CARE HOME ADULTS 18-65
Laverneo Pennywell Road Nookside Sunderland SR4 9HZ Lead Inspector
Unannounced Inspection 25th January 2006 10:00 Laverneo DS0000015745.V267872.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 Laverneo DS0000015745.V267872.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. Laverneo DS0000015745.V267872.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Laverneo Address Pennywell Road Nookside Sunderland SR4 9HZ 0191 528 6908 0191 242 1648 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) SCOPE Ms Elaine Douglass Care Home 4 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (1), Physical disability (3) of places Laverneo DS0000015745.V267872.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 12th August 2005 Brief Description of the Service: Laverneo is a purpose built detached bungalow in the Pennywell area of Sunderland. The service is run by the charity, SCOPE and New Leaf Housing Association owns the property. 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 with 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 DS0000015745.V267872.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took 3.5 hours over one day in January 2006. However the manager was unavailable at that time so a follow up telephone conversation took place with her two days later to discuss issues about the home and the Requirements and Recommendations of the previous report. In her absence staff on duty accommodated the inspection process with confidence. The views of four service users and three 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. As part of the inspection process a sample of service users’ care files and the homes records were also examined as well as a tour of the building. What the service does well: What has improved since the last inspection?
So that service users are aware of the cost of their care and who is responsible for paying the fees the full amount is now included in their individual contracts. It clearly states what is included in and what part of the fee service users are responsible for. The document also identifies how service users will access their money to pay this.
Laverneo DS0000015745.V267872.R01.S.doc Version 5.1 Page 6 Service users discussed with enthusiasm, the holidays taken during the previous summer, and the decision taken by them to have individual holidays in locations preferred and chosen by the individual, rather than going away in a group. This demonstrates the progress and further development of the service users who are now able to communicate confidently their individual wishes and preferences based on experiences provided. 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 DS0000015745.V267872.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 Laverneo DS0000015745.V267872.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): 2, 5 It is the policy of the home to carry out preadmission assessments with each service user prior to moving into the home and to continue the assessment process periodically to ensure that the service needs and their aspirations continue to be met. Service users are given contracts so that they are aware of the terms and condition of their stay. EVIDENCE: The organisation has comprehensive policies and procedures regarding the admission process. All of the service users’ care files were examined and records demonstrate that pre admission assessments had taken place, by Care Managers and medical professionals, prior to the service users moving into the home. Regular monitoring and reviews of the service users needs are carried out and where needed a multi disciplinary team is involved. This allows service users and staff to discuss any changing care needs or individual aspirations while also having professional advice. One review recorded that a physiotherapist and dietician gave advice in relation to one person’s changing needs, and one monthly review recorded a discussion in relation to one person’s hopes for a holiday abroad. Individual care files include contracts that determine the terms and conditions of each service’s user stay at the home. They also include the cost of the fees charged by the home.
Laverneo DS0000015745.V267872.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): 7 Service users rights are upheld and respected by being supported in all decision-making on a personal and group level. By being offered different opportunities and experiences service users are supported to take control of their own lives. EVIDENCE: Observations during this and previous inspections demonstrate that many of the homes daily issues and decisions are discussed and solved around the home’s dining table. Here service users are actively encouraged to take part in discussions and the decision-making process that affects themselves and the development of the service. Staff stated that this process has progressed over a period of time and has resulted in the development of individual service user’s confidence and skills equipping them to make their own choices and decisions. One service user discussed, with enthusiasm, how they had recently visited a travel agent’s to book a holiday abroad, where they were given many brochures to make their choice of destination from. Their decision to go abroad was made from the first experience to a hot country made the previous
Laverneo DS0000015745.V267872.R01.S.doc Version 5.1 Page 10 year. However another service user who had experienced the same holiday has decided to remain in a cooler climate this year. Staff stated that the recognition of individual likes and dislikes was important and service users now chose to take individual different holidays according to their preferences. Records demonstrate service users preferences, likes and dislikes. Service users manage their finances with the support of staff and any limitations in relation to this are recorded following risk assessment. Records of all financial transactions are recorded in service users files and money held is stored in a secure location. Laverneo DS0000015745.V267872.R01.S.doc Version 5.1 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): Standards not assessed on this occasion. EVIDENCE: Laverneo DS0000015745.V267872.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 Medication arrangements are appropriate for the needs of service users, and are managed in a safe manner that protects service users from harm. EVIDENCE: The home has policies and procedures in place for the safe receipt, recording, storage, handling, administration and disposal of medicines. Medicines are stored appropriately and a drug fridge has been provided for medicines that require cold storage. All staff have completed a twelve week medication course on the safe administration of medicines. The home has regular contact with the pharmacist and GP should there be any concerns regarding service users health care. Currently no service user self medicates. A discussion took place with a member of staff regarding the recording of the application of creams. It was agreed that creams that are prescribed for occasional use only, are only signed for when used. However if a cream is prescribed by a GP for daily use as a course of medication, then this should be signed for appropriately displaying the appropriate code whether administered or not. Laverneo DS0000015745.V267872.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): No standards assessed on this occasion. EVIDENCE: Laverneo DS0000015745.V267872.R01.S.doc Version 5.1 Page 14 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27, 28, 30 As a result of a planned redecorating 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 home was specifically built for the current service users’ needs in 1992. It is a detached bungalow set in its own grounds close to all local amenities. The furniture and fittings are domestic in style, providing a bright cheerful environment and all areas including the gardens are easily accessible to the service users. Service users were observed moving around the house, from the kitchen/dining area to their individual bedrooms independently and safely. The issues relating to the refurbishment needs of the kitchen and bathroom remain. The manager stated that these should be addressed in the near future. A clean fresh and comfortable environment reflects good cleaning routines. Laverneo DS0000015745.V267872.R01.S.doc Version 5.1 Page 15 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 Regular training opportunities ensure that service users are appropriately supported and protected by a competent and qualified staff team. EVIDENCE: The home has a training budget and training and development plan to ensure the staff maintain and develop skills to meet the needs of the service users. Staff confirmed that they all have a training and development file and at least five days paid training each year. Training covers issues relating to the needs of the service users for example safe working practices, cerebral palsy disability, diabetes and challenging behaviour as well as mandatory training. Staff confirmed that their training needs are addressed and confirmed that they all now have NVQ 2 and some have, or are working towards, NVQ3. As the manager was not available on this occasion staff files could not be accessed, however staff files were examined at a previous inspection where records demonstrated the above training. Laverneo DS0000015745.V267872.R01.S.doc Version 5.1 Page 16 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, 42 The manager, who is well supported by the staff team, provides a service that is well run, monitored and focussed on the best interests of the service users. EVIDENCE: There is a clear administrative system that supports a well run home. Records are accessible, clear and stored securely, however the fire records in relation to the checking of the fire equipment and the recording of fire drills/instruction has recently been changed and in the absence of the manager staff could not locate it. This meant that recent records in relation to fire safety in the home could not be accessed. Observations and discussions with service users and staff confirmed that effective relationships continue to develop between service users, staff and the manager. Service users and staff spoke about the manager and the running of the home with confidence and respect. Staff were observed working appropriately in relation to health and safety procedures. Health and safety issues have been addressed in the main body of
Laverneo DS0000015745.V267872.R01.S.doc Version 5.1 Page 17 this report and include issues relating to; the recording of the administration of skin creams; training in relation to the administration of insulin and enemas; refurbishing of the kitchen and bathroom; the recording of fire procedures. Laverneo DS0000015745.V267872.R01.S.doc Version 5.1 Page 18 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 3 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 2 25 X 26 X 27 2 28 2 29 X 30 3 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 3 X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 2 2 X 3 X X X X 2 X Laverneo DS0000015745.V267872.R01.S.doc Version 5.1 Page 19 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 YA20YA42 Regulation 13(2) Requirement Timescale for action 28/02/06 2 3 The medication record should make it clear when a cream is prescribed for occasional use, and when it is prescribed as a course to be followed daily, and the record sheet must be complete as appropriate. YA19 13(1)&(2)(b) So that the administering of & 18(1) insulin and the giving of YA20YA42 enemas by the care staff of the home, is monitored and the procedures carried out continue to be appropriate, safe and up to date, arrangements must be made for a health care professional specialising in these procedures to review and retrain staff if needed. A report relating to this must be supplied by the professional carrying out the review and a copy sent to the CSCI. YA24YA27YA29 23 The registered manager must ensure that the bathroom is redecorated and refurbished to meet the service users assessed
DS0000015745.V267872.R01.S.doc 30/03/06 30/03/06 Laverneo Version 5.1 Page 20 4 YA24YA28 23 needs. (Timescale of 01.01.05 not met.) The registered manager must ensure that the kitchen units are replaced with units that meet the requirements of the home and assessed needs of service users.The kitchen also requires redecoration.(The timescale of 01.02.05 was not met) 30/03/06 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 Refer to Standard YA30 Good Practice Recommendations It is recommended that the laundry is refurbished to include wall coverings that are easy to clean. Laverneo DS0000015745.V267872.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT 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 Laverneo DS0000015745.V267872.R01.S.doc Version 5.1 Page 22 - 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!
