Inspection on 25/01/06 for Lawrence House

This inspection was carried out on 25th January 2006.

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

Lawrence House 15/01/07

Lawrence House 11/11/05

Lawrence House 17/12/04

Lawrence House 23/09/04

Lawrence House 10/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Lawrence House Lawrence House Landkey Road Barnstaple Devon EX32 9BX Lead Inspector Susan Taylor Unannounced Inspection 25th January 2006 14:00 Lawrence House DS0000043932.V274164.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 Lawrence House DS0000043932.V274164.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. Lawrence House DS0000043932.V274164.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lawrence House Address Lawrence House Landkey Road Barnstaple Devon EX32 9BX 01271 377189 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) Linda Harvey Linda Harvey Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Lawrence House DS0000043932.V274164.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users will be aged between 25 and 65 years Three named service users over the age of 55 may continue to reside at the home On the termination of their residency the home will revert to its registered categories and the Registered Persons must notify the Commission of the fact. The Registered Person/Manager Linda Harvey maintains her Nurse registration or undertakes NVQ level 4 in Care and Management/Registered Manager`s Award by 31/12/05 To accommodate one named service user out of age range. On termination of their residency, the home will revert to the registered categories and the registered person must notify the Commission of the fact. To enable one named service user to reside at the home To provide personal care to ten (10) young adults (up to age 65 years) with learning disabilities (LD 11th November 2005 3. 4. 5. 6. Date of last inspection Brief Description of the Service: Lawrence House provides 24-hour residential care for 10 people who have learning disabilities. At night-time there are two staff sleeping in. Lawrence House is a large detached Victorian house standing in its own grounds and is a short walk away from the centre of Newport. There is a ramp leading up into the rear entrance of the Home. Wheelchair users cannot easily be accommodated. Service user’s rooms are on the ground and first floors. All vary in size and have an outlook over the garden. Lawrence House DS0000043932.V274164.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection of Lawrence House that took five hours over one day. During a tour of the building, the inspector met five residents who made comments about their care, daily lives and accommodation at the home. In addition to this, records were inspected and staff were interviewed. One comment card was received from a relative of a resident. Residents made positive comments such as “I like to manage my own money and I can do” and “we all have our own accounts” and “we clean our own rooms [with help from staff]” and “you get a choice, the staff show you a colour chart [in respect of décor]” A relative wrote, “My brother has never been happier. Lawrence House is the best thing that’s happened to him”. The people living at Lawrence House have previously told the inspector they prefer the term ‘resident/s’ therefore this is used throughout the report. What the service does well: Lawrence House is a well managed home. ‘Total Communication’ is used in the home, to ensure that residents are fully involved in decision making about their lives there. Residents are confident that the staff understand their needs because they are discussed with them. The team have the confidence to allow residents to take risks so that they enable them to develop as individuals. Residents have few restrictions in their lives and they lead busy and fulfilling lives. The home is clean and well maintained. Residents have a say about how their bedrooms, and other communal areas are decorated. They are also encouraged to personalise their bedrooms with items such as photographs, pictures and ornaments. Lawrence House DS0000043932.V274164.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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. Lawrence House DS0000043932.V274164.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 Lawrence House DS0000043932.V274164.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 The needs of residents are clearly stated in care plans and known by staff. EVIDENCE: Two care files demonstrated that comprehensive assessment information had been obtained. Assessments had been regularly reviewed with the individual concerned. The home had obtained a copy of the care plan produced for care management purposes for both individuals. Lawrence House DS0000043932.V274164.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): 6,7, 9 Lawrence House philosophy of care is inclusive and encourages residents to fully engage in planning and reviewing their own care. The arrangements for the management of resident’s money safeguard their financial interests. Risks and quality of life issues are carefully managed so as to ensure that residents have few restrictions in the lives. EVIDENCE: Care plans were well maintained and in a ‘total communication format’. Two residents told the inspector that they had been fully involved in planning their care, and that this had been reviewed with them on a regular basis. A relative wrote, “My brother has never been happier. Lawrence House is the best thing that’s happened to him”. The inspector read minutes of residents meetings, which illustrated that a discussion had taken place about advocacy services known as ‘People First’. Three residents told the inspector that they had volunteered to help with this scheme. Financial records were inspected for two residents. The individual’s concerned told the inspector that they were satisfied with the way their money is handled in the home. One person said, “I like to manage my own money Lawrence House DS0000043932.V274164.R01.S.doc Version 5.1 Page 10 and I can do” and “we all have our own accounts”. Balances were audited and found to be in order. Two signatures were seen on balance sheets denoting withdrawals. Comprehensive risk assessments had been completed with every resident, which clearly identified strategies for minimising the risks highlighted. Lawrence House DS0000043932.V274164.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): None EVIDENCE: Lawrence House DS0000043932.V274164.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): None EVIDENCE: Lawrence House DS0000043932.V274164.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): None EVIDENCE: Lawrence House DS0000043932.V274164.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): 24,30 Residents live in a comfortable and well-maintained home. Steps taken to minimise the risk of infections, are inclusive of residents and are successful. EVIDENCE: Five residents showed the inspector their bedrooms, which reflected individual tastes. One person said that they liked ‘sci-fi’ programmes and their room was full of memorabilia reflecting this interest. Another resident told the inspector “we clean our own rooms [with help from staff]” and “you get a choice, the staff show you a colour chart [in respect of décor]”. Touring the premises the inspector saw that the home was clean and very well maintained. Infection control measures such as hand washing had been discussed with residents and staff. Notices were seen in bathrooms, which prompted users about hand washing and these were in a ‘total communication’ format. The manager told the inspector that one resident was unwell and had been encouraged to stay in bed. The inspector met the individual concerned; who said that they felt well cared for and didn’t “feel like mixing with people at the moment”. Lawrence House DS0000043932.V274164.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): 34 Recruitment procedures had improved, are robust and therefore protect residents EVIDENCE: The recruitment procedures were followed up as a result of a requirement made at the last inspection. The home’s recruitment procedure had been updated to include guidance about POVA checks. Two files were seen which demonstrated that appropriate references, including CRB/POVA checks had been obtained. Lawrence House DS0000043932.V274164.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): None EVIDENCE: Lawrence House DS0000043932.V274164.R01.S.doc Version 5.1 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 x ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 x 33 x 34 3 35 x 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 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 x x x x x x x x x x Lawrence House DS0000043932.V274164.R01.S.doc Version 5.1 Page 18 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 Lawrence House DS0000043932.V274164.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Lawrence House DS0000043932.V274164.R01.S.doc Version 5.1 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!