Inspection on 28/01/08 for Levitt Mill

This inspection was carried out on 28th January 2008.

CSCI found this care home to be providing an Good service.

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

Other inspections for this house

Levitt Mill 26/09/08

Levitt Mill 04/01/07

Levitt Mill 05/06/06

Levitt Mill 24/01/06

Levitt Mill 17/05/05

Levitt Mill 02/02/05

Levitt Mill 19/08/04

Similar services:

Pennine Camphill

Muston Road (70)

Grayling

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

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

CARE HOME ADULTS 18-65 Levitt Mill Levitt Mill Wood Lee, Blyth Road Maltby Rotherham South Yorkshire S66 8NN Lead Inspector Sarah Powell Unannounced Inspection 28th January 2008 09:00 DS0000041903.V355678.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 DS0000041903.V355678.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. DS0000041903.V355678.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Levitt Mill 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) Levitt Mill Wood Lee, Blyth Road Maltby Rotherham South Yorkshire S66 8NN 01709 815565 01709 818532 levitt.mill@craegmoor.co.uk www.craegmoor.co.uk Sapphire Care Services Limited Mr Wayne Philip Cocksedge Care Home 10 Category(ies) of Learning disability (10) registration, with number of places DS0000041903.V355678.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following category: Learning disability - Code LD The maximum number of service users who can be accommodated is: 10 4th January 2007 2. Date of last inspection Brief Description of the Service: Levitt Mill is a converted mill and barn set in extensive grounds providing accommodation for ten service users with learning disabilities aged 18 to 65. There are six bedrooms all with en-suite in the mill and four bedrooms all ensuite in the barn; both units have communal lounges, dining rooms, bathrooms, kitchens and laundry facilities. The home is on the outskirts of Maltby near Rotherham with facilities nearby including pubs, shops, restaurants and leisure facilities. The fees at Levitt Mill range from £1941.61 to £2553.08 per week. Fees depend on the needs of the people and for any further information contact the home. DS0000041903.V355678.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. This was an unannounced visit, which took place on 28th January 2008 at 9 am and finished at 15.30 hrs. A total of 6.5 hours was spent in the home. An expert by experience, Mr Andrew Bright also attended the home from 10:00 until 12:00. Andrew had experience and knowledge of people with a learning disability. His role during the site visit was to talk to people and observe the daily routines. This included people’s choices, activities, privacy and dignity, meals and the environment. Andrew’s feedback is included in this report. The visit included talking with people living at the home, the manager, two new deputy managers, eight staff and professionals. We also walked round the building to gain an overview of the facilities and we checked some records. Some surveys forms were sent to people who live at the home and their relatives. At the time of this visit five were completed and returned to the Commission. The comments received were very positive. The manager completed an annual quality assurance assessment (AQAA) and returned this prior to the visit. This focuses on how well outcomes are being met for the people using the service. It also gives us some numerical information about the service. What the service does well: Clear information of what the home provides is available to all perspective clients. Good assessments are undertaken by suitably qualified staff to determine peoples needs can be met. Person centred plans were in place and were very good. They identified peoples needs and showed all health care needs were met. Professionals told us that staff meet the people’s health care needs keep them informed and will ask for advice. A good programme of activities was provided giving people choices and variation. Meeting peoples social and recreational needs. One person was ready to go shopping at the time of the visit she told us “I like shopping and staff look after me”. DS0000041903.V355678.R01.S.doc Version 5.2 Page 6 Staff were very supportive of people one staff member referred to the people as friends. The environment was well maintained and homely and standard of cleanliness was very good. 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 summary of this inspection report can be made available in other formats on request. DS0000041903.V355678.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 DS0000041903.V355678.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&5 People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People in the home had their needs assessed prior to moving into the home and each were provided with a written contract and statement of terms and conditions to ensure these could be met. EVIDENCE: Suitably qualified staff carried out the pre admission assessments on people who wanted to move into the home. The assessments were very detailed with all peoples needs identified, ensuring that the home could meet their needs before a place was offered to them, Every person in the home had a contract, and terms and conditions issued at the time of moving in. The manager was also in the process of completing the company’s new terms and conditions for all the people, this gave clear information on what was provided for the people living in Levitt Mill and met the standard. DS0000041903.V355678.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. People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person in the home had a plan of care with clearly identified needs, these were met, and people were treated with respect, were able to make decisions about their lives and take risks as part of an independent lifestyle. EVIDENCE: Two people in the home were case tracked and their plans were looked at in detail. The plans had identified the needs of the people with good recordings of the measures to take to meet their needs. The plans were regularly reviewed; people and their relatives were involved in this process. This ensured their views were listened to and their needs met. People spoken to were aware of the plans. Andrew looked at the two plans of care and was very impressed with the person centred plans, which were in a format that the people were able to understand. DS0000041903.V355678.R01.S.doc Version 5.2 Page 10 Andrew also said “I am pleased to see detailed input from the persons mother”. Relatives told us in the questionnaires they completed that they were aware of the plans and had been involved in changes and reviews. This ensured their relatives’ needs were being met. People were supported to make decisions about their lives and take risk as part of an independent lifestyle. Assistance was given if required. Andrew observed this while he was at the home and he told us “I felt the staff were very supportive with the residents, one staff member referred to the residents as friends. I observed staff sitting and chatting with residents and helping one resident when he became anxious and upset and I felt that residents had a good relationship with staff”. DS0000041903.V355678.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. People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People exercised choice and control over their daily lives and activities ensuring their needs were met. EVIDENCE: There was a good programme of activities arranged daily for the people based on their choices. Andrew said “I was very impressed to see a picture based activities board for residents to choose different activities. There were also individual residents’ activity plans. Each plan had activities planned from 10am to 9pm. The activities were very varied” He also told us “I did wonder if some of the activities would be realistically done in a short time span for example, theme park and fishing”. DS0000041903.V355678.R01.S.doc Version 5.2 Page 12 Some wording on the picture board was not appropriate this was discussed with the manager who told us that it would be changed. Andrew told the Manager “I would recommend that the wording on each activity plan is changed from ‘refusing to take part’ to ‘choosing not to take part”. This promotes choice for people. Andrew discussed activities with people and staff and recommend that some of the evening activities were outside based, such as, going to the pub, discos, meals out, cinema and theatre. He also found there was a lack of community-based activities, with only one resident going to a day centre. He recommended that people are given the opportunity to gain skills on college courses and to do voluntary and paid work within the local community. The manger had looked into this previously but told us this would be looked at again particularly as they had some new people living at Levitt Mill. Staff supported people to have relationships with family and friends and some people had regular contact with family. Staff spoken to were aware that relationships had to be appropriate to protect people due to their learning disabilities they were not always able to make an informed decision. People were offered a healthy diet and often did the shopping with a support worker. People helped prepare their meals and were bale to get a drink from the kitchen when they choose with help from staff. Two people were out shopping on the morning of the visit. One staff member told Andrew, “We try to take 2 clients shopping with us so they can choose what they would like. Its all about giving choices.” Staff told us people enjoyed their meals and mealtimes, they were able to choose what they wanted to eat, although a healthy diet was promoted and encouraged. Ensuring the people ate a balanced diet. DS0000041903.V355678.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): 18, 19 & 20. People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. . Peoples health care needs were met and they were supported in the way they preferred. Medication procedures protected people. EVIDENCE: All health care needs of people were met and regular input from health care professionals was obtained. Their advice was followed and well documented in the plans ensuring the wellbeing of the people who lived in the home. Two health care professionals completed a questionnaire the comments were very positive. One stated “I find the support staff very efficient when supporting health care needs and will usually contact myself for advice and keep me informed”. DS0000041903.V355678.R01.S.doc Version 5.2 Page 14 People were treated with respect and privacy and dignity upheld. During the visit we observed staff interacting well with people. One person said “The staff are lovely I am very happy”. Medication procedures were good, however the manger had been having some problems with the GP practice, which he was resolving by meeting with the practise manager. We were reassured by the actions of the manager regarding the problems and were confident that he would resolve the issues to safeguard the people. All staff who administered medication had received medication training and the manager regularly check competencies to ensure safety of people. Procedures for disposal of medication had been improved although it could be improved further. Medication for disposal was put in a box, but not recorded in the returns book until the day it was returned. This could result in errors and put people at risk. DS0000041903.V355678.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who lived in the home were listed to and protected. EVIDENCE: There was a comprehensive complaints procedure, which was clearly displayed, in the entrance hall. This was in an easy read format for the people to understand. All people we spoke to were aware of the procedure and the questionnaires returned told us that relatives were aware of how to make a complaint and they would either speak directly with staff or the manager. The manager had received a number of concerns which had all been resolved, good records were kept of outcomes. This showed they had been fully investigated, acted on and taken seriously. All staff had received training in adult protection; all staff we spoke to had a good knowledge of the procedures and what to do should an incident occur. Staff were also aware of the whistle blowing policy, which safeguards people in the home. DS0000041903.V355678.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30. People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was well maintained clean, pleasant and comfortable ensuring people lived in a safe environment. EVIDENCE: The environment was homely, well maintained and personalised. There was a maintenance programme in place to ensure the standards were maintained for the people. The manager had also just received approval to convert a small lounge, which was not used into a relaxation room designed specifically for people with learning disabilities. DS0000041903.V355678.R01.S.doc Version 5.2 Page 17 Andrew thought the mill was very well decorated; he particularly liked the curtains and soft furnishings, as it didn’t look like a ‘care’ home. Although he felt the barn was not as well decorated it was less homely than the mill. It made him feel like he was in a more traditional care home. The manger had identified that the floor-covering in the barn was very clinical and had requested a new floor covering to provide a more homely room for the people. Andrew looked at a number of bedrooms and he told us, “the rooms were very spacious and I like the way they all had their own toilet and sink, with some having a bathroom and shower”. It was observed during the tour of the building that all bedrooms had locks to the door but all doors were left unlocked. A staff member told us that none of the residents had keys. Andrew suggested that all residents had the choice of having a key to lock their bedroom door with staff support. The standard of cleanliness observed during the visit was very good and no odours were noted anywhere in the building providing a pleasant and hygienic home for the people who lived there. The relative questionnaires returned said the home was always clean when they visited. DS0000041903.V355678.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35. People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff were appropriately trained, the recruitment procedures were robust ensuring people were in safe hands at all times, had their needs met and were protected. EVIDENCE: Care staff numbers were determined by the needs of the people and appropriate levels were maintained on the day we visited ensuring peoples needs were met. The manager had developed a new staff-working rota, the staff worked in 4 teams and did a set pattern of shifts. The manager told us this was working much better and staff preferred this system. It ensured appropriate staff were on duty to meet he needs of the people. Staff told us “We work well in the teams and the training is good”. DS0000041903.V355678.R01.S.doc Version 5.2 Page 19 Two new deputy managers were in post and on their induction at the time of the visit. The manager was also recruiting more care staff to ensure the home was fully staffed to ensure peoples needs were met. The manager had made good progress with NVQ training for care staff. Some staff had recently enrolled on the training. This would bring the home to above 50 trained to level 2 when they had completed the course, ensuring staff are appropriately trained to meet peoples needs. All mandatory training was up to date, the company had robust systems in place to ensure this remained up to date for all staff ensuring people were in safe hands at all times. A thorough recruitment procedure was in place, two staff files were seen on the day of the visit and contained all the required information. Protecting people who lived there. DS0000041903.V355678.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42. People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management and administration safeguards people, good health and safety policies and procedures were in place ensuring the safety of people in the home. EVIDENCE: The manager was qualified and experienced to run the home. He had achieved the registered managers award and continually kept himself updated to ensure the homes stated purpose, aims and objectives were met. DS0000041903.V355678.R01.S.doc Version 5.2 Page 21 Quality monitoring was carried out, the manager did regular audits and the provider carried out regulation 26 visits, these are visits to gain feedback from staff, people living at the home and relatives. The provider would also look at the environment and care plans and other documentation, which may be relevant. The home had a comprehensive health and safety policy. We were able to evidence that regular maintenance of equipment and systems was carried out. Risk assessments were carried out on all safe-working practices, regular audits were carried out on the building and all accidents were properly recorded and reported ensuring people in the home were safeguarded. DS0000041903.V355678.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 X 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 x DS0000041903.V355678.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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard YA5 YA14 YA20 YA26 YA24 Good Practice Recommendations It is recommended that the new terms and conditions are completed for each person. It is recommended that more evening activities are outside based, and the wording on the activity picture board is changed. Continue to liaise with the GP practice to resolve the problems with the medication. Give people the choice to have a key for their rooms. It is recommended that the floor covering in the lounge in the Barn is replaced with something that is more homely. DS0000041903.V355678.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 DS0000041903.V355678.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. Re-publishing this information is in breach of the terms of use of that website. 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