Inspection on 22/11/05 for Lawn House Care Home

This inspection was carried out on 22nd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Lawn House Care Home 12/03/08

Lawn House Care Home 13/02/07

Lawn House Care Home 21/07/05

Lawn House Care Home 17/02/05

Lawn House Care Home 07/10/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Lawn House Care Home 4 Lawn Road Portswood Southampton Hampshire SO17 2EY Lead Inspector Janet Shipman Unannounced Inspection 22nd November 2005 09:30 Lawn House Care Home DS0000037558.V259647.R01.S.doc Version 5.0 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 Lawn House Care Home DS0000037558.V259647.R01.S.doc Version 5.0 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. Lawn House Care Home DS0000037558.V259647.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Lawn House Care Home Address 4 Lawn Road Portswood Southampton Hampshire SO17 2EY 02380 584911 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) Park Care Homes (No 2) Ltd Mrs Suzanne Welsh Care Home 10 Category(ies) of Learning disability (10), Mental disorder, registration, with number excluding learning disability or dementia (10) of places Lawn House Care Home DS0000037558.V259647.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users may be accommodated between 18 - 60 years of age Date of last inspection 21st July 2005 Brief Description of the Service: Lawn House is a large detached home which provides long term residential care for up to 10 adults who have a learning disability. The home is in walking distance to local shops and amenities, there is also good public transport links to Southampton city centre . Lawn House is run and owned by Craegmoor Healthcare who provide services to vulnerable children and adults across England and Wales. The accommodation is organised over two floors with a third floor that is not used for service user access. There are 10 single bedrooms all with ensuite WC, shower or bath. Three bedrooms are on the ground floor and seven on the first floor. The ground floor has an office, walk in shower, entrance lobby and hall leading to the kitchen. The dining room leads to the lounge area where there are French windows onto the garden that can accommodate people who have mobility difficulties. To the rear of the lounge is a small activities area. There are four communal service users WCs, one communal bath and one wheelchair accessible shower. The home has a shaft lift to the areas of the home accommodating service users. There are two small mezinine areas with steps near to the stair well. Lawn road is a “no through road”. Staffing is provided 24 hours a day, with sleep-in staff at night. Lawn House Care Home DS0000037558.V259647.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection of Lawn House Lane took place on 22 November 2005. At the time of the inspection three service users were out attending their day service and five service users were at home but all had activities planned to go out individually with staff for walks and trips to the pub. The manager of the home assisted the inspector throughout the inspection. Discussions were held with three service users and staff. Full access to any information requested was provided with records and documentation identified in the report being viewed. What the service does well: What has improved since the last inspection? Action taken since the last inspection include the following: The kitchen has now been completely refurbished. Food is readily available for service users to make themselves drinks and snacks throughout the day and evening. Agreement has also been reach for the communal shower to be refurbished and the front of the house repainted in the new year. Service users are involved in shopping, planning menus, preparation and cooking of food. Daily records are now completed with the service user to increase service user’s input and awareness of their personal plans. The concern regarding one service user and his irregular sleep patterns has now been resolved through the consultant psychiatrists involvement. Service users where appropriate were consulted on whether they wish to move towards self Lawn House Care Home DS0000037558.V259647.R01.S.doc Version 5.0 Page 6 administering their medication, in each case the service users have requested to retain the system they have currently. Risk assessments have been further developed since training was given to staff on care/activity planning. Risk assessments now include both the issues of risk and potential benefits to the person. Information is now being produced into a more user-friendly style with the use of photographs and signs/symbols. 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. Lawn House Care Home DS0000037558.V259647.R01.S.doc Version 5.0 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 Lawn House Care Home DS0000037558.V259647.R01.S.doc Version 5.0 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): 3&4 Prospective service users are thoroughly assessed prior to being offered a permanent placement in the home. Prospective service users and their relatives/representatives have an opportunity to visit the home. EVIDENCE: The inspector viewed the file of the last service user who was admitted to the home approximately one year ago. A full assessment was carried out by the manager of Lawn House in both the service user’s previous residential home and the day service that he attended in order to gain a full picture of the persons needs. A person centred plan has been developed and the inspector went through the plan with the service user who was able to confirm his wishes, dreams and aspirations as well as his general needs which concurred with what had been written in his plan. The service user had also signed the document and personal plans in his file. The inspector was informed that generally prospective service users have two introductory visits, which includes a tea visit and an overnight stay depending on circumstances and the needs of the individual. The service user was able to confirm that he had visited the home on two occasions before he moved in and told the inspector that he liked living at Lawn House. Through discussion and information on file it was clearly evidenced that the service user has developed a number of independent living skills since moving to Lawn House. Lawn House Care Home DS0000037558.V259647.R01.S.doc Version 5.0 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 The home promotes the rights of service users to make choices, partake in life decisions and participate in the day to day running of the home. EVIDENCE: Since the last inspection the home has been developing ways to support people with limited communication skills to be more involved in decisions about the home and increasing their own independence skills. Staff have received training on care planning and identifying needs when planning activities. Daily records are now completed with the service user to increase service user’s input and awareness of their personal plans. More pictorial formats have been produced. An excellent example for one service user who mainly uses Makaton as his form of communication has a section in his daily file which has individual photographs of him demonstrating each signs that he uses. The inspector was also shown minutes from the last service user meeting which had the agenda in both written and pictorial format, parents and relatives were invited to the meeting and service users talked about the things that were important to them and things that they liked and disliked about their lives. One service user said in the meeting that he didn’t like the colour of his room. This was followed up by the manager and his room has been re Lawn House Care Home DS0000037558.V259647.R01.S.doc Version 5.0 Page 10 decorated with a colour of his choice. The inspector was shown his bedroom and the service user told the inspector that he liked his room now. The recommendation from the last inspection report in relation to risk assessments has been met. Risk assessments have been further developed since training was given to staff on care/activity planning and now include both the issues of risk and potential benefits to the person. Lawn House Care Home DS0000037558.V259647.R01.S.doc Version 5.0 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): 11 & 14 The home supports service users to meet their hopes, dreams and aspirations through providing different opportunities and experiences. The activities undertaken are full and varied and are appropriate to the individual needs of the service user. EVIDENCE: At the time of the inspection visit three service users were attending their day service, the inspector observed one service user clearly indicating through nonverbal communication that he did not want to go to his day service and this was respected by staff. Two service users went out individually with staff support for a walk and a trip to the pub. The inspector spoke with two service users about their hopes, dreams and aspirations that had been documented in the person centred plans. One service user had said he wanted to travel the world and he talked about how he would like to travel on a cruise ship and his favourite place to visit was America. Service users person centred plans document their independent living skills, communication and social kills as well as documenting individuals emotional needs which clearly state what makes them unhappy and how they react in these situations. Lawn House Care Home DS0000037558.V259647.R01.S.doc Version 5.0 Page 12 The home provides a range of leisure activities based on service users needs and wishes. Service users told the inspector that they go to the cinema, bowling, to watch football matches, a local pottery club, cricket and have parties and discos in the home where one service user told the inspector that he likes to be the DJ. Service users plan their own holidays, this year a group went to Blackpool and the inspector was shown a photograph that they had taken and service users told the inspector what they did during their holiday. One service user said he really enjoyed the holiday. Another service user chose to go to Iceland for his holiday which had been a place he wanted to visit. Religious and spiritual needs are catered for by the home, there are a number of service users who attend church on a regular basis. Lawn House Care Home DS0000037558.V259647.R01.S.doc Version 5.0 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 the following standard(s): 21 The home ensures that service users wishes will be respected in the event of illness and death. EVIDENCE: The home has a policy on the event of a service users dying. Each service user has identified their wishes on the event of their death, which not only identifies how they would like to be buried but also on the type of service they would like and wishes such as personal songs and hymns. This information is recorded on a personal plan in their file and was viewed by the inspector. The recommendation from the last inspection report that a GP should be consulted regarding guidance to one service users medication and his irregular sleep patterns has been resolved through the consultant psychiatrists involvement. A recommendation was also made with regard to reviewing the medication administration system with the aim to promote increased service user independence. Service users where appropriate were consulted on whether they wish to move towards self administering their medication, in each case the service users have requested to retain the system they have currently. This needs to be documented on their individual care plan and reviewed again at a later date. Lawn House Care Home DS0000037558.V259647.R01.S.doc Version 5.0 Page 14 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): The standards were not assessed on this occasion. EVIDENCE: Although standard 22 was not assessed, the complaints log was viewed and no complaints have been made since the last inspection. Lawn House Care Home DS0000037558.V259647.R01.S.doc Version 5.0 Page 15 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): 25 Service user bedrooms are personalised and provide appropriate equipment to promote independence and meet service users individualised needs. EVIDENCE: A sample of bedrooms were viewed by the inspector and it was evident that service users had been supported and encouraged to personalise their individual rooms. One service user who showed the inspector his room had all his medals and trophies that he had won at bowling on a display shelf and was able to take them off the shelf and talk about them to the inspector. Most service users have hi fi and television equipment in their bedrooms and one service user told the inspector that he has a mobile phone. A number of bedrooms have been re-decorated and service users were able to confirm that they chose the colour they wanted and new furnishings. From the recommendations raised at the last inspection in relation to the environment – the kitchen has now been refurbished with new cupboards, work surfaces, cooker, fridge freezer. Service users told the inspector that they really liked the new kitchen. Service users are involved in shopping, planning menus, preparation and cooking of food. Food is readily available for service users to make themselves drinks and snacks throughout the day and Lawn House Care Home DS0000037558.V259647.R01.S.doc Version 5.0 Page 16 evening. The inspector observed two service users making themselves a drink and one service user making a snack of toast. Agreement has been made with Craegmoor to have the communal shower refurbished and the outside of the home re-painted early next year. Lawn House Care Home DS0000037558.V259647.R01.S.doc Version 5.0 Page 17 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): 36 The home ensures that staff are regularly supervised to ensure they are competent to carry out their role. EVIDENCE: Care staff appeared to have a good knowledge and understanding of the service users needs and were observed interacting in a positive, warm friendly way with service users. The home operates a keyworker system. Each service user has a keyworker whose role is to ensure that the individual needs of the service user are met through the person centred planning system in place. Staff receive bi-monthly supervisions and an annual appraisal. Supervision sessions are carried out by the manager and three seniors all of who have received performance management training. Supervision sessions cover induction, keyworking tasks, practice issues, extra responsibilities and training and development. Supervision records were seen as well as a table listing the dates for staff supervision throughout the year. Lawn House Care Home DS0000037558.V259647.R01.S.doc Version 5.0 Page 18 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): The standards were not assessed on this occasion. EVIDENCE: Lawn House Care Home DS0000037558.V259647.R01.S.doc Version 5.0 Page 19 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 3 3 X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score X 3 X X X X X LIFESTYLES Standard No Score 11 3 12 X 13 X 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X X 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Lawn House Care Home Score X X X 3 Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000037558.V259647.R01.S.doc Version 5.0 Page 20 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Lawn House Care Home DS0000037558.V259647.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. 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