CARE HOME ADULTS 18-65
Leanne 158 Warwick Road Carlisle Cumbria CA1 1LG Lead Inspector
Liz Kelley Unannounced Inspection 31 January 2006 02:00 Leanne DS0000022710.V266252.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 Leanne DS0000022710.V266252.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. Leanne DS0000022710.V266252.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Leanne Address 158 Warwick Road Carlisle Cumbria CA1 1LG 01228 525936 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) Mrs Anne Langhorne Mrs Anne Langhorne Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Leanne DS0000022710.V266252.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 25th May 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 en-suite 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 DS0000022710.V266252.R01.S.doc Version 5.0 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 DS0000022710.V266252.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Leanne DS0000022710.V266252.R01.S.doc Version 5.0 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 the following standard(s): These standards were assessed and met at the last inspection. EVIDENCE: Leanne DS0000022710.V266252.R01.S.doc Version 5.0 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 the following standard(s): 9 The home has developed a good balance between risk and a duty of care which has enabled the resident to take part in activities commensurate with his abilities. EVIDENCE: 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. 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. The impact of getting older was also discussed and how this had limited some abilities to take part in community activities independently. 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. Leanne DS0000022710.V266252.R01.S.doc Version 5.0 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 the following standard(s): 12,13,15 and 17 The home provides the resident with a life that has routine and predictability which is to his choosing and which maintains his mental well-being and promotes his general good health. 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 family members are undertaking. These include light DIY jobs, decorating and sweeping the yard, and going out with the owners husband. The meals in this home are good offering both choice and variety and catering for special dietary needs. Leanne DS0000022710.V266252.R01.S.doc Version 5.0 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 the following standard(s): 20 and 21 The manager makes sound judgements and keeps good records of medications that promotes the health and well-being the resident. The home has sensitively handled the ageing process and offered support to minimise any impact on independence. EVIDENCE: The manager keeps MAR sheets which were examined and were in good order. Good health care records are kept and this includes communication from health care professionals. A CPN visits on a fortnightly basis to administer injections. These are also recorded on the MAR sheet. Regular visit are made to the GP and records kept. 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. Leanne DS0000022710.V266252.R01.S.doc Version 5.0 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 the following standard(s): 22 The home has a satisfactory complaints system with evidence of service users able to express their views on the home, and these being acted upon. EVIDENCE: The resident was observed freely expressing opinions to the manager and other ways of expressing views more formally via the complainants procedure were seen. The open atmosphere created within the home ensures that the resident feels free to express his opinions and is confident that they will be listened to and concerns acted upon. The resident has contact from a CPN every other week and they spend time talking in private, and the resident said they felt they could speak openly to this person. Leanne DS0000022710.V266252.R01.S.doc Version 5.0 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 the following standard(s): These standards were assessed and met at the last inspection. EVIDENCE: Leanne DS0000022710.V266252.R01.S.doc Version 5.0 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 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): The residents’ needs are well met by Mrs Langhorne who provides supportive and enabling care. EVIDENCE: Mrs Langhorne works alone and does not employ any staff. She has developed good links with the local mental Health Team who she uses for advice and support. Family members help out by including the resident in daily life in the house. Leanne DS0000022710.V266252.R01.S.doc Version 5.0 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 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): 39 and 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 resident. The residents said that he would speak to Mrs Langhorne if he had any concerns or complaints, and said that she would try to sort things out. 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 DS0000022710.V266252.R01.S.doc Version 5.0 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 X X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X 3 X Standard No 24 25 26 27 28 29 30
STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score 3 X X X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Leanne Score X X 3 3 Standard No 37 38 39 40 41 42 43 Score X X 3 X X 3 X DS0000022710.V266252.R01.S.doc Version 5.0 Page 16 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Leanne DS0000022710.V266252.R01.S.doc Version 5.0 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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