Inspection on 01/01/06 for Leahurst

This inspection was carried out on 1st January 2006.

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

Leahurst 18/11/09

Leahurst 09/09/09

Leahurst 15/08/07

Leahurst 06/02/07

Leahurst 25/08/05

Leahurst 12/01/05

Leahurst 07/09/04

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

CARE HOME ADULTS 18-65 Leahurst Coronation Drive Widnes Cheshire WA8 8AZ Lead Inspector Anthony Cliffe Unannounced Inspection 1st February 2006 09:00 Leahurst DS0000005193.V279531.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 Leahurst DS0000005193.V279531.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. Leahurst DS0000005193.V279531.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Leahurst Address Coronation Drive Widnes Cheshire WA8 8AZ 0151 495 1919 0151 423 3513 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) Hilton Residential Homes Limited Mr Michael Moran Care Home 26 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (26), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (26), Physical disability (1) Leahurst DS0000005193.V279531.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The total number of Service Users must not exceed 26 26 of the Service Users may be MD 26 of the Service Users may be MD(E) 1 of the MD Service Users may also be PD Date of last inspection 25th August 2005 Brief Description of the Service: Leahurst care home provides personal care for 26 adults with enduring mental health needs. The home has two double bedrooms but uses these for single occupancy. There are two buildings, the main building with a first floor three bedroom flat and the lodge a three bedroom detached property. The flat and the lodge have their own kitchen, bathroom and living areas. The home is close to local shops and a mile away from Widnes town centre. It is on a local bus route and close to two railway stations. Leahurst DS0000005193.V279531.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A regulatory inspector conducted this unannounced inspection on 1st February 2006 over a period of five hours. Feedback was given to the senior support worker. Records were inspected and staff practice was observed. Discussion took place with residents and staff. What the service does well: What has improved since the last inspection? What they could do better: Residents care plans should incorporate the information in other professionals care plans regarding the role of staff at Leahurst in monitoring residents’ mental health needs. The testing of portable electrical appliances, gas safety, servicing of the fire alarm and testing for legionella must be completed as required. Leahurst DS0000005193.V279531.R01.S.doc Version 5.1 Page 6 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. Leahurst DS0000005193.V279531.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 Leahurst DS0000005193.V279531.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 None of these standards were assessed, as there have been no admissions to the home since January 2005. EVIDENCE: Leahurst DS0000005193.V279531.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,and 8 Residents make decisions and are consulted about their needs and lifestyles taking account of individual risks, which are recorded in their care plans. These are reviewed regularly and reflect residents’ mental health needs but need to incorporate the information identified in the Care Programme Approach documents. EVIDENCE: The records of residents were examined. It was evident from records and discussions with residents and staff that residents are able to choose their own lifestyle and staff support them to plan their lifestyle. Some of the residents are on the enhanced Care Programme Approach and are difficult to engage with. Some of the residents refuse to engage with the local mental health services. The records of one resident detailed a number of attempts to support a resident to attend out patient appointments. This was successful following an internal review with the resident and concern raised by staff about the resident’s mental health the resident attended an out patient appointment. Medication was reviewed by the psychiatrist. It was noted in the review notes that the resident said he ‘trusted’ staff at Leahurst to have recorded his wishes expressed at the review. Another resident had been involved in an incident in the local community. Staff were quick to respond and liaise with the resident’s key worker under the Care Leahurst DS0000005193.V279531.R01.S.doc Version 5.1 Page 10 Programme Approach (CPA). A review of the resident’s mental health needs was arranged. The resident’s CPA care plan contained details of the role of Leahurst staff in supporting the resident to develop budgeting skills, and a social network. The Leahurst care plan was reviewed in December 2005 but did not refer to the role identified in the CPA care plan that the manager was to monitor the resident’s threats of self harm. These threats were not identified as a significant risk to the resident in the CPA risk assessment. See recommendation 1. Leahurst DS0000005193.V279531.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): 13, 15 ands 17 Residents have opportunities to develop and peruse their own relationships, lifestyles and interests. Residents are offered a healthy choice in their diet. EVIDENCE: Residents were seen to move freely in and out of Leahurst. A number of residents talked about their contact with their families. One resident visited his mother daily and spent a lot of time with her. Another resident said he received regular telephone calls from his mother and she visited weekly. A resident talked about his contact with his family and said ‘I can go as I please. I can go to the local shops or pub if I wish. I do occasionally money permitting. We all still go out for a pub lunch and I sometimes go to the MIND centre, but it can be rough in there. I am going out with my cousin and uncle today. We do this every week. He picks me up and we go into Widnes or Warrington. I like to go to the antiques or charity shop and we go to a café for something to eat’. Another resident said ‘ I am going into town to buy some toiletries. There is a great cheep shop there. I don’t like going to the supermarket. I might go to the MIND centre but some of the people there are a bit noisy and I don’t like that. Jenny talked to me about going on holiday. I am going if I can afford it. I go into town a few days a week. I haven’t gone out as much lately, as I didn’t feel like it’. Leahurst DS0000005193.V279531.R01.S.doc Version 5.1 Page 12 The chef had attended a residents’ meeting in January 2006to discuss the menu provided. Minutes of the meeting were available. Six residents and two staff attended the meeting. Meals were discussed and a decision to review the menu taken. A decision to remove sweet and sour chicken to an alternative instead of remaining on the menu was taken, as not all residents liked it. Venues for evening meals out for ‘a meal and few drinks’ were discussed. Residents came up with several venues of their choice. A senior support worker discussed holiday arrangements and confirmed that a chalet at Pontins, Prestatyn had been booked as agreed. This was a self-catering holiday. Residents gave suggestions for days out. Leahurst DS0000005193.V279531.R01.S.doc Version 5.1 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): 18 and 19 Residents receive support to maintain their health and welfare. EVIDENCE: Residents are supported to maintain their health and welfare. A resident’s care plan review confirmed that staff had arranged a dental appointment as agreed at the review. The resident had signed the care plan review to agree the content. Another care plan had been reviewed to reflect how staff monitor and support residents to manage their mental health as recommended at the last visit. Positive outcomes were recorded for a resident. Staff had engaged the resident in a review of his care following concerns about his mental health needs. The resident identified that the medication changed by his psychiatrist had not worked and requested it was recorded he remain on his preferred medication. His request was recorded. Prior to the review staff became concerned about the resident’s mental health and his medication changed by his psychiatrist. The resident was seen again in October 2005 and his original medication recommenced. Following this the care plan was reviewed with the resident in November 2005. His key worker discussed aspects of the resident’s mental health that staff had been concerned about. The resident had been seen to isolate himself and was heard shouting, swearing and banging doors. The resident identified the behaviour as associated with his ‘voices’ increasing and said he preferred to go to is room to cope with them. He was advised he could talk to staff about his distress and said he knew he could talk to staff about his ‘voices’. The resident agreed to a plan to monitor his mental health needs which included attending out patient appointments with his psychiatrist, Leahurst DS0000005193.V279531.R01.S.doc Version 5.1 Page 14 liaison with his key worker under the CPA and encouraging him to talk about his feelings. A resident said that support was provided as he chose and said ‘ I have a time table to follow but its not strict. If I need help to do my room or to do my washing and ironing then I can ask. I like my clothes to be clean’. Another resident said ‘ I have a timetable that I agreed, but you don’t have to stick to it. My key worker has changed to Jenny. I can talk to staff about how I feel. I don’t have a CPN and they have asked if a male CPN is ok. I know I don’t have to have a male it’s my choice’. Leahurst DS0000005193.V279531.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 Residents’ views are taken seriously and acted upon. EVIDENCE: The company complaints procedure was displayed in the entrance to the home. No complaints were recorded. Residents said they knew that they could complain to staff or the manager. No issues or expressions of dissatisfaction about the facilities and services available at Leahurst were made. Residents meetings was held in July 2005 and January 2006. The senior care staff on duty could not produce the minutes of the meeting for January 2006 and stated that residents were reminded at meetings about the complaints procedure. Leahurst DS0000005193.V279531.R01.S.doc Version 5.1 Page 16 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 and 30 Residents live in a comfortable and safe environment, which is clean and hygienic. EVIDENCE: A tour of the main building, first floor flat and lodge was undertaken. A number of residents’ bedrooms were seen. A vacant bedroom had been redecorated. The kitchen areas of the lodge and first floor flat are old but serviceable. These areas were clean. The kitchen in the main building used by resident is well maintained. Leahurst DS0000005193.V279531.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): 35 A competent and appropriately trained staff team cares for residents. EVIDENCE: Staff had received training on the NOMAD medication system, moving and handling, food hygiene and infection control. Eight of the eleven staff working at the home have an NVQ 2 qualification. Two recently employed staff attended a ‘working in care’ induction day in January 2006. Leahurst DS0000005193.V279531.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 Resident’s safety is not sufficiently promoted and protected and this needs to improve. EVIDENCE: All staff had fire safety training in September 2005. A fire drill took place in October 2005 and included residents and staff. The fire alarm was recorded as tested every week and emergency lighting every month. The annual service for the fire alarm, portable electrical appliance testing, gas safety and legionella testing could not be verified. The manager confirmed the registered person as required had not done these. Leahurst DS0000005193.V279531.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME 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 3 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 X 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 X x LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X x X X X X X 1 x Leahurst DS0000005193.V279531.R01.S.doc Version 5.1 Page 20 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA42 Regulation 13(4), 23(2)(4) Requirement The registered person must ensure that all parts of the home to which residents have access are safe any activities free from risks and risks to health and safety eliminated. Including the required testing of electrical equipment, electrical safety systems, gas and water supply. Timescale for action 01/04/06 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 YA6 Good Practice Recommendations Residents care plans should incorporate the information in other professionals care plans regarding the role of staff at Leahurst in monitoring residents’ mental health needs. Leahurst DS0000005193.V279531.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Leahurst DS0000005193.V279531.R01.S.doc Version 5.1 Page 22 - 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!