Inspection on 16/11/06 for Leonard Cheshire Home

This inspection was carried out on 16th November 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 found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Leonard Cheshire Home 08/02/06

Leonard Cheshire Home 02/03/05

Leonard Cheshire Home 16/06/04

Leonard Cheshire Home 03/02/04

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

CARE HOME ADULTS 18-65 Leonard Cheshire Home Mickley Hall Mickley Lane Totley Rise Sheffield South Yorkshire S17 4HE Lead Inspector Mr Rob Curr Key Unannounced Inspection 16 November 2006 09:00 th Leonard Cheshire Home DS0000021792.V312283.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 Leonard Cheshire Home DS0000021792.V312283.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. Leonard Cheshire Home DS0000021792.V312283.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Leonard Cheshire Home Address 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) Mickley Hall Mickley Lane Totley Rise Sheffield South Yorkshire S17 4HE 0114 236 9952/3 0114 262 0234 none www.leonard-cheshire.org.uk Leonard Cheshire Mrs Iris Gwendoline Webster Care Home 40 Category(ies) of Physical disability (40) registration, with number of places Leonard Cheshire Home DS0000021792.V312283.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th February 2006 Brief Description of the Service: The Leonard Cheshire organisation work with disabled people throughout the world. It offers support and campaigns for the rights of people living with disabilities. Mickley Hall is one of their residential services. It offers long-term support for 40 adults with a physical disability. Leonard Cheshire Home DS0000021792.V312283.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over three separate days. The manager was not present when the inspection commenced. The Care manager was helpful and assisted the inspector throughout the inspection. The manager was present son after the inspection began. The inspector was escorted on a partial tour of the building. A variety of policies, procedures, and records were checked. The service users were very helpful during the inspection process, offering ample opportunity to talk about what life was like at the home. In all – 5 service users and 3 staff members were spoken to. Current fees range from £453 - £1127 per week. What the service does well: All of the service users that met with the inspector were very happy at the home. One service user said that ‘nothing was too much trouble for the staff’. Cleanliness and hygiene standards in the house and kitchen areas were very good. Despite a number of service users having difficulties with personal hygiene there were no unpleasant odours. The staff and service users are to be commended for the cleanliness of the environment. Service users said that their relatives and friends were always made to feel welcome and that they could approach ‘all’ the staff if they wanted anything. The service users confirmed that they were fully involved in the admissions process including assessment and review. One person said that his relatives had been fully involved in the planning of his care needs. The dependency levels of the service users were monitored closely and appropriate staffing levels deployed when necessary. There were numerous planned activities and a number of service users had been on individually planned holidays. There was a friendly and cheerful atmosphere promoted by the staff. The Manager and the staff team displayed a real commitment and enthusiasm to improve the service at Mickley Hall. Leonard Cheshire Home DS0000021792.V312283.R01.S.doc Version 5.2 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. Leonard Cheshire Home DS0000021792.V312283.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 Leonard Cheshire Home DS0000021792.V312283.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 and 4. Quality in this outcome area was good. This judgement has been made using available evidence, talking with service users and including a visit to the home. Service users needs were assessed prior to admission and they were fully involved in the assessment process, so this ensured that the home was able to meet their needs. There were service users that fell outside of the category of ‘physical disability’ (PD). The staff said that the manager did not offer places to any individual whose needs they could not meet. The staff training plan was on target. EVIDENCE: Copies of full needs assessments were in the service users files. All the relevant information from the assessments had been built into the care plan. One service user said that she had been invited to view the home and attend a variety of meetings prior to them moving in. There were a number of service users suffering from various mental health problems. Leonard Cheshire Home DS0000021792.V312283.R01.S.doc Version 5.2 Page 9 The varied needs of the service user group were discussed with the manager. It was stated that the organisation might need to be in discussions with the CSCI with regard to registering to care for other appropriate service user groups. Staff training records indicated that they had undertaken relevant training. Leonard Cheshire Home DS0000021792.V312283.R01.S.doc Version 5.2 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 the following standard(s): 6,7,8,9 and 10 Quality in this outcome area was good. This judgement has been made using available evidence, talking with service users and including a visit to the home. The information within the care plans was very clear. The care planning process has empowered service users to make decisions about their lives with support from staff and others. Service users were involved in making decisions about their own lives, including holidays. People could choose their GP and could see them in private so that their privacy and dignity was respected. Risk assessments to minimise any risks associated with the service user’s lifestyles had been devised and had been regularly reviewed. Systems were in place to ensure that service user’s confidentiality was maintained in the home. Leonard Cheshire Home DS0000021792.V312283.R01.S.doc Version 5.2 Page 11 EVIDENCE: Five risk assessments were checked these contained clear information in order to minimise risks to service users. Not all of them had been reviewed on a regular basis. Peoples likes and dislikes in relation to food was recorded in care plans to ensure the staff knew the service users personal preferences. Service users meetings were organised regularly and the service users said, “I need to have meetings with staff”, “we talk about holidays and outings”, the staff said this gave people the opportunity to be consulted on how the home was organised and run. The service user’s files were found to be stored securely and staff showed an awareness of confidentiality issues. The staff and service users said that they could see their files with staff support. Leonard Cheshire Home DS0000021792.V312283.R01.S.doc Version 5.2 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 the following standard(s): 12,13,14,15,16 and 17. Quality in this outcome area was good. This judgement has been made using available evidence, talking with service users and including a visit to the home. Some of the people have regular opportunities to access age, peer and culturally appropriate activities; others with higher support needs had limited opportunities. One person regularly accessed community day services and leisure activities. They were also supported to access other community facilities, such as shops, pubs and the local countryside etc. The service users were supported to have appropriate relationships with their peers and relatives. The staff showed respect for the people; in the way they spoke to and addressed them. The service users were observed to be offered choices and were supported to make everyday decisions. Meals were nutritious and balanced. Leonard Cheshire Home DS0000021792.V312283.R01.S.doc Version 5.2 Page 13 EVIDENCE: Service users told the inspector that they took part in a range of leisure and daily activities on a regular basis. They said they had attended college courses. One service user said “I have had classes, “ I attend a variety of community meetings with my personal assistant and go to the theatre and pubs with friends”. This confirmed that service users were enabled to take part in their local community and to maintain relationships. One person told the inspector, “the staff are very good, they have some difficult situations to deal with”. Staff were observed to treat people with respect as they knocked on doors before entering, addressed people by their preferred names and spoke of them with regard. The inspector observed service users taking part in a training and awareness event. This session was to enlighten service users in relation to disability and diversity issues. This clearly underpins the empowerment of service users. There was a supply of nutritious food in the kitchen. This enabled people to make choices at each mealtime. The service users said they enjoyed the food on offer at the home. Leonard Cheshire Home DS0000021792.V312283.R01.S.doc Version 5.2 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 the following standard(s): 18,19 and 20 Quality in this outcome area was good. This judgement has been made using available evidence, talking with service users and including a visit to the home. Staff were supportive and helped service users to choose their daily routines. Health needs were met and monitored and people were helped to identify their own needs through their involvement in care planning. This ensured the well being of the service users The organisation had a medication policy. This was consistently implemented. A range of health care professionals visited the home to assist in meeting the needs of the service users. EVIDENCE: Staff provided sensitive and flexible personal support. Service users said they were encouraged to choose what time to get up and go to bed. The files checked had a section to record visits, treatment and identified future needs relating to healthcare professionals. Access to Psychologists etc, had been provided where there was an identified need. Leonard Cheshire Home DS0000021792.V312283.R01.S.doc Version 5.2 Page 15 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 was good. This judgement has been made using available evidence, talking with service users and including a visit to the home. The service users were aware of how to make a complaint and were confident that they would be listened to. An adult protection procedure was in place to ensure people’s safety was promoted. EVIDENCE: The complaints procedure was available, which contained relevant information and provided the reader with details of who to contact outside the home, to ensure complaints were taken seriously. The home kept a record of complaints. The daily notes indicated that an incident had taken place resulting in a service user ‘hitting’ a member of staff. The records surrounding this incident were not clear. There was no indication as to why this situation had occurred or what the outcome was both for the service user or the member of staff. Staff training in adult abuse had been identified within the training plan and the majority of staff had already undertaken this training. The service users and staff stated that they had confidence in the homes manager. They said that she would listen and respond to any concerns they raised. One person said that he was positively to spoke out at meetings. Everyone spoken to said they felt safe at the home. Leonard Cheshire Home DS0000021792.V312283.R01.S.doc Version 5.2 Page 16 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): 24,25,26,27,28 and 30. Quality in this outcome area was good. This judgement has been made using available evidence, talking with service users and including a visit to the home. The home was generally well maintained, well decorated and homely. The service user’s bedrooms were comfortable, individually personalised and furnished to meet their needs. The garden areas around the house were in good order. Service users were seen enjoying the outside facilities throughout the day. EVIDENCE: An inspection of the environment showed that generally the home was clean, well maintained and provided homely and comfortable accommodation to meet the service user’s needs. A number of bedrooms were checked. They had all been decorated to meet the individual persons needs and reflected their individual tastes. Leonard Cheshire Home DS0000021792.V312283.R01.S.doc Version 5.2 Page 17 Continuous refurbishment that had taken place to improve the environment for the service users. People said how happy they were with the improvements. Two service users said that the staff and management had worked ‘very hard to improve our home’. There were a number of minor repairs required to improve the environment. There was a clear recording system of the maintenance and repair needs. The laundry facilities in the house were sufficient to meet the service user’s needs. However, the laundry area needed some improvement. Leonard Cheshire Home DS0000021792.V312283.R01.S.doc Version 5.2 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 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): 31,32,33,34,35 and 36. Quality in this outcome area was adequate. This judgement has been made using available evidence, talking with service users and including a visit to the home. Sufficient staff were provided to meet the needs of the service users. The recommendation that 50 of the care staff team are qualified to National Vocational Qualifications (NVQ) level 2 had been achieved. The manager had clearly identified the training needs of the staff group. There were staff vacancies at the time of the inspection. The recruitment policies and procedures were not followed consistently. These practices do not ensure that staff are suitable for the post. EVIDENCE: The service users felt that there were enough staff on duty during the day and night to care for their needs. 4 people said that the staff were ‘very good’ and ‘nothing was too much trouble’. One service user said that he was interested in being involved with the recruitment process for the staff team. This was discussed with the manager who showed a willingness to promote such practices. Leonard Cheshire Home DS0000021792.V312283.R01.S.doc Version 5.2 Page 19 A group of staff were currently undertaking the NVQ at level 2 and some have registered to commence the training. Staff have also achieved level 3. Staff confirmed that they received more than 3 days paid training each year. The home had recruitment systems in place to protect residents, however, the following issues were noted: • • • Full employment histories had not been provided Not all references were from previous employers Staff were recruited before a criminal record bureau disclosure had been received. Leonard Cheshire Home DS0000021792.V312283.R01.S.doc Version 5.2 Page 20 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): 37,38,39,40,41,42 and 43. Quality in this outcome area was good. This judgement has been made using available evidence, talking with service users and including a visit to the home. The manager was registered with the Commission for Social Care Inspection. Quality assurance systems ensured that service user’s views, on all aspects of the home were included in developments and changes. A health and safety policy was in place. Staff had received appropriate training, and the recording of accidents and risk assessments were in place. Leonard Cheshire Home DS0000021792.V312283.R01.S.doc Version 5.2 Page 21 EVIDENCE: Service users and staff said that they had ‘every confidence’ in the manager and her staff team. They told of occasions when the manager had supported them in upholding their rights in relation to ‘certain things’. One service user said that the manager has ‘an open door policy’ and that he could approach her for support ‘at any time’. This ensured that service user rights and best interest were safeguarded. The organisation carried out regular monitoring visits. The inspector noted that audits had been maintained in relation to: • • • • • Daily recordings Medication record sheets Fire records Service users finances Health & safety A member of the committee regularly informs the CSCI of the outcome of these visits. A health and safety policy was in place. Staff had received appropriate training, and the recording of accidents and risk assessments were in place. There were regular fire drills. Leonard Cheshire Home DS0000021792.V312283.R01.S.doc Version 5.2 Page 22 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 2 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 3 LIFESTYLES Standard No Score 11 X 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 X 3 3 3 3 3 3 3 Leonard Cheshire Home DS0000021792.V312283.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 YA1 Regulation 4, 16 Requirement The organisation must review the category of service users they support and approach the CSCI to amend the registration category if necessary. Care plans must be regularly reviewed. Review the identified incident – make a detailed report of the incident and forward a copy to the local office of the CSCI. Under no circumstances must staff be recruited prior to an appropriate CRB disclosure being received. All recruitment procedures must be adhered to. Timescale for action 05/02/07 2 3 YA6 YA23 15 13 05/02/07 05/02/07 4 YA34 Sch 2 20/12/06 5 YA34 Sch 2 20/12/06 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 YA30 Good Practice Recommendations Consideration should be given to refurbishing the laundry DS0000021792.V312283.R01.S.doc Version 5.2 Page 24 Leonard Cheshire Home area. Leonard Cheshire Home DS0000021792.V312283.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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 Leonard Cheshire Home DS0000021792.V312283.R01.S.doc Version 5.2 Page 26 - 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!