Inspection on 15/02/06 for Lawwood

This inspection was carried out on 15th February 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lawwood 27/06/07

Lawwood 13/10/05

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 15th February 2006 10:00 Lawwood DS0000061819.V281483.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 Lawwood DS0000061819.V281483.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. Lawwood DS0000061819.V281483.R01.S.doc Version 5.1 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.V281483.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The service should employ a suitably qualified and experienced 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 13th October 2005 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.V281483.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took 5½ 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 agreement. The manager completed a pre-inspection questionnaire. What the service does well: This home aims to provide good quality care and support for current and future service users. The management team were cooperative in their approach to the inspection process. The atmosphere in Lawwood was welcoming, supportive and friendly, relationships amongst every one were fine. The standard of the accommodation was very good. Individual Plans drawn up with each person, made sure staff were aware of their needs and knew how to support them. Everyone was being given opportunity to get out into the local community and join in different activities. “I’m still working voluntary in the charity shop” said one person I help with the shopping every week” said another. 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 and friends. Every one was happy with the meals provided and people were involved with choosing menus and cooking. “Oh yes we get some good meals” one person said. 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. Personal care was being provided sensitively. There was plenty of staff to support people with activities outings and one to ones. 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. “I like the staff they are good to you” “they look after us well” The manager was well qualified and experienced. Lawwood DS0000061819.V281483.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. Lawwood DS0000061819.V281483.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 Lawwood DS0000061819.V281483.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): None of the above standards were fully assessed at this inspection; please refer to the previous inspection report dated 13th October 2005. EVIDENCE: Lawwood DS0000061819.V281483.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 Service users had individual written Plans, which responded to their support needs and outlined goals and activities. EVIDENCE: Individual 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. Service users spoken with were aware of their individual Plans; they said they signed in agreement with them. The Plans were based upon initial assessment/reviews. Care notes provided a good reflection of each person’s daily living and specifically responded to identify needs/goals. Lawwood DS0000061819.V281483.R01.S.doc Version 5.1 Page 10 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, 15, 17 The service users were being offered opportunities to engage in a range of activities and were supported to use community resources. Good arrangements were in place to enable service users to maintain links with families and friends. The catering arrangements provided for the residents tastes, choice, diet and skill development. EVIDENCE: 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, TV, knitting and cooking. During the inspection several service users went out into the local community. Some of the service users said they had been on holiday to the Lake District; others were planning to go abroad later in the year. Lawwood DS0000061819.V281483.R01.S.doc Version 5.1 Page 11 Service users explained they were keeping in touch with members of their families and friends, by telephone, visits, or short breaks away. Again the managers and staff had worked hard to enable service users to re-establish or continue, appropriate relationships with their families and friends. Service users said they were happy with the variety and quality of the meals provided. Some said they were involved with shopping for provisions. A revised four-week menu plan had been introduced which was being changed two monthly. The service users said they were being asked every week about the choices for the evening meal, with two main options being offered. Service users said they could have whatever they wanted for breakfast and lunch. Records were seen of the meals served. 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 and baking. Healthy eating was being encouraged; some individual diet plans were in place. Lawwood DS0000061819.V281483.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): 18, 19, 20 Support with personal care was provided sensitively in response to service users needs and wishes. Arrangements were in place to monitor the service users’ general health and wellbeing and to access appropriate health care services. Medication management practices were in need of improvement for the protection of the service users and staff. EVIDENCE: Service users personal care support needs were highlighted in their individual Plans as appropriate. Service users spoken with felt this support was provided sensitively and discreetly. Health care matters were reflected within individual Plans. Records showed general health was being monitored and support was being provided for appointments. Service users spoken with confirmed they had received attention from health care professionals including GPs, Consultants and Dentists. Medication storage facilities were satisfactory. Medication policies were available. All staff responsible for medication administration had received training. Records were seen of service users’ agreement to staff managing Lawwood DS0000061819.V281483.R01.S.doc Version 5.1 Page 13 their medication. Individual risk assessments had been completed with service users on managing their own medication. There was no policy or individual protocols for ‘when necessary’ medication, or on medication leaving the home with service users. The policy for covert medication was within the Royal Pharmaceutical guidance book. Hand written entries on MAR (medication administration records) had not been countersigned. One MAR sheet showed a change in medication, but there was no record to support the reason for the change, or to provide clear instructions/directions for staff. Another entry stated ‘R’ but it was not clear what this meant. There were no suitable storage facilities should service users be prescribed controlled drugs. It was not clear from the information available if the medication training was accredited. Lawwood DS0000061819.V281483.R01.S.doc Version 5.1 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): 23 Satisfactory arrangements were in place for protecting the residents from abuse, but guidance for managers and staff still needed developing to ensure an appropriate response. EVIDENCE: The protection/abuse policies contained extensive information based upon the Department of Health guidance No Secrets. A physical intervention/restraint policy was available. Some staff had covered protection and abuse matters as part of NVQ (National Vocational Qualifications) training. A revised abuse referral procedure had been introduced; this included details similar to the staff whistle blowing procedure and did not provide appropriate instructions for managing allegations, suspicions or incidents of abuse. A policy had been introduced about children visiting the home; this needed developing further in line with local child protection procedures. Lawwood DS0000061819.V281483.R01.S.doc Version 5.1 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, 30 The standard of the accommodation was very good, providing the service users with suitable facilities and an attractive, clean, homely place to live. EVIDENCE: 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. Most bedrooms had recently been fitted with new, custom-made wardrobes and drawers, some had new beds. One lounge had been redecorated; service users said they had been involved with choosing colour scheme and the new carpet. A new sofa and chairs had been provided. The standard of furnishings were very good and they were homely in style and good quality. The room designated for smoking had a computer; some service users were imputing their own passwords for Internet access. Satellite television was available. There was a pleasant private courtyard to the rear of the home. The home was very clean and free from unpleasant smells. The laundry area was easily cleanable and contained appropriate washing equipment, liquid soap Lawwood DS0000061819.V281483.R01.S.doc Version 5.1 Page 16 and paper towels. Hygiene policies were in place. Some staff had undertaken training in infection control. Lawwood DS0000061819.V281483.R01.S.doc Version 5.1 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 Recruitment practices indicated attention was being given employing suitable staff and protecting the service users, but records needed clearly to show this. 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. EVIDENCE: The records of the two most recently recruited support staff were examined; both included satisfactory information including checks and completed application forms. Interview notes had not been kept and a record had not been kept to show gaps in employment had been discussed and clarified. 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. Observation of staff working with service users indicated positive relationships had been developed; staff were respectful and sensitive to the needs of the service users. Service users made positive comments about the staff team. Lawwood DS0000061819.V281483.R01.S.doc Version 5.1 Page 18 Staff training and development was ongoing, seven support staff had completed NVQ level 2 in promoting independence. Two staff were undertaking NVQ level 3 and two senior staff had applied for NVQ level 4 in care management. Existing staff had completed First Aid and Moving and Handling and Medication awareness training. New staff were undertaking induction training. Individual training records were seen to be kept, including induction training checklists and records of one to one supervisions and appraisals. Lawwood DS0000061819.V281483.R01.S.doc Version 5.1 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): 37, 42 The manager of Lawwood had the ability, experience and qualifications to effectively manage the service for the benefit of the service users. Health and safety was being promoted for the benefit of the residents, staff and visitors. EVIDENCE: The atmosphere in Lawwood was friendly, supportive and welcoming. 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. Amanda Balmer, registered manager had relevant qualifications including RMN (Registered Mental Nurse) the Registered Managers Award and certificates in training. The home was found to be free from any obvious hazards to health and safety. Health and Safety policy statements were available. All staff had been provided with health and safety handbooks. Health and safety risk Lawwood DS0000061819.V281483.R01.S.doc Version 5.1 Page 20 assessments had been completed. The pre inspection questionnaire showed equipment had been serviced and that installations and maintenance checks were ongoing. Fire drills were being carried out, fire equipment was being checked and tested. All staff had completed First Aid training. Training in safe working practices, such as moving and handling and infection control was ongoing, or being arranged. Lawwood DS0000061819.V281483.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 X 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 2 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 3 33 3 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X X X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 4 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X X X X 3 X Lawwood DS0000061819.V281483.R01.S.doc Version 5.1 Page 22 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 YA20 Regulation 13,17 Requirement A record must be kept of any changes in service users prescribed medication, such as discontinued items and revised instructions for administration of newly prescribed items. 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 of 31/12/05 not fully met) Records must be kept to show any gaps in employment have been explored and approved. Timescale for action 17/03/06 2. YA23 13 31/03/06 3. YA34 17,19 17/03/06 Lawwood DS0000061819.V281483.R01.S.doc Version 5.1 Page 23 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 YA20 Good Practice Recommendations Policies on covert administration should be personalised to Lawwood and reflect current practice. Policies and procedures on medication leaving the home with service users/representatives; should be defined and introduced in line with current good practice. Criteria for the administration of when required and variable dose medication should be clearly defined and recorded for each service user prescribed such items. A second member of staff should witness all hand written entries on Medication Administration Record charts. There should be a ‘signature’ list for staff authorised to administer medication; this should ease the identification of initials. Action should be taken to clarify and show the medication training provided is accredited, and includes an assessment of staffs’ competence to complete these tasks. Suitable storage facilities should be available should a service users be prescribed controlled drugs. The procedure for reporting suspicions, allegations and incidents of abuse should include telephone numbers and addresses of the appropriate agencies. Child protection policies and procedures should be defined and introduced in accordance with localised child protection protocols. Records should be kept of staff recruitment interviews. 2. YA23 3. YA34 Lawwood DS0000061819.V281483.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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 Lawwood DS0000061819.V281483.R01.S.doc Version 5.1 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. 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