Inspection on 25/04/07 for Lawreth

This inspection was carried out on 25th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Lawreth 12/01/06

Lawreth 18/08/05

Lawreth 17/03/05

Lawreth 23/08/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Lawreth 267 Station Road Seaham Durham SR7 0BH Lead Inspector Ms Kathy Bell Key Unannounced Inspection 25th April 2007 11:00 Lawreth DS0000007599.V335639.R01.S.doc Version 5.2 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 Lawreth DS0000007599.V335639.R01.S.doc Version 5.2 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. Lawreth DS0000007599.V335639.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lawreth Address 267 Station Road Seaham Durham SR7 0BH 0191 5130111 0191 5637711 Lesley.lane@espa.org.uk 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) European Services for People with Autism Limited Ms Jean Guy Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Lawreth DS0000007599.V335639.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th January 2006 Brief Description of the Service: Lawreth is registered to provide care (but not nursing care) for two people with learning disabilities between the ages of 18 and 65 years. The home provides a specialist service for people with autism and physical disabilities. The home is a bungalow which has been adapted to meet the needs of the disabled resident. It provides two single bedrooms, a lounge, kitchen/dining room and a garden. It is furnished and decorated in a domestic style to a good standard. The building is near the town centre of the coastal town of Seaham. Lawreth is managed by the organisation now known as European Services for People with Autism Ltd (ESPA) which was established in 1987 and runs a range of services for young adults autism spectrum disorders. The weekly charge for the service ranges from £1163.75 to £1975.15p each week. This information was supplied to CSCI in February 2007. Lawreth DS0000007599.V335639.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place during one day in April 2007. It was the one inspection due to be carried out this year and the home only knew the inspection was going to take place the day before. The Inspector, Kathy Bell, looked at the building and some records, and talked to the manager and staff. Both residents were at home during part of the inspection but were not able to take part in the inspection fully because of their learning and communication difficulties. However, their parents had completed a questionnaire from CSCI. Their responses showed that they were very pleased with the home and care provided. What the service does well: The home provides a service which has been designed specially for the current residents. The building was adapted before the disabled resident moved in so that his needs could be met. The small scale of the home has been particularly successful for the other resident because staff can avoid situations which upset him. The home provides a specialist service for people with autism, providing good, relevant training for their staff and with advice readily available for staff from a psychologist, speech therapists and psychiatrist. Staffing levels are good, as they need to be to provide enough support and supervision to residents and to enable them to have an active life, with plenty of activities outside the home. The home respects the rights of individuals and staff work hard to offer appropriate choices to residents in their daily lives. There are thorough systems to make sure that the home is running safely, doing what it sets out to do and is meeting the expectations of residents, relatives and care managers. One relative said in the questionnaire she filled in, that she was very pleased with all aspects of sons care. Lawreth DS0000007599.V335639.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Lawreth DS0000007599.V335639.R01.S.doc Version 5.2 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 Lawreth DS0000007599.V335639.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard two. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has carried out a full assessment of each residents needs to make sure that they will be able to meet those needs. EVIDENCE: Both residents have lived in the home for some time and had previously lived in other services run by ESPA. The organisation was therefore well aware of their particular needs and preferences. The manager spent time working in the college where one resident lived previously, getting to know him and learning how to communicate with him. Before the first admission, ESPA carries out a full assessment, involving specialists such as a psychologist and obtaining comprehensive background information. Residents are only admitted after the admissions panel has agreed the placement. Lawreth DS0000007599.V335639.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents each have a care plan which describes the care they need. These provide detailed guidance to make sure that staff are aware of residents needs and wishes and how these must be met. Residents can make their wishes known about their day-to-day lives and staff respect their choices. The home manages risks properly, and does not restrict residents rights without good reason. Lawreth DS0000007599.V335639.R01.S.doc Version 5.2 Page 10 EVIDENCE: Each resident has a care plan which describes the care they need. These are very detailed and take into account residents wishes. They include assessments by ESPAs speech therapist and guidance to staff on how to respond to any challenging behaviour. The care plans show that staff respect residents rights to independence as far as possible. Staff explained how they are kept up-to-date with any changes in the care plans. Residents can show by their reactions whether they want to do something or not and the manager described how they respect these choices. Staff offer, for example, choices of activities based on what they have seen residents have enjoyed before. They have developed a book of pictures to help residents understand the choices they have and to tell staff what they want. Records showed that sometimes a resident chooses to do an activity he likes and sometimes does not. Daily routines are built round the choices residents have shown they want to make, for example an after-dinner nap for one resident. Staff record how they have looked at any risks there might be to residents well-being, and put in place safeguards to protect them while still giving them as much freedom as possible. For example, they make sure that enough staff are provided to allow a resident to take part in activities they enjoy, safely. Staff described how these risk assessments are used on a day-to-day basis. This makes sure that staff with the level of experience and confidence needed to help residents with any particular activity are available. The risk assessments have been reviewed regularly to make sure they are up-to-date. Lawreth DS0000007599.V335639.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are helped to take part in a range of leisure activities, for pleasure and personal development. A range of art and craft and social activities are provided at ESPAs own day centre. The home has its own vehicle so that residents can easily be taken out to use local community facilities.This makes their lives as much like anyone elses as possible. Staff help to maintain contact between residents and their families. The home acknowledges residents rights and tries as far as possible to enable them to exercise these rights. Staff try and provide a good diet, taking into account residents choices. Lawreth DS0000007599.V335639.R01.S.doc Version 5.2 Page 12 EVIDENCE: Residents have an active life, with a variety of leisure activities. Within the home, residents work with staff in the greenhouse and garden. They go out and about in the homes own vehicle, using pubs, shops and other community facilities. Pottery, cafe visits, sensory room, aerobics, arts and crafts, IT and photography are available in ESPAs day centre. Staff respect residents rights to choose their daily routines and activities. ESPA has produced more accessible versions of important procedures like the complaints procedure and staff do record their efforts to explain this to residents. Risk assessments record when staff do restrict residents freedoms for their own safety. Staff help residents maintain contact with their families. Staff keep detailed records of the food offered and eaten by one resident to enable them to make sure he is eating adequately. They respond to his particular needs by offering snacks he will enjoy if he has refused the main meal. They are aware of residents likes and dislikes. Two staff were soon going to attend a course on healthy eating and the home receives advice from a dietician on the menus provided. Lawreth DS0000007599.V335639.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Care plans provide detailed guidance to staff on meeting personal care needs and these take into account residents wishes and rights to independence. The home has a number of systems to help staff make sure that health needs are met and receives regular support from a specialist doctor. There are established satisfactory systems for handling and giving medication to residents which include a full recording system. EVIDENCE: Care plans include detailed guidelines on how residents like to be cared for. This helps staff to act in the consistent way which residents prefer. The guidelines on helping one resident to bathe give staff permission to respond to his own assessment of if he feels fit enough to be more independent on that day, but within limits necessary for his health and safety. The guidelines also take into account individual staffs abilities and confidence in helping him. Lawreth DS0000007599.V335639.R01.S.doc Version 5.2 Page 14 The home has obtained specialist advice on providing the correct equipment to help the resident move around the building and the manager described how they ask for advice whenever needs change. The manager described how care practices respect residents rights to privacy. Staff make sure that residents received a good standard of health care. They arrange regular checkups such as dental care and the dentist has recorded his compliments about how the staff maintain dental hygiene. Records also showed that people received regular eye checks and chiropody. Staff stayed with a resident during a hospital admission to reduce the stress for him and ensure his needs were met. Staff record when they have asked the psychiatrist for advice and there are clear records of the advice given and any changes of medication. When necessary, they have recorded their monitoring of the effects of any changes of medication to help the doctor in his assessment. The home has an established system for handling medication. Staff have received training in this and the system covers all the necessary areas including ordering, storage, administration and disposal. A sample of records showed that staff were following the procedures and staff confirmed they had been trained in the use of emergency medication. Lawreth DS0000007599.V335639.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure so it will listen to the views of residents and their relatives. The home takes all reasonable steps to protect residents from abuse, by providing training, procedures and oversight by senior staff. EVIDENCE: The home has a satisfactory complaints procedure and this has been produced in a form which could be easier for some residents in ESPAs services to understand. Staff have recorded when they have tried to explain this to residents. A full text version is also given to parents. Parents confirmed in the questionnaire that they had been given information on how to complain. Records and discussion with the manager showed how staff are always trying to respond to the wishes of residents. Staff receive regular refresher training on preventing abuse and the organisation has satisfactory policies and procedures to protect residents. The manager has had training on safeguarding adults which was designed for managers of care homes. Lawreth DS0000007599.V335639.R01.S.doc Version 5.2 Page 16 ESPAs procedures require staff to include detailed guidelines in care plans on how staff can respond to any challenging behaviour, including the use of restraint. Senior staff check the records of any incidents involving restraint to make sure that residents are kept safe from harm. Full records are kept of money handled for residents and these are checked by ESPAs finance department. Lawreth DS0000007599.V335639.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides a pleasant, comfortable place to live which meets residents needs. The home seemed clean and hygienic on the day of inspection. EVIDENCE: The building is a bungalow which has been specially adapted to meet the needs of a disabled resident. It provides two single bedrooms, a lounge and kitchen/dining room. A bathroom and extra separate toilet have been made accessible for both residents. The building is furnished and decorated in a domestic style and appears well maintained. Office space has been provided in the garage to make sure that the kitchen/dining area remains fully available for residents. The home appeared clean and well cared for. Lawreth DS0000007599.V335639.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 33, 34 and 35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Enough staff are on duty at all times to meet the needs of residents. Staff seemed to have the personal qualities, skills and training needed for this home. Comprehensive training is provided, including good support for new staff. This make sure that staff have the knowledge and skills to provide the specialised care needed in this home. Proper checks are carried out on new staff to make sure that only suitable people begin working in the home. EVIDENCE: There are always at least two staff on duty through the daytime and evening, and normally three during the daytime which can include the manager. The staffing levels enable the home to run safely, provide individual attention for residents and give them an active lifestyle. Night staffing consists of one waking person which seems enough to meet the residents needs. Lawreth DS0000007599.V335639.R01.S.doc Version 5.2 Page 19 ESPA has an established system for recruitment, which includes all required checks. Only one new member of staff has recruited since the last inspection and records showed that Criminal Records Bureau/POVA checks had been carried out. Only one reference had been obtained (from the most recent employer) because this worker had previously been employed by the company which runs Lawreth. The company should consider some way of recording that a senior person has reviewed their records of previous employees and been satisfied that they should recruit them again. During previous inspections, records have shown that normally three references are obtained. There is a comprehensive training system for new staff and existing staff. This includes key areas such as food hygiene, first aid and medication and also subjects specific to the type of home, such as restraint and autism. Recently staff have had extra training to help them consider carefully each residents wishes about how staff care for them. Two staff are to go on training on healthy eating and the manager has had training on eating difficulties. All the staff have had training on diversity to make sure they understand the need to respect everyones different needs and choices. Staff have had training in moving and handling but refresher training was only planned for once every three years. Two thirds of the staff have now achieved the recommended qualification for care staff of National Vocational Qualification in care at level 2. This is more than the minimum of 50 qualified which was recommended in the National Minimum Standards. Lawreth DS0000007599.V335639.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has the skills and personal qualities she needs to run the home well but has not yet achieved the recommended qualifications. Arrangements for making sure that the home provides a safe place to work and live are satisfactory. ESPA has good systems to check how successful the home is in meeting the needs of residents. EVIDENCE: The manager showed her detailed knowledge of the needs of both residents. The arrangements for health and safety, continued in-house training and supervision of staff show a well-run home. Lawreth DS0000007599.V335639.R01.S.doc Version 5.2 Page 21 Staff confirmed that they are well supported and the manager is always ready to help and advise. She is working towards the recommended qualifications for managers. Good attention is paid to making sure that the health and safety of residents and staff are protected. Regular safety checks, fire drills and maintenance are carried out. Staff have had training in using a hoist. One of the staff confirmed that she was trained and then the manager watched her to make sure she could use the hoist safely. However refresher training in moving and handling is only planned for every three years, rather than yearly, which is recommended. ESPA has a number of systems to make sure that the home provides a good service. There is an annual development plan which is linked to individual goals for each resident. Each year residents and their relatives complete a survey so that Espa knows what they think of the service. A senior member of the staff of Espa visits the home once a month to check how it is running. Lawreth DS0000007599.V335639.R01.S.doc Version 5.2 Page 22 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 4 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 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 4 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 3 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 2 X 4 X X 3 X Lawreth DS0000007599.V335639.R01.S.doc Version 5.2 Page 23 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. 1 2. 3 Refer to Standard YA34 YA37 YA42 Good Practice Recommendations The company should consider a way of recording that they have checked their own past employment records when recruiting someone who has previously worked for them. The manager should achieve NVQ 4 in management and care. Staff should receive refresher training in moving and handling once a year . Lawreth DS0000007599.V335639.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Lawreth DS0000007599.V335639.R01.S.doc Version 5.2 Page 25 - 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!