Inspection on 12/10/05 for Lenore, The

This inspection was carried out on 12th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lenore, The 19/03/08

Lenore, The 29/03/07

Lenore, The 23/02/06

Lenore, The 04/02/05

Lenore, The 16/09/04

Lenore, The 18/02/04

Similar services:

22 Sandown Road

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Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 The Lenore 1 Charles Avenue Whitley Bay Tyne and Wear NE26 1AG Lead Inspector Glynis Gaffney Announced 12 October 2005 at 10am 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. The Lenore B53 B03 Lenore V234819 12102005 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Lenore Address 1 Charles Avenue Whitley Bay Tyne and Wear NE26 1AG 0191 2513728 0191 2513728 NA Mrs Teresa Duchett 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 Jennifer C Ashworth CRH 21 Category(ies) of LD Learning Disability - 3 registration, with number MD Mental Disorder - 18 of places The Lenore B53 B03 Lenore V234819 12102005 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 04/02/05 Brief Description of the Service: The Lenore is a large older style Home situated in a residential street within Whitley Bay. Local facilities such as shops, restaurant and pubs are all within easy walking distance. The Home caters for 21 residents with a range of mental health care needs. Single room accommodation is provided and is spread over the first and second floors of the Home. En-suite facilities are not available. Communal facilities are provided as follows: - a dining room; four lounges; eight toilets; two showers and three bathrooms. Pleasant outdoor areas are provided to the front and side of the Home. Street parking is available. The Home was well maintained, domestic in appearance, clean and tidy at the time of the inspection. The Lenore B53 B03 Lenore V234819 12102005 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and took place over seven hours. A sample of care and other records were examined. Three staff on duty and three residents were spoken to. Survey questionnaires were also sent to residents and professional visitors to the Home. What the service does well: The Home encourages residents to: • • • Make major life decisions and everyday choices; Take control of their own lives; Take an active part in drawing up their care plans and in doing so, places each resident at the centre of the care plan process. Care plans reflect residents’ needs, wishes and future hopes.The Home is well maintained and has an ongoing programme of refurbishment and redecoration. The Lenore was safe, clean, hygienic and had a domestic atmosphere. The Manager and Provider are always willing to support the process of inspection and are happy to engage in a constructive debate about inspection outcomes. Staff were kind, respectful, considerate and had developed warm and caring relationships with the people in their care. Residents were very satisfied with the care and support provided. Staff communicated with residents in a positive manner building upon their strengths and abilities. The staff team are very positive about, and display a real commitment to, the work they carry out with residents. Prospective and existing residents have access to important information about the running of the Home. The Lenore B53 B03 Lenore V234819 12102005 Stage 4.doc Version 1.30 Page 6 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. The Lenore B53 B03 Lenore V234819 12102005 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Lenore B53 B03 Lenore V234819 12102005 Stage 4.doc Version 1.30 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 standard(s) 1, 2, 3 and 5. The Home’s Service User Guide and Statement of Purpose provide existing and prospective residents with good information about the services provided at the Lenore. Residents have been provided with an opportunity to read and sign the Home’s Statement of Terms and Conditions. Staff have the skills, qualities and experience needed to provide residents with a good standard of care. The Lenore B53 B03 Lenore V234819 12102005 Stage 4.doc Version 1.30 Page 9 EVIDENCE: A Service User Guide and Statement of Purpose were in place and contained the required information. The information made available to residents is well written and easy to understand. A copy of the Home’s Complaints Procedure and most recent inspection report were available within the reception area. Residents confirmed that they were able to understand the range of information produced by the Lenore. There have been three admissions into the Home during the last 12 months. Prospective residents are only considered for admission following receipt of a Care Management assessment, care plan and where appropriate, a risk assessment. An in-house assessment is conducted to ensure that the Home is able to meet prospective residents’ needs. Community based mental health professionals support residents during their admission into the Home. Prospective residents are encouraged to visit the Home before accepting a placement. The offer of a longer-term placement is subject to a satisfactory twelve-week trial period on both sides. The Home does not accept usually accept residents on an emergency basis. Needs identified at the preadmission stage are integrated into residents’ initial care plans and risk assessments. Staff were observed communicating with residents in a positive manner. Residents expressed no concerns about how they were spoken to by staff. Arrangements are in place to enable staff to receive the training required to meet residents’ assessed needs. For example, new staff are provided with access to qualifying induction training on commencing work at the Home; a number of staff have received training in the management of abuse and selfharming behaviour; four staff have obtained a ‘Certificate in Care Practices’. Completed Statement of Terms and Conditions were available in residents’ care records. Residents said that they had been provided with an opportunity to read and sign the Statement. The Lenore B53 B03 Lenore V234819 12102005 Stage 4.doc Version 1.30 Page 10 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, 8 and 9. Residents’ care plans covered all aspects of health, personal and social care and ensure that staff are provided with the information they need to satisfactorily meet residents’ needs. Residents receive good support allowing them to develop confidence in making decisions about their lives. Satisfactory arrangements are in place to support residents to take risks as part of an independent lifestyle. EVIDENCE: Care plans were in place for each resident and covered assessed areas of need. Each plan examined had been reviewed on a six monthly basis. Restrictions have been placed upon the rights of a small number of residents to make decisions in some areas of their lives. Such action has been taken to protect the well-being and safety of the residents concerned. This is always done in conjunction with other professionals involved in the care of the resident concerned. Restrictions negotiated with residents are referred to in their care plans. Individualised care plans and risk assessments are devised in response The Lenore B53 B03 Lenore V234819 12102005 Stage 4.doc Version 1.30 Page 11 to the presentation of challenging behaviours. Residents said that their care plans had been drawn up in conjunction with them and they had been asked to sign them. A Key Worker system is not in use within the Home. Residents confirmed that they had been provided with an opportunity to hold a copy of their own care plan. Residents are provided with support and the information they need to make informed decisions about their daily lives. For example, all of the residents interviewed said that they were able to: • • • • Choose what time to get up and go to bed; Access the Home and their bedrooms at any time; Choose how to spend their time and with whom; Manage their own finances with or without staff support. Residents are provided with opportunities to participate in the day-to-day running of the Home. For example, residents said that: • • • • Residents’ Meetings usually take place on a monthly basis; They are made aware of what is going on within the Home; They are encouraged to comment upon the quality of facilities and services provided at the Home; They are encouraged to take responsibility for shopping, cooking and cleaning. Residents are encouraged to take responsible risks as they go about their daily lives. Risks taken by residents are carefully assessed and monitored by staff. Any risk assessment information obtained prior to, or following admission, is integrated into each resident’s care plan. Completed risk assessment information was available in the care records examined. Where staff had identified that particular residents were at significant risk due to their chosen lifestyle, Care Management and health care professionals were consulted about how to manage particular risks both within, and outside of, the Lenore. The Lenore B53 B03 Lenore V234819 12102005 Stage 4.doc Version 1.30 Page 12 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, 12, 13, 15 and 16. Residents are provided with satisfactory opportunities for personal development. Opportunities are provided for residents to find and keep jobs and to take part in fulfilling activities. Residents are well supported by staff to become part of, and participate in, their local community. Residents are supported to maintain appropriate relationships with their families and friends allowing them to feel valued and cared for. The Lenore B53 B03 Lenore V234819 12102005 Stage 4.doc Version 1.30 Page 13 EVIDENCE: Residents are provided with opportunities to maintain and develop social, emotional, communication and independent living skills. For example: residents said that: • They are encouraged to keep their own bedrooms clean; • Opportunities are provided which allow them to practice food preparation and cooking skills; • They are responsible for their own food shopping; • They are provided with opportunities to eat together and socialise; • Staff are always on hand to provide advice and emotional support. The selection of case records examined confirmed that residents are: • Provided with assistance to access specialist support services as and when required. It was confirmed that all residents have a Consultant Psychiatrist who regularly reviews their mental health and current medication; • Encouraged and supported to access local facilities and amenities in accordance with their personal preferences. Residents are supported to find out about, and take up opportunities for, paid employment. For example, one resident confirmed that he continues to take up paid employment which involves driving and delivering meals to older people. He also said that ‘staff are very supportive and proud that I have managed to keep my job for so long.’ Residents are supported to become part of, and participate in, their local community. Two residents interviewed said that they visit: • Local shops and pubs on a daily basis; • Use local GP and dental practices. Staff keep residents up to date with what is going on in their local community. Residents are registered with local GPs and staff will, upon request, attend GP or hospital appointments. The Home has no stigmatising signs publicising its status as a care home. Family and friends are made to feel welcome and can be seen in private if this reflects the wishes of the resident. Restrictions would only be applied if a particular resident’s well-being was considered to be at risk. Opportunities are available for residents to meet with non-residents. Although residents are free to form personal friendships and relationships with people of their choice, where staff feel that a particular relationship poses a threat to a resident’s well-being, staff would counsel the person concerned in order to minimise any risks identified. Other professionals involved in the care of the person considered would be consulted. The Lenore B53 B03 Lenore V234819 12102005 Stage 4.doc Version 1.30 Page 14 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 and 20. Staff provided personal support in such a way as to promote and protect residents’ privacy, dignity and independence. The arrangements in place to meet residents’ physical and emotional health care needs were satisfactory and allows them to lead valued fulfilling lives. The systems in place to support the safe administration, storage and disposal of medication were satisfactory and promoted residents’ good health. The Lenore B53 B03 Lenore V234819 12102005 Stage 4.doc Version 1.30 Page 15 EVIDENCE: None of the current residents require assistance with mobility or intimate care. Staff provide guidance regarding personal care where necessary. Aids and adaptations to promote independence are not required. Residents are able to fully express their wishes and preferences with regards to their everyday lives. Residents said that they were: • • Supported to make choices about when they had a bath; Able to make their own choices about what to wear and eat. Residents’ health care needs are satisfactorily met. They are encouraged to use community-based services and visit their GP, dentist and optician on ‘an as and when’ required basis. A satisfactory Medication Policy was in place. An information source was available providing staff with access to drug information. The medication records examined were satisfactorily completed. Medicines were satisfactorily stored. Controlled Drugs were not in use at the time of the inspection. A local pharmacist visits the Home on an annual basis and provides advice and guidance. All staff administering medication have received accredited training in the handling of medicines. A formal system was in place to identify residents. Checks of the air ambient temperature in the room within which medicines were stored were being undertaken. Although hand wash facilities were not available, staff had access to an alcohol hand wash. Guidance on the self-administration of medication was included within the Home’s Medication Policy. Lockable facilities were available within residents’ bedrooms. The Lenore B53 B03 Lenore V234819 12102005 Stage 4.doc Version 1.30 Page 16 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. A satisfactory Adult Protection Policy was in place to ensure an appropriate response is made to any suspicion or allegation of abuse received by the Home. Positive action is taken by the Provider and Manager to protect the well being of vulnerable adults living at the Home. EVIDENCE: The Home’s Adult Protection Policy complied with relevant guidance and legislation. There has been one adult protection concern raised with the Home since the last inspection. The concern raised had not arisen as a consequence of poor practice on the part of the Home. This matter is currently under investigation and will be monitored by the Commission. The Lenore B53 B03 Lenore V234819 12102005 Stage 4.doc Version 1.30 Page 17 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) Key Standards not assessed at this inspection. EVIDENCE: The Lenore B53 B03 Lenore V234819 12102005 Stage 4.doc Version 1.30 Page 18 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) Key Standards not assessed on this occasion. EVIDENCE: The Lenore B53 B03 Lenore V234819 12102005 Stage 4.doc Version 1.30 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 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. Residents live in a home which is run and managed by a person who is fit to be in charge, is of good character and able to discharge her responsibilities fully. EVIDENCE: The Home’s Manager is both competent and experienced in managing the Lenore. Mrs Ashworth is part way through her management qualifying training and has undertaken periodic training to update her knowledge, skills and competence. The Manager is well supported by the Provider. The Lenore B53 B03 Lenore V234819 12102005 Stage 4.doc Version 1.30 Page 20 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 3 3 3 x 3 Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 3 3 3 x 3 3 x Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Lenore Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x x x x x x B53 B03 Lenore V234819 12102005 Stage 4.doc Version 1.30 Page 21 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. Standard YA 20 Regulation 13(2) Requirement Advice should be sought from the Health Protection Unit regarding whether the alcohol handwash provided in the room within which medicines are stored and administered is adequate. The Registered Manager must complete her qualifying management training by the 1st July 2007. Timescale for action 01/04/06 2. YA37 10(2)(3) 01/07/07 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. Refer to Standard Good Practice Recommendations The Lenore B53 B03 Lenore V234819 12102005 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Northumbria House Manor Walks Cramlington NE23 6UR 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 The Lenore B53 B03 Lenore V234819 12102005 Stage 4.doc Version 1.30 Page 23 - 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. 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