Inspection on 05/07/05 for Lawn Court

This inspection was carried out on 5th July 2005.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lawn Court 10/02/09

Lawn Court 15/03/07

Lawn Court 14/02/06

Lawn Court 02/12/04

Lawn Court 30/06/04

Lawn Court 04/02/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Lawn Court 26-27 Park Road Bexhill-on-sea East Sussex TN39 3BZ Lead Inspector Alexis Reilly Unannounced 5 July 2005 11:30 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. Lawn Court H59-H10 S21153 Lawn Court V221407 050705 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Lawn Court Address 26-27 Park Road Bexhill-on-sea East Sussex TN39 3BZ 01424 211476 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) MACA Mrs Sandra Collins Care Home 18 Category(ies) of Mental disorder (MD) 18 registration, with number of places Lawn Court H59-H10 S21153 Lawn Court V221407 050705 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of service users to be accommodated is eighteen (18) 2. Service users must be aged between eighteen (18) and sixty-five (65) years on admission 3. Service users with a diagnosis of Mental disorder, excluding learning disablility or dementia only to be accommodated Date of last inspection 2 December 2004 Brief Description of the Service: Lawn Court is situated in Bexhill on Sea, overlooking Egerton Park. The home is near to the town centre and seafront, and to the local faciliites. The building comprises of four levels with the lounge, dining room and kitchen located on the lower ground floor, the building also has a non-smoking lounge. The service has a self-contained bed sit incorporated in the building for service users to try more independently living. The service has 16 single rooms and one double rooms which is used as a single room. The single rooms have no en suite facility, however the double room does have an en suite. Lawn Court H59-H10 S21153 Lawn Court V221407 050705 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection began at 11.20am and finished at 2.30pm. During the inspection the inspector examined the care plans, risk assessments and assessment documents of residents placed since the last inspection. Policies in relation to the protection of children and vulnerable adults were examined. The complaints book was also examined. The inspector spoke with three members of staff and three residents. What the service does well: What has improved since the last inspection? What they could do better: Following an inspection on the 2nd December 2004, documents were requested prior to the placement of a resident within the service. Although these documents had been produced, the inspector has concerns with regard to the robustness of theses documents, and also to the relevance of them in relation to the particular resident identified. Further issues and concerns with regard to this particular resident were a blank weekly activities plan. There was also some confusion with regard to what this residents activities were during the later half of the week with regard to finding employment. Lawn Court H59-H10 S21153 Lawn Court V221407 050705 Stage 4.doc Version 1.20 Page 6 In addition the inspector interviewed two members of care staff who were unaware of the particular issues regarding this resident. This issues needs to be addressed as a matter of urgency. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Lawn Court H59-H10 S21153 Lawn Court V221407 050705 Stage 4.doc Version 1.20 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 Lawn Court H59-H10 S21153 Lawn Court V221407 050705 Stage 4.doc Version 1.20 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) 1,2,3,4 & 5 Lawn Court always ensures that potential residents receive a variety of information and visit the service prior to making a decision to move there. EVIDENCE: Prior to offering a resident a placement within Lawn Court, the service ensures the resident has all the information with regard to the service offered, fees and terms and conditions of contract. Residents are given a handbook and licence agreement. Residents often have a gradual introduction to Lawn Court, this can incorporate various overnight stays. Lawn Court H59-H10 S21153 Lawn Court V221407 050705 Stage 4.doc Version 1.20 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) 6,7,8,9 & 10 The service supports residents in taking risks, however it has failed to provide adequate risk assessments in relation to one resident placed. This issue needs to be addressed as a matter of urgency. EVIDENCE: Residents have the opportunity to share in the household tasks, such as washing up, laying tables, and choosing their own menus. Residents decide the decoration of their own room and choose the colours and decoration of communal areas. An example of residents’ choice is that all residents agreed as a group on which lounge was to be a non-smoking area. ‘MACA’ head office runs a user involvement group where policies and procedures are discussed with residents. This involvement group has been in place for two years. The service has a policy in place on confidentiality. In general risk assessments in the service are good. However in relation to one particular resident, the inspector has concerns with regard to the assessment of risk. The plan of activities for this resident was left blank. However staff were able to inform the inspector what activities the resident engaged in during the week. Lawn Court H59-H10 S21153 Lawn Court V221407 050705 Stage 4.doc Version 1.20 Page 10 However there was some confusion about the activities carried out in the later part of the week with regard to looking for employment. The resident informed the inspector that he had placed an advert offering his services for work. Staff appeared to be unaware of this fact, and there was no risk assessments’ in place. Lawn Court H59-H10 S21153 Lawn Court V221407 050705 Stage 4.doc Version 1.20 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) 11 Lawn court promotes independence and residents are involved in daily routines within the service. EVIDENCE: Daily routines and house rules promote independence and there are no set times for rising or going to bed. Staff will knock on residents’ doors if they do not rise at the expected time. Residents have their own front door key, and are asked to let staff know if they plan stay out all night due to fire regulations. Lawn Court H59-H10 S21153 Lawn Court V221407 050705 Stage 4.doc Version 1.20 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 standard(s) 18,19 & 20 Residents are supported in all areas of personal and emotional care, and residents are encouraged to be involved in managing their own medication. EVIDENCE: Residents receive support and guidance from staff but are not assisted with bathing or nursing care. Regular health screening is organized through the service users GP. The home receives good support from the external health care professionals and community mental health teams. Staff encourage residents to attend medical health reviews and the dentist, but if they decide not to attend that is their decision. Residents who self-administer their medication have locked facilities in their bedrooms. The home operates a blister pack system. MACCA provide training for new staff on medication during their induction. Medication records were not checked on the inspection. The service has a policy in place and procedure to follow in the event of an unexpected death. This information is included as part of new staff’s induction. Lawn Court H59-H10 S21153 Lawn Court V221407 050705 Stage 4.doc Version 1.20 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 standard(s) 22 Lawn Court acts appropriately with regard to complaints made in the service. EVIDENCE: Lawn court has a complaints policy in place. Residents can and do access this, complaints were recorded and dealt with appropriately. The service has had one complaint since the last inspection this was in relation to a disagreement between residents. Lawn Court H59-H10 S21153 Lawn Court V221407 050705 Stage 4.doc Version 1.20 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 standard(s) 25,26 & 28 There is a need for a redecoration programme, especially in relation to the bedrooms, to be completed within the timescales set by the organisation. EVIDENCE: Redecoration and replacement carpet and furniture in some of the rooms is required, this was a requirement from the last two inspection. Two of the bedrooms have been redecorated so far and the service had planned to originally complete this work by April 2005. The service had also planned to refurbish the small kitchen used by the residents to prepare drinks by June 2005. This refurbishment work will now take place during the next 12 months. The building comprises of 1 smoking lounge, 1 non smoking lounge, a service users kitchen, training kitchen, garden and dining room. All residents have separate bedrooms. Lawn Court H59-H10 S21153 Lawn Court V221407 050705 Stage 4.doc Version 1.20 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35 & 36 The service has a learning and development plan in place and a training budget. EVIDENCE: The service has a ‘MACA’ learning and development programme in place, and a training budget to meet this. The following training has been carried out over the last 12 months; manual handling, food hygiene, first aid, POVA, Topps induction training, and hearing voices. Further training provided by Together has been a boundary course, working with people with personality disorders. There is a planned training session on working with forensic service users. The service is on course to achieve 50 of staff with a qualification of NVQ level 2 or above. Staff receive regular recorded supervision. Currently the Registered Manager supervises the deputy manager and the two senior and one care worker. The senior care worker supervises the social care workers. Supervision is carried out monthly with annual appraisals. Lawn Court H59-H10 S21153 Lawn Court V221407 050705 Stage 4.doc Version 1.20 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 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) 40 The service has failed to provide adequate policies when these have been requested, in relation to the protection of children and vulnerable adults within the service. EVIDENCE: Following the previous inspection carried out on the 2nd December 2004, the inspector requested that particular policies were sent to CSCI. These documents were not received at the CSCI. However the Deputy Manager was able to show the inspector the documents during the inspection. Unfortunately the inspector has concerns with regard to the robustness of these documents. Two staff were interviewed on the day of the inspection and were unaware of risks associated with one particular resident. Lawn Court H59-H10 S21153 Lawn Court V221407 050705 Stage 4.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 2 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score x 2 3 x 3 x x Standard No 11 12 13 14 15 Lawn Court 3 x x x x Standard No 31 32 33 34 35 36 Score x x 3 x 3 3 Version 1.20 Page 18 H59-H10 S21153 Lawn Court V221407 050705 Stage 4.doc 16 17 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x 2 x x x Lawn Court H59-H10 S21153 Lawn Court V221407 050705 Stage 4.doc Version 1.20 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 YA9 Regulation 14(1)(2) Requirement The service must ensure it has sufficient risk assessments in place for residents. Staff must be aware of risk areas. Bedroom require redecorateing apart from bedroom 11, all the bedrooms within the service require replacement carpets. A percentage of the rooms also require new furniture. The service has planned for this maintenance work to be completed within the year. The service must ensure it has the relevant policies and procedures in place to protect vulnerable adults and children. Timescale for action 28th July 2005 1st April 2006 2. YA25 16(2)(c) 23(2)(d) 3. YA40 13(4)(c ) 28th July 2005 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 Good Practice Recommendations Lawn Court H59-H10 S21153 Lawn Court V221407 050705 Stage 4.doc Version 1.20 Page 20 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Lawn Court H59-H10 S21153 Lawn Court V221407 050705 Stage 4.doc Version 1.20 Page 21 - 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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