Inspection on 28/12/06 for Lemsford Road

This inspection was carried out on 28th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lemsford Road 05/12/05

Lemsford Road 12/07/05

Lemsford Road 13/01/05

Lemsford Road 17/08/04

Lemsford Road 03/12/03

Lemsford Road 17/06/03

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

CARE HOME ADULTS 18-65 Lemsford Road 66 & 66a Lemsford Road St. Albans Hertfordshire AL1 3PT Lead Inspector Alison Jessop Key Unannounced Inspection 28th December 2006 10:00 Lemsford Road DS0000019445.V325527.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 Lemsford Road DS0000019445.V325527.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. Lemsford Road DS0000019445.V325527.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lemsford Road Address 66 & 66a Lemsford Road St. Albans Hertfordshire AL1 3PT 01727 850 436 01727 810 723 Lemsford.Road@unitedresponse.org.uk www.unitedresponse.org.uk United Response 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 Terri Jenner Care Home 11 Category(ies) of Learning disability (11), Physical disability (11) registration, with number of places Lemsford Road DS0000019445.V325527.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th December 2005 Brief Description of the Service: 66 Lemsford Road is a detached house divided into three separate living areas on three floors. 66a Lemsford Road is a detached annex house standing in the large garden of the main building. There is also a large outbuilding that is used for activities and staff training. In each of the four living areas there are single bedrooms, a lounge, a kitchen diner, a laundry and bathrooms. There is a large garden to the side and rear of the house. Lemsford Road is a busy road about one mile from central St. Albans but within easy reach of all amenities of the city. It has good access to major roads (M1 and M25) and has excellent public transport links. The home, which is owned by the Health Authority, is staffed and run by United Response. It offers care services for 11 adults with learning and physical disabilities. The current fees for accommodation are £1288.29. Lemsford Road pays for one holiday a year for each resident and some outings and activities throughout the year. Lemsford Road DS0000019445.V325527.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One Regulatory Inspector carried out this unannounced inspection over half a day. Feedback was gained from service users and time was spent talking to the staff team including the manager who was available to answer questions throughout the inspection. Records were also scrutinised. The outcome of this key inspection was very positive. What the service does well: What has improved since the last inspection? All doors and windows of the home have been replaced. This has increased the safety of residents and improved the appearance of the home. A medication fridge has been supplied so that medication can be stored at the correct temperature. Paper towels have been provided in all toilets increasing infection control measures. Lemsford Road DS0000019445.V325527.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Lemsford Road DS0000019445.V325527.R01.S.doc Version 5.2 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 Lemsford Road DS0000019445.V325527.R01.S.doc Version 5.2 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. 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. Admissions are not made to the home until a full needs assessment has been undertaken, ensuring that so far as possible service users needs can be met. EVIDENCE: Needs assessments are comprehensive and are carried out by a competent person. Service users and their families are invited to visit the home and trial periods are arranged. Lemsford Road DS0000019445.V325527.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans contain comprehensive information about service users current needs and risk assessments had also been regularly reviewed. Staff appeared to have a good understanding of service users needs and preferences. EVIDENCE: Care plans are person centred and covers all aspects of personal and social support. Risk assessments contain comprehensive advice on how to manage risk. One service user has been experiencing regular epileptic seizures and her care plan contained protocols on managing this, which have been created with input from other professionals. Feedback from service users was very positive. One service user said that he attends college and travels independently on public transport. Staff initially travelled with the service user until both the service user and staff were confident that the journey could be completed independently. A Lemsford Road DS0000019445.V325527.R01.S.doc Version 5.2 Page 10 recommendation has been made for care plans to be available in a more accessible format. Lemsford Road DS0000019445.V325527.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home understands the importance of enabling service users to achieve their goals, follow their interests and be integrated into community life and leisure activities. Residents receive support and guidance about a balanced diet and are involved in planning menus. EVIDENCE: Service users have a weekly activity plan, which includes visits to day care services. On the day of the inspection some of the service users went out to the theatre to see the pantomime. There is a large annex in the garden where service users can enjoy activities and where regular art and crafts sessions are held. Lemsford Road DS0000019445.V325527.R01.S.doc Version 5.2 Page 12 Another service user who has an interest in aeroplanes had been taken on a trip in a small aircraft. Service users and staff had been on a day trip to Southend on Sea to see the Christmas lights. Service users living on the ground floor of the home were observed enjoying listening to music in the company of the staff. Staff have ensured that a service user who has been unwell recently has continued to participate in outings and activities. Lemsford Road DS0000019445.V325527.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans give a comprehensive overview of service users health needs. Care practice observed was sensitive and dignified. Service users appeared to feel comfortable with the staff and service users emotional needs appeared to be considered. EVIDENCE: Care plans in relation to personal care and healthcare are comprehensive and individual preferences are documented. For those service users who are unable to verbally communicate, body language and reactions of service users are observed and documented. One service user who has epilepsy has required an increase in her care due to frequent seizures. Protocols are place and relevant health care professionals are involved. Procedures relating to medication are generally satisfactory, however a number of medications being stored in the medication cabinet could not be accounted for as no stock records were available. Lemsford Road DS0000019445.V325527.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Policies and procedures regarding protection of individuals are available to staff. The service has a complaints procedure that is up to date, very clearly written, and is easy to understand. EVIDENCE: No complaints have been received since the last inspection and staff spoken to are aware of the Protection of Vulnerable Adults and Whistle Blowing procedure. An incident had been reported to the Commission where a staff member had gone off shift early leaving service users at risk. This was dealt with satisfactorily in accordance with the homes disciplinary procedure. Policies and procedures regarding protection of adults are of a very commendable quality, and the home is open in discussing incidents with external bodies (CSCI, local adult protection) to clarify difficult judgements. Lemsford Road DS0000019445.V325527.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The living environment is appropriate for the particular lifestyle and needs of the residents and is homely, clean, safe and comfortable. EVIDENCE: The house is clean, attractively decorated and offers a homely environment to service users. Service users bedrooms are very spacious and are individually decorated to reflect service users personalities and interests. The kitchens on the ground floor and in 66a Lemsford Road are in a state of disrepair and require replacing. The kitchen on the on the ground floor at number 66 requires redecoration, in particular the ceiling above the dining table. Lemsford Road DS0000019445.V325527.R01.S.doc Version 5.2 Page 16 The bathroom on the ground floor has a large damp patch on the wall. This must be repaired and redecorated. A small area on another bathroom wall where a toilet cistern has been replaced requires redecoration. Lemsford Road DS0000019445.V325527.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff members undertake external qualifications beyond the basic requirements. Managers encourage and enable this and recognise the benefits of a skilled, trained workforce. Staff meetings take place regularly. Supervision sessions are regular and staff find them helpful. Notes are taken of meetings and sessions. EVIDENCE: New staff undertake a comprehensive induction and shadow other workers for nine shifts prior to working with service users alone. During this time mandatory training is completed. Staff also have the opportunity to attend specialist training as part of their ongoing development. 16 staff have completed or are currently completing an NVQ qualification. The manager has completed NVQ level 4, Registered Managers Award and is a qualified NVQ Assessor. Lemsford Road DS0000019445.V325527.R01.S.doc Version 5.2 Page 18 Records pertaining to recruitment are satisfactory. Lemsford Road DS0000019445.V325527.R01.S.doc Version 5.2 Page 19 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. 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 well run by a qualified, competent and experienced manager who leads a dedicated staff team who work very well together. The team works to continuously improve services and provide an increased quality of life for residents. EVIDENCE: Management processes ensure that staff receive feedback on their work. A quality audit is carried out annually where relatives, visitors and other professionals can offer feedback. Advocacy services are utilised when required. Lemsford Road DS0000019445.V325527.R01.S.doc Version 5.2 Page 20 Residents meetings are not appropriate for the residents living at Lemsford Road however monthly art and craft sessions enable service users to communicate effectively. The home has a good record of meeting relevant health and safety requirements and legislation. Records are of a good standard and are routinely completed. A lock on a kitchen cabinet, which contains cleaning chemicals, is broken and although staff have reported this for repair this remains outstanding. Lemsford Road DS0000019445.V325527.R01.S.doc Version 5.2 Page 21 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 4 ENVIRONMENT Standard No Score 24 2 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 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 2 3 X 3 X X 2 X Lemsford Road DS0000019445.V325527.R01.S.doc Version 5.2 Page 22 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. 2. Standard YA20 YA24 Regulation 13(2) Requirement Timescale for action 07/02/07 30/06/07 3. YA42 All medication stock must be recorded for auditing purposes. 23(2)(b) Some areas of the home require redecoration. The bathroom wall requires redecoration and the area above the toilet cistern. Kitchens on the ground floor and in number 66a Lemsford Road require replacing as they are in a state of disrepair. 13(4)(a)&(c) Cleaning chemicals must be stored securely. The lock on the kitchen cabinet must be replaced. 07/02/07 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. 2. Refer to Standard YA21 YA6 Good Practice Recommendations The resident’s wishes and plans for after death arrangements should be fully recorded on their care plans. Service users care plans should be available in a more DS0000019445.V325527.R01.S.doc Version 5.2 Page 23 Lemsford Road accessible format. Lemsford Road DS0000019445.V325527.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Lemsford Road DS0000019445.V325527.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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