Inspection on 13/10/05 for Lawwood

This inspection was carried out on 13th October 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lawwood 27/06/07

Lawwood 15/02/06

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

CARE HOME ADULTS 18-65 Lawwood 87 Todmorden Road Burnley Lancashire BB11 3ES Lead Inspector Mr Jeff Pearson Unannounced Inspection 13th October 2005 10:30 Lawwood DS0000061819.V253008.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 Lawwood DS0000061819.V253008.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. Lawwood DS0000061819.V253008.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Lawwood Address 87 Todmorden Road Burnley Lancashire BB11 3ES 01282 435832 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) Lawwood Ltd Mrs Amanda Balmer Care Home 10 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (10) of places Lawwood DS0000061819.V253008.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The service should employ a suitably qualified and expereinced manager who is registered with the Commission for Social Care Inspection The home may accommodate up to 10 (ten) adults up to the age of 65 years who have mental health problems. The staffing levels must be maintained at those agreed for registration. Date of last inspection Brief Description of the Service: Lawwood is registered to provide personal care and accommodation for 10 adults over the age of 18 with a mental illness. Lawwood is a double fronted mid terraced property situated upon a busy road, in a residential area. The home is close to a number of local resources and community facilities. The accommodation available is of a very good standard, homely and domestic in style, all bedrooms are single (one has an en-suite toilet) There are two lounges, a room for smoking and a separate dining room. Satellite television is provided. There are two enclosed courtyard areas with seating, to the rear of the home. Staff are on duty to provided support 24 hours per day. ‘People carrier’ type transport is available to enable service users to visit relatives, take short trips and outings within the community. Lawwood DS0000061819.V253008.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took 6 hours over 1 day and was carried out by 1 inspector. There were 10 service users accommodated in the home. During the inspection the service users, the registered manager, homeowner and staff were spoken with. The files of 3 service users were examined as part of ‘case tracking’, this being a method of focusing upon a representative group of service users. Various records and policies were looked at, including the records of the two most recently employed staff. A tour of the home was carried out; service users’ bedrooms were viewed with their permission. What the service does well: The atmosphere in Lawwood was welcoming, supportive and friendly, relationships amongst every one were fine. The standard of the accommodation was very good “I love the place” said one service user, “It’s pretty good actually” said another. People living in the home were being supported to make decisions and choices within their lives, as individuals and as a group. Meetings were held so people could voice their opinions and make suggestions. When asked about meetings one comment was “They run through things with us and ask us what we think, they take notice of us” Individual Plans drawn up with each person, made sure staff were aware of their needs and knew how to support them. Thought had been given to people taking risks and how staff should respond to these situations. Everyone was being given opportunity to get out into the local community and join in different activities. “They’ve got me going to different places,” said one person. Holidays abroad and in the UK were being arranged each year. Contact with relatives and friends was very good, people said they were keeping in touch with their families. One service user explained “I go to see my daughter and grandchildren every week now” People were getting support with medical needs, such as seeing the Doctor or attending hospital appointments, their mental ill heath was being kept an eye on. Every one was happy with the meals provided and people were involved with choosing menus and cooking. “The food is good” one person said, “We can brew up whenever we want, the kitchen is open all the time” People were being enabled to raise concerns, or make complaints. Good practices were in place for making sure suitable staff are employed at the home. Staff training and development was ongoing, more than half had NVQ’s in promoting independence (National Vocational Qualifications). The staff on duty were enthusiastic about their work, they treated people living in the home sensitively and with respect. Lawwood DS0000061819.V253008.R01.S.doc Version 5.0 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. Lawwood DS0000061819.V253008.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 Lawwood DS0000061819.V253008.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): 1, 2 Progress had been made with updating the homes written material, to provide clear and accurate information about the services available. The admission process ensured the residents’ were properly assessed, their needs and wishes known and planned for prior to moving into the home. EVIDENCE: The statement of purpose and guide to the home were seen, they had been revised to include all the necessary details. The format of this information was attractive and appealing. Service users spoken with said they had been given a copy of the guide and felt it was a good reflection of the services and facilities provided at Lawwood. The service users case files included assessment information from Social Services and details of assessments completed as part of the Care Programme Approach (CPA) as appropriate. Pre admission assessments had also been carried out the homes’ manager. The assessment details included much relevant information. Records showed house rules and other matters had been agreed with service users prior to moving in. Copy letters were seen confirming the home could meet the service users’ needs. Each service user had a care plan in place. Lawwood DS0000061819.V253008.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): 6, 7, 9 Service users had individual written Plans which responded to their support needs and outlined goals and activities. Systems were in place to enable service users to make decisions and choices, as individuals and as a group. Assessing and managing responsible risk taking was effective in helping to ensure a reasonable balance is achieved between personal safety, independence, choice and rights. EVIDENCE: Service users spoken with were aware of their individual Plans; they said they signed in agreement with them. Plans examined as part of case tracking, were sensitively written and included details of each persons support needs and goals, the action to be taken and by whom. The Plans were based upon initial assessment/reviews. Care notes provided a good reflection of each person’s daily living and specifically responded to identified needs/goals. Lawwood DS0000061819.V253008.R01.S.doc Version 5.0 Page 10 The care planning process showed service users were being supported to make choices and decisions in their daily lives. Service users said meetings were held, usually on a Friday, for group discussions information sharing, they felt involved with day-to-day matters in their home. Any restrictions on choices, in the persons’ best interest had been agreed and recorded in their Plan. Risk assessments had been completed, key risk factors had been highlighted and graded, possible outcomes (positive and negative) had been considered. Risk management strategies were in place and specific signs for staff to look out for had been noted. Lawwood DS0000061819.V253008.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): 12, 13, 14, 15, 16, 17 Service users were being offered opportunities to engage in a range of activities, they were supported to use community resources. Arrangements were in place to enable service users to maintain links with families and friends. Independence was being promoted and rights were being respected, some rules had been agreed to clarify any limitations and responsibilities. The meals supplied were sufficient in providing for the residents tastes, preferences and diet. EVIDENCE: During the inspection several service users went out into the local community. Individual Plans showed proposed activities and outings. Service users spoke of the various activities, both in and out of the home, including clubs, day centres, voluntary work, pubs, shops, church, sports/fitness centres, shopping, knitting and cooking. Some of the service users had just returned from a holiday abroad, others had been away earlier in the year. Lawwood DS0000061819.V253008.R01.S.doc Version 5.0 Page 12 Service users explained they were keeping in touch with members of their families and friends, by telephone, visits, or short breaks away. Considerable efforts had been made to successfully reunite one service user with her family. Service users said they were generally happy with the variety and quality of the meals provided. They were being asked about the weeks’ menu in advance and on a daily basis, the menus seen showed two options were usually offered. Mealtimes were flexible, depending what was happening in the home. Service users made drinks and snacks for themselves and said they could get involved with cooking. Healthy eating was being encouraged; some individual diet plans were in place. Lawwood DS0000061819.V253008.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): 19 Arrangements were in place to monitor the service users’ general health and wellbeing and to access appropriate health care services. EVIDENCE: Service users spoken with confirmed they had received attention from health care professionals including GPs, Consultants and Dentists. Health care matters were reflected within individual Plans. Records showed general health was being monitored and support was being provided for appointments. Service users were receiving annual health care checks. Lawwood DS0000061819.V253008.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): 22, 23 The service users had access to a clear complaints procedure which included appropriate details. Their views were being listened to and acted upon. Satisfactory arrangements were in place for protecting the residents from abuse, but guidance for managers and staff needed developing to ensure an appropriate response. EVIDENCE: The complaints procedure had clear details explaining how to go about making a complaint; service users were aware of the procedure and knew they could contact the Commission to raise concerns. The meetings held, provided for open discussion, one service user said the manager explained things in the meetings; she felt they were good for getting things sorted. The protection/abuse policy contained extensive information based upon the Department of Health guidance No Secrets. The procedure for referring allegations, suspicions and incidents of abuse was unable to be found. A ‘whistle blowing’ policy was available within the staff policies and procedures file. Individual signed agreements were in place about arrangements for handling service users monies. A physical intervention/restraint policy had been introduced. Some staff had covered protection and abuse matters as part of NVQ (National Vocational Qualifications) training. Lawwood DS0000061819.V253008.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): 24, 25, 27, 30 The standard of the accommodation was good, providing the service users with suitable facilities and an attractive, clean, homely place to live. EVIDENCE: Lawwood had been combined with the Lawwood Rehab, the next-door property to provide a larger home with places for more people. This had improved the living accommodation for the service users, a room for smoking had been created and a larger dining room and ground floor bedroom, with en-suite toilet had been provided. In addition a new kitchen had been fitted and the laundry had been re-located to better place. The communal rooms were decorated to a good standard and the service users said they liked the new furniture. Some decorating was still ongoing. All the service users spoken with said they were happy with their bedrooms, those seen were furnished to a good standard and included the occupants’ own belongings. Records were kept of each person’s preferences about furnishings and facilities. Doors were fitted with suitable locks, with some service users holding keys. Lawwood DS0000061819.V253008.R01.S.doc Version 5.0 Page 16 Bathrooms and toilets were of good standard and provided for service users needs; thermostats had been fitted to baths and showers. The home was clean and free from unpleasant smells. The laundry area had recently been tiled, was easily cleanable and contained appropriate washing equipment, liquid soap and paper towels. Hygiene policies were in place. Lawwood DS0000061819.V253008.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): 32, 33, 34, 35 Staff training and development was ongoing, progress had been made in enabling staff to gain recognised qualifications to improve the quality of service for the residents. Staffing arrangements were sufficient in aiming to ensure the resident’s needs are effectively and safely met. Recruitment practices showed attention was being given employing suitable staff and protecting the service users. EVIDENCE: The required numbers of staff were on duty. Staff rotas and records of hours worked, indicated that appropriate staffing levels were being kept with extra staff also being on duty for activities, outings and one to one support. The records of the two most recently recruited support staff were examined; both included satisfactory information including checks and interview notes. Service users spoken with expressed an appreciation of the staff team. Staff on duty interacted well with the service users, they appeared well motivated and were enthusiastic about their work. Lawwood DS0000061819.V253008.R01.S.doc Version 5.0 Page 18 Nine support staff had completed NVQ level 2 and four were doing this level. Three staff had completed NVQ level 3 and one was doing this level and two senior staff had started NVQ level 4. All staff had completed First Aid and Moving and Handling and Medication awareness training. New staff had completed induction training. The provision of equal opportunities/anti discriminatory practices was discussed with the Manager. Lawwood was providing placements for local University RMN students. The Manager explained part of their placement involved sharing appropriate learning with the staff team. Lawwood DS0000061819.V253008.R01.S.doc Version 5.0 Page 19 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): 38, 39 The management and leadership approach had helped create a supportive, positive environment for the service users and staff. Progress had been in developing quality assurance systems to help ensure the home is run in the best interest of the service users. EVIDENCE: The atmosphere in Lawwood was friendly and supportive, relationships between service users management and staff were good. The service users spoken with expressed an appreciation of the manager and homeowner. Staff and service users meetings, provided the opportunity for people to influence future planning in the home. Lawwood had attained Investors In People Accreditation. Service users were being enabled to complete questionnaires on a six monthly basis. An evaluation of their responses had been produced. Lawwood DS0000061819.V253008.R01.S.doc Version 5.0 Page 20 The manager said relatives and the Community Mental Health team had also been sent quality assurance surveys. A report and action plan following the quality assurance process was to be included in the service user guide. Lawwood DS0000061819.V253008.R01.S.doc Version 5.0 Page 21 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 3 3 X X X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 X 3 X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 4 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Lawwood Score X 3 X X Standard No 37 38 39 40 41 42 43 Score X 3 3 X X X X DS0000061819.V253008.R01.S.doc Version 5.0 Page 22 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. 1 Standard YA23 Regulation 13 Requirement A procedure for reporting suspicions, allegations and incidents of abuse must be produced and made available. The procedure must ensure referrals are made to the appropriate agencies, namely Social Services and Public Protection. Timescale for action 31/12/05 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 YA23 Good Practice Recommendations The procedure for reporting suspicions, allegations and incidents of abuse should include telephone numbers and addresses of the appropriate agencies. 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