CARE HOME ADULTS 18-65
Leanne 158 Warwick Road Carlisle Cumbria CA1 1LG Lead Inspector
Liz Kelley Unannounced 25 May 2005 14:30 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 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 Stationary 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. Leanne v218102 f58 f10 s22710 leanne v218102 250505 ui stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Leanne Address 158 Warwick Road Carlisle Cumbria CA1 1LG 01228 525936 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Anne Langhorne Care Home 3 Category(ies) of MD - Mental Disorder registration, with number of places Leanne v218102 f58 f10 s22710 leanne v218102 250505 ui stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 22 February 2005 Brief Description of the Service: Leanne provides accommodation, care and support for one resident who has lived in the home for 13 years. Although the home is registered to accommodate up to three service users the registered manager does not intend to admit any more residents. The registered manager is the main carer and aims to provide care in a family environment with the resident being treated as an addition to her own family. The home is situated near the centre of Carlisle close to shops, doctors, dentists etc and within easy reach of the town centre. The premises are a large older terraced property with enclosed front courtyard and rear yard. The resident has sole use of a large ground floor bed/sitting room with an ensuite combined bathroom/toilet. Shared space is available in the form of a two sitting rooms, a large “family” kitchen with dining area and a large enclosed rear yard with patio furniture. Leanne v218102 f58 f10 s22710 leanne v218102 250505 ui stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This type of accommodation and service would be better suited for inclusion in an Adult Placement Scheme, which is similar to fostering, and is more appropriate for inspecting a family style of living. However, this is not currently available in Cumbria, and therefore, standards relating to care homes were adapted to inspect this home. This inspection took place in the late afternoon and the one resident and manager were spoken to. A partial tour of the premises took place and the residents file was examined. What the service does well: 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.
Leanne v218102 f58 f10 s22710 leanne v218102 250505 ui stage 4.doc Version 1.30 Page 6 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 Standards Statutory Requirements Identified During the Inspection Leanne v218102 f58 f10 s22710 leanne v218102 250505 ui stage 4.doc Version 1.30 Page 7 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 standard(s) 2 The manager had received appropriate assessments that assured that the resident was placed in a home were their needs could be met. EVIDENCE: Community Care assessments had taken place and a referral had been made from Carlisle Mental Health team, with the appropriate paperwork. The manager had visited the resident and had them to stay prior to a decision to moving permanently into the home was made. Leanne v218102 f58 f10 s22710 leanne v218102 250505 ui stage 4.doc Version 1.30 Page 8 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 standard(s) 6,7 The residents care needs were well met, including promoting good levels of independence. This was assisted by a care plan which was up-to-date and in good detail. EVIDENCE: The manager kept a care plan which detailed the changing needs of the resident, and made adjustments to the level of support that was required. Promoting independence was featured in the care plan and discussed with the manager who gave good detail on how this was being carried out to the benefit of the resident. Leanne v218102 f58 f10 s22710 leanne v218102 250505 ui stage 4.doc Version 1.30 Page 9 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 standard(s) 11,16, The manager has a good understanding of rights and responsibilities which leads to the resident being involved in, and encouraged to make decisions and choices. EVIDENCE: The resident is encouraged and prompted to carry out personal care tasks and to retain independence skills. He is also encouraged to carry out chores in his own room and stated that he enjoys doing these and keeping busy, and he enjoys being included in tasks that other members of the family are undertaking. These include light DIY jobs, decorating and sweeping the yard. Leanne v218102 f58 f10 s22710 leanne v218102 250505 ui stage 4.doc Version 1.30 Page 10 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 standard(s) 18,19 The health and personal appearance of the resident is well looked after by the manager who provides appropriate levels of support to ensure that he is in good health and has access to health care services. EVIDENCE: A recent spell in hospital demonstrated that the health of the resident is being well monitored and the manager took all the necessary steps to ensure that he received the care he required to make a quick recovery. The manager was currently battling to get access to dental care which was an issue in this area, but she was persevering and calling upon other professionals for support. Leanne v218102 f58 f10 s22710 leanne v218102 250505 ui stage 4.doc Version 1.30 Page 11 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 standard(s) 23 The resident is safeguarded from abuse by the managers awareness of rights and open style of running the home. EVIDENCE: The manager demonstrated a good awareness of different forms of abuse and the rights of the individual. She encourages the resident to have regular contact with day services and a social worker visits on a regular basis. The resident feels able to discuss any issues with the manager, he stated and is always given time alone with visitors to discuss his experience of living in the home. Leanne v218102 f58 f10 s22710 leanne v218102 250505 ui stage 4.doc Version 1.30 Page 12 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 standard(s) 24,25,30, The home provides the resident with a comfortable, safe and clean place to live which is centrally located to the community and assists the resident in accessing the community and enjoying a domestic style of life. EVIDENCE: The Home’s location offers easy access to local amenities; it is unobtrusive and blends in with other houses in the road, which allows the resident to have access to all local facilities and the community. The furnishings and decoration were of a high standard and homely in style. The bedroom accommodation was spacious and furnished to meet the needs of the resident being more like a large self-contained flat. Located on the ground floor, it has a separate sitting area, dining area, and French windows that open onto the rear yard. The yard had numerous tubs and flowers and areas for sitting and the resident said he liked to spend time out here. The resident is encouraged to keep their room clean as part of their care plan, this was being carried out to good standards. Leanne v218102 f58 f10 s22710 leanne v218102 250505 ui stage 4.doc Version 1.30 Page 13 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 The resident benefits from being cared for by a manager who is knowledgeable and understanding of the needs of people with mental health problems. EVIDENCE: The manager has the background and experience of caring for people with mental health problems and utilises local expertise of other professionals in this field. The social worker and community psychiatric nurse visit on a regular basis. The manager is the sole carer and does not employ any other staff. Leanne v218102 f58 f10 s22710 leanne v218102 250505 ui stage 4.doc Version 1.30 Page 14 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,42 The home is run in a way that is beneficial to the resident being on a small, domestic scale with administration having a low profile. EVIDENCE: The registered manager has created an open and inclusive atmosphere within the home, which was confirmed by observation and by discussions with the service user. The manager was aware of the need to safeguard the health, safety and welfare of the service user. Records held in the home were deemed to be orderly, up-to-date and relevant. The home was covered by public liability insurance. Leanne v218102 f58 f10 s22710 leanne v218102 250505 ui stage 4.doc Version 1.30 Page 15 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 x 3 x x x Standard No 22 23
ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 x x x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 4 x x x x 3 Standard No 11 12 13 14 15 16 17 3 x x x x 3 x Standard No 31 32 33 34 35 36 Score 3 x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Leanne Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 x x x x 3 x v218102 f58 f10 s22710 leanne v218102 250505 ui stage 4.doc Version 1.30 Page 16 yes 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 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. Refer to Standard Good Practice Recommendations Leanne v218102 f58 f10 s22710 leanne v218102 250505 ui stage 4.doc Version 1.30 Page 17 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith, Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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