Inspection on 07/09/06 for Leanne

This inspection was carried out on 7th September 2006.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Leanne 31/01/06

Leanne 25/05/05

Leanne 22/02/05

Leanne 09/08/04

Leanne 24/03/04

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

CARE HOME ADULTS 18-65 Leanne 158 Warwick Road Carlisle Cumbria CA1 1LG Lead Inspector Liz Kelley Unannounced Inspection 7th September 2006 14:00 Leanne DS0000022710.V304206.R01.S.doc Version 5.2 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.V304206.R01.S.doc Version 5.2 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.V304206.R01.S.doc Version 5.2 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.V304206.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st January 2006 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. All referrals are made, and funded via the Integrated Health and Social Services Team. The current scale for charging is £381 Leanne DS0000022710.V304206.R01.S.doc Version 5.2 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. As part of the inspection a visit was made to the home and the one resident and manager were spoken to. A partial tour of the premises took place and the residents’ files were 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.V304206.R01.S.doc Version 5.2 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.V304206.R01.S.doc Version 5.2 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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home has robust and well-established procedures in place to introduce new residents. However, the manager does not intend to take any further service users. 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 DS0000022710.V304206.R01.S.doc Version 5.2 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): 6,7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents care needs were well met, including promoting good levels of independence 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. . 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 manager has frequent discussions on risk areas such as smoking, money and supported needed to go into town or leave the house. Leanne DS0000022710.V304206.R01.S.doc Version 5.2 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): All the above standards Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents rights are promoted with a good degree of control and choice. EVIDENCE: The resident is encouraged and prompted to carry out personal care tasks and to retain independence skills. 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. Also the resident is 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. The resident described the home as “lovely” and said he was very settled and happy here. He was particularly pleased to keep cats that he was responsible for looking after. Interaction between the manager and resident was observed to be positive, relaxed and of a warm nature. The meals in this home are good offering both choice and variety and catering for special dietary needs. Leanne DS0000022710.V304206.R01.S.doc Version 5.2 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): 18,19,20 and 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good systems have been developed to monitor individual’s health and medication. Established links with local health care professionals ensure residents receive effective and timely health care. EVIDENCE: The manager makes sound judgements and keeps good records of medications that promotes the health and well-being the resident. 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. Recent communications were examined from an occupational therapist to assist in promoting physical independence. A CPN visits on a fortnightly basis to administer injections. These are also recorded on the MAR sheet. A feedback card was received from the visiting CPN stating “ In my professional opinion I feel the resident is well cared for in all aspects of care, physical and mental needs. He states he is very happy living at Leanne care home”. Regular visit are made to the GP, opticians, dentist and records kept. Leanne DS0000022710.V304206.R01.S.doc Version 5.2 Page 11 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. The home has sensitively handled the ageing process and offered support to minimise any impact on independence. Leanne DS0000022710.V304206.R01.S.doc Version 5.2 Page 12 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The resident is safeguarded from abuse by the manager’s 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 and CPN visit 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. Financial transactions on behalf of the residents were all documented and receipts and signatures gained to approve authorisation. Leanne DS0000022710.V304206.R01.S.doc Version 5.2 Page 13 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The resident benefits from living in a well kept and safely maintained home that is centrally located for local amenities. EVIDENCE: 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. 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 has 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 DS0000022710.V304206.R01.S.doc Version 5.2 Page 14 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): 32,34,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. The resident benefits from the male presence in the house and enjoys discussions on areas he finds interesting, such as football, their work and DIY jobs which he is often included in. Leanne DS0000022710.V304206.R01.S.doc Version 5.2 Page 15 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): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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.V304206.R01.S.doc Version 5.2 Page 16 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 3 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 3 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 3 33 X 34 3 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 X X 3 X Leanne DS0000022710.V304206.R01.S.doc Version 5.2 Page 17 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.V304206.R01.S.doc Version 5.2 Page 18 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 © 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 Leanne DS0000022710.V304206.R01.S.doc Version 5.2 Page 19 - 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!