking a long time. Two service users were observed being assisted by staff to transfer from different positions, one from a chair to the floor, and another from a chair to a standing position in front of a walking support frame, and allowed to move to different areas of the house independently. This was consistent with guidelines in the individual care plans. Laverneo B52-B02 S15745 Laverneo V219406 12 Aug 05 Stage 4.doc Version 1.40 Page 14 Records also confirmed that all service users are supported to deal with their emotional needs in a calm and constructive way and where needed specialist guidance is sought. Although the home provides various technical aids to assist service users throughout the home, the aids in the kitchen and the bathroom should be updated to promote further safety and independence. Laverneo B52-B02 S15745 Laverneo V219406 12 Aug 05 Stage 4.doc Version 1.40 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 standard(s) 22,23 Arrangements are in place to help protect service users from abuse and to seriously address complaints and concerns about the service. EVIDENCE: Staff confirmed that they have received awareness training regarding abuse and adult protection, as well as training in relation to handling verbal and aggressive behaviour. In discussion staff were able to appropriately describe what action to take in a situation where they witnessed abuse. A copy of the local authority’s adult protection procedure is available within the home, to guide staff on what to do and the people to contact in the event of witnessing abuse, or having an alleged abusive situation reported to them. The home has a comprehensive complaints procedure that is in video format for service users to access. Service users confirmed that they were aware of the procedure and were confident that any concern or complaint made by them is taken seriously. They described how they discuss concerns as soon as they arise, usually around the dining table where they are openly discussed and addressed. They also confirmed that if they wanted to make a formal complaint they knew who to go to. Laverneo B52-B02 S15745 Laverneo V219406 12 Aug 05 Stage 4.doc Version 1.40 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 standard(s) 24,25,27,28,29 As a result of a planned refurbishment programme the standard of the environment is good, providing service users with an attractive and homely place to live. However to ensure that service users and staff are not at risk, and service users’ changing needs are addressed, the plans for the bathroom and kitchen to be refurbished must go ahead. EVIDENCE: The passage way and all of the service users bedrooms have been decorated since the last inspection. Service users bedrooms are individualised through the décor, small furnishings and personal possessions. Service users confirmed that they had chosen the colours and the small furnishings for their individual rooms. One service user demonstrated how they had made their choice, by first deciding what they wanted from a range of items in a store catalogue, and then going out with staff to purchase them. . The manager stated that she had sought advice from an Occupational Therapist and the Company’s Health and Safety advisor in relation to the
Laverneo B52-B02 S15745 Laverneo V219406 12 Aug 05 Stage 4.doc Version 1.40 Page 17 refurbishment needs of the bathroom. Both have advised that a high/low bath, with space at either side for staff to support service users, would protect service users and staff from possible injury. The Occupational Therapist also gave advice on the needed improvements of the kitchen that is currently poorly equipped in relation to storage, workspace and appliances. Estimates for the refurbishments have been received and these, with the reports from the Occupational Therapist, are to be sent to New Leaf the housing agency responsible for the building. Laverneo B52-B02 S15745 Laverneo V219406 12 Aug 05 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,36 The home employs a competent and qualified staff complement via robust recruitment and selection processes, which means that service users are effectively supported and protected by staff. EVIDENCE: The examination of staff rotas confirmed that an adequate number of staff are on duty each day to address the needs of the service users. This includes three members of staff on duty during the day and one on sleep in duty at night. The examination of staff files provides evidence that good recruitment procedures are in place including the request of two references and clear CRB checks. Staff discussed the needs of the service users with respect and understanding. When observing staffs’ social interaction with service users, their response, and the way they addressed service users’ needs, it was evident that positive relationships have developed between them. There has been a consistent staff team for the past four years and all staff are now qualified in NVQ, this is commended. Laverneo B52-B02 S15745 Laverneo V219406 12 Aug 05 Stage 4.doc Version 1.40 Page 19 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) 39,42 The manager, who is well supported by the staff team, provides a service that is well managed and effectively monitored, and as a result provides a supportive, effective and safe service for service users. EVIDENCE: There is a clear administrative system that supports a well run home. Records are accessible, clear and stored securely. The manager has now completed the Regulation Managers Award and has attended training courses relevant to her role. Observations and discussions with service users and staff confirmed that effective relationships have developed between service users, staff and the manager. Service users and staff were observed approaching the manager with confidence and respect. Laverneo B52-B02 S15745 Laverneo V219406 12 Aug 05 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 x x x x 2 Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 x x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 2 x 3 2 2 2 x Standard No 11 12 13 14 15 16 17 x 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score x 4 4 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Laverneo Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x B52-B02 S15745 Laverneo V219406 12 Aug 05 Stage 4.doc Version 1.40 Page 21 yes 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 24,27,29 Regulation 23 Requirement Timescale for action 30.12.05 2. 24,28 23 3. 5 5(1)(b) The registered manager must ensure that the bathroom is redecorated and refurbished to meet the service users assessed needs. (Timescale of 01.01.05 not met.) The registered manager must 30.12.05 ensure that the kitchen units are replaced with units that meet the assessed needs of service users.The kitchen requires redecoration.(The timescale of 01.02.05 was not met) So that service users are aware 30.09.05 of the cost of their care and who is responsible for paying the fees the full amount must be included in their individual contracts. 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 30 Good Practice Recommendations It is recommended that the laundry is refurbished to include wall coverings that are easy to clean.
B52-B02 S15745 Laverneo V219406 12 Aug 05 Stage 4.doc Version 1.40 Page 22 Laverneo Commission for Social Care Inspection Baltic House Port of Tyne South Shields NE34 9PT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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