Inspection on 04/11/05 for Leighton House

This inspection was carried out on 4th November 2005.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Leighton House 18/11/08

Leighton House 30/01/07

Leighton House 17/05/05

Leighton House 03/12/04

Leighton House 17/08/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Leighton House Merry Den Care 44 Station Street Cinderford Gloucestershire GL14 2JT Lead Inspector Mr Richard Leech Unannounced Inspection 4th November 2005 10.30 Leighton House DS0000060129.V260790.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 Leighton House DS0000060129.V260790.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. Leighton House DS0000060129.V260790.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Leighton House Address Merry Den Care 44 Station Street Cinderford Gloucestershire GL14 2JT 01594 827358 01594 827358 merrydencare@aol.com 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 Denise Carol Leighton Mrs Denise Carol Leighton Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Leighton House DS0000060129.V260790.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th May 2005 Brief Description of the Service: Leighton House was first registered in May 2004. The home provides care for two service users with learning disabilities. The property is a two-storey terraced house near the centre of Cinderford. The service users are accommodated in single rooms on the first floor. There is a shared bathroom and toilet on the first floor and a toilet on the ground floor. The home has a lounge and a separate dining room, as well as a small back garden with seating and a summerhouse. The home provides transport for the service users and supports them to access activities in the local community. The provider is in day-to-day charge of the home and acts as manager. Leighton House DS0000060129.V260790.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection began at 10.30 and lasted for about two hours. Both service users were out at the time but were spoken with on the telephone later that day. Comment cards were also left for them to complete if they wished to. During the inspection requirements and recommendations from the last report were checked. Some records were looked at including staffing files, care plans and financial documents. The summary below reflects the relatively limited scope of this inspection. The report should be read in conjunction with the previous inspection report for a fuller picture of the home. What the service does well: What has improved since the last inspection? What they could do better: More care needs to be paid to ensuring that prescribed medication is securely and appropriately stored. This requirement was also made in the last report. Some recommendations are made for the home to consider. Leighton House DS0000060129.V260790.R01.S.doc Version 5.0 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. Leighton House DS0000060129.V260790.R01.S.doc Version 5.0 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 Leighton House DS0000060129.V260790.R01.S.doc Version 5.0 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 standards in this section were inspected on this occasion. EVIDENCE: There have been no new admissions since the last inspection. Leighton House DS0000060129.V260790.R01.S.doc Version 5.0 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): None of the standards in this section were fully inspected on this occasion. EVIDENCE: Care plans were not checked in detail. However, those viewed had evidence of regular review. The manager said that one person had copies of their care plans, although the other person preferred not to have copies. Care plans will be looked at in more detail during future inspections. The manager described the progress that one person had recently made, saying that they were more assertive and independent, and providing examples. There are plans to further develop the person’s independence. The manager also described issues around duty of care, such as balancing the person’s need for space and quiet with maintaining a varied range of activities. One risk assessment was viewed. This was about the risks posed to service users by household chemicals. It was agreed that this risk assessment should include more information about how the risk was being appropriately managed. It had also not been reviewed since September 2004. All personal information appeared to be securely stored on the day of the inspection. Leighton House DS0000060129.V260790.R01.S.doc Version 5.0 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): 16 Service users are supported to determine their own routines and to take control of their lives. EVIDENCE: The manager described how the routines in the home were flexible and driven by service users’ choices. For example, one person elects to spend most of the morning at a café and will then often choose to visit friends at varying times. The manager said that mealtimes are flexible and that the service users can eat in the lounge or their rooms if they wish (though choose to eat together). The manager described how the service users were in charge of their evening and weekend routines and how there were no set times for anything. The service users expressed satisfaction with their routines and indicated that they felt in control of how they spent their time. They commented positively on their activities. The service users were mostly positive about the food served in the home and indicated that they were offered choice over what they ate. Leighton House DS0000060129.V260790.R01.S.doc Version 5.0 Page 11 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): None of the standards in this section were inspected on this occasion. EVIDENCE: The manager stated that one person who used to have their skin checked over for rashes and other complaints has now been supported to do this independently. It was agreed that this is a much better arrangement. The manager reported that the person also attends a chiropodist every six weeks and that their general health and hygiene is very good. In the last report a requirement was made for medication to be appropriately stored. During this visit some prescribed cream was found in a kitchen cupboard alongside sugar and tea. It was agreed that this is unacceptable and that closer attention must be paid to appropriate storage of medication. Some over-the-counter herbal remedies belonging to the manager were stored in a kitchen cupboard. These should be stored off the premises, or securely if brought in for a shift. Medication records and the locked cabinet were not checked on this occasion. Leighton House DS0000060129.V260790.R01.S.doc Version 5.0 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): 23 Arrangements are in place which help to protect service users from the risk of abuse. EVIDENCE: The manager said that three staff had recently attended local ‘Alerter’s Guide’ training and that more staff (including herself) would attend this in the near future. She said that adult protection and abuse issues are discussed during induction, supervision and staff meetings in terms of general awareness and whistle blowing. The manager plans for annual external training in this area. The manager said that she has obtained details of the PoVA scheme. She reported that she was not aware of any adult protection issues in the service and that no staff had whistle blown. Some service users’ financial records were sampled and appeared to be in order. The manager said that both service users now retain most of their money and sign to indicate when they receive any cash. The service was still retaining small amounts of loose change for service users. It was agreed that there appeared to be no need to retain any of the service users’ money and the manager indicated that this would be phased out gradually. Some dates in the financial records were incorrect. Care should be taken to ensure that the dates are accurate. The manager said that service users’ benefits are paid directly into their accounts, with a standing order set up to pay for their contributions to care. She said that a local specialist financial team from Social Services had confirmed that the service users were receiving all of their benefit entitlements. Leighton House DS0000060129.V260790.R01.S.doc Version 5.0 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): None of the standards in this section were fully inspected on this occasion. EVIDENCE: In the last report a number of requirements were made around aspects of the physical environment. These were found to have been addressed. The carpet on the stairs was becoming threadbare in places. The manager said this was going to be replaced in the near future as part of redecorating the hall and landing (the walls had been stripped ready for decoration). This will be checked during the next inspection. The bathroom carpet was stained and becoming worn. This should also be replaced. A number of recommendations were also made in the last report. These appeared to have been mostly addressed. The manager said that she was looking into providing liquid soap and paper towels in the ground floor toilet. A new, larger fridge has been purchased. The sleep-in room still contained some personal belongings of the manager. She said that she is in the process of buying a new property and that the items would then be moved to there. A bag of frozen vegetables was split and wide open in the freezer. The contents were transferred to a sealed container during the inspection. Leighton House DS0000060129.V260790.R01.S.doc Version 5.0 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 & 35. The home’s procedures for recruiting staff reduce the risk of unsuitable carers being employed. A good staff training programme promotes consistency and good practice in their work supporting service users. EVIDENCE: One new staff member has been recruited since the last inspection. Their staffing file included the information required under the Care Homes Regulations. The manager said that all staff are taking NVQ level 2 in care through a local college. Two have completed this and plan to start the level 3 qualification. Service users said that the staff were ‘ok’, ‘friendly’ and ‘nice’. Training records for three staff members were sampled. These provided evidence of core training (such as first aid and food hygiene) being up to date and of other relevant training being provided such as about autistic spectrum conditions and the safe handling of medication. Leighton House DS0000060129.V260790.R01.S.doc Version 5.0 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 The manager is competent and experienced, promoting positive outcomes for service users. Systems are in place for monitoring and improving the quality of care and the service users feel valued and listened to. EVIDENCE: During the original registration process the manager provided a certificate as evidence of achieving the Registered Manager’s Award in April 2003. She also has a HNC in Caring Services (managing care), which was agreed at the time as meeting the criteria for qualifications in care. The manager said that she plans to take further courses in the future to update her knowledge and skills. The manager has acted as an NVQ assessor and attended a considerable number of other relevant training courses. She has been in a managerial post working with adults with learning disabilities since 1997. Prior to this she worked in less senior roles in the sector. Leighton House DS0000060129.V260790.R01.S.doc Version 5.0 Page 16 In the last report a recommendation was made about ensuring that standards are maintained in the manager’s absence. She described addressing the points raised with staff and expressed confidence that there would be no repeat of the shortfalls identified during the last inspection when the manager was away. The manager said that there are regular residents’ meetings. Minutes are kept and topics include food and activities. A service user confirmed that these meetings take place and that their views were listened to and taken forward. The manager gave examples of actions that had resulted from these meetings. The manager said that there is regular, informal feedback from service users and that reported that they were becoming increasingly confident in speaking up. She said that other forms of quality monitoring included discussion in supervision and staff meetings, and management review meetings. Leighton House DS0000060129.V260790.R01.S.doc Version 5.0 Page 17 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 x 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x x x x 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 x 13 x 14 x 15 x 16 3 17 Standard No 31 32 33 34 35 36 Score x 3 x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Leighton House Score x x x x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x x x DS0000060129.V260790.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? YES 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 (2) & (4) Requirement Prescribed medication must be appropriately stored at all times (timescale of 15/06/05 not met). Timescale for action 20/11/05 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 YA9 Good Practice Recommendations Ensure that risk assessments include full information about how a risk is appropriately managed. Ensure also that risk assessments are reviewed regularly. Store over-the-counter herbal remedies belonging to staff off the premises. If they are brought in for a shift then store them securely during this time. Ensure that all dates in service users’ financial records are accurate. Consider replacing the bathroom carpet. 2 3 4 YA20 YA23 YA27 Leighton House DS0000060129.V260790.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 Leighton House DS0000060129.V260790.R01.S.doc Version 5.0 Page 20 - 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. 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