Inspection on 25/07/07 for Leyland House

This inspection was carried out on 25th July 2007.

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 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

Leyland House 19/09/06

Leyland House 21/12/05

Leyland House 07/04/05

Leyland House 20/10/04

Leyland House 31/07/04

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

CARE HOME ADULTS 18-65 Leyland House 22 Leyland Avenue St. Albans Hertfordshire AL1 2BE Lead Inspector Pat House Unannounced Inspection 25th July 2007 10:00 Leyland House DS0000019446.V346646.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 Leyland House DS0000019446.V346646.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. Leyland House DS0000019446.V346646.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Leyland House Address 22 Leyland Avenue St. Albans Hertfordshire AL1 2BE 01727 763 707 01727 763 707 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) New Link Residential Homes Association Manager post vacant Mr Keith Hung Mrs Sinikka Hung Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Leyland House DS0000019446.V346646.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th June 2007 Brief Description of the Service: Leyland House is an end of terrace property in a cul-de-sac in a residential area of St Albans, and provides a home for three service users who may be of either sex. The current people have been resident at Leyland House for between seven and twelve years. The home is domestic in size and character, having an open-plan living area, a kitchen and bathroom on the ground floor; three bedrooms, a toilet, a small office and a staff sleeping-in room on the first floor. There is a small area to the front for car parking and a rear garden with lawn and flowerbeds. There are local shops in the vicinity and the city centre is within walking distance. Public transport services are available nearby. The home’s statement of Purpose and Service User’s Guide are displayed in the office and copies are available on request. Fees for residence at the home are currently £737.51 per week. All referrals to the home are made through the Local Authority. Leyland House DS0000019446.V346646.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one day with one inspector. The proprietor was present for the second half of the visit and an additional support worker was on duty and was spoken with. Two residents were in the home initially and one returned later. Residents spoke briefly to the inspector. A selection of records was examined and all areas of the home were visited. The proprietor has recently sent out quality questionnaires to a variety of people with interests in the home as well as to service users. Comments and outcomes from the returned questionnaires will be included in the Annual Quality Assessment document being completed for the CSCI. What the service does well: What has improved since the last inspection? Individual risk assessments have been completed for the safe management of hot water in the home. The bathroom has been provided with soft paper towels and liquid soap as recommended in current guidelines for the prevention of the spread of infection. Leyland House DS0000019446.V346646.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. Leyland House DS0000019446.V346646.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 Leyland House DS0000019446.V346646.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): Standard 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Full assessments are completed for all prospective service users so that all parties can be sure the home can meet all the individual’s needs. EVIDENCE: There have been no new residents admitted to the home since the last inspection. Full assessments of each service user’s needs were made before each of the present residents moved into the home and details were seen documented on the care plans checked. The support worker spoken with confirmed that the admissions procedure includes trial visits for the prospective service user so that all parties can be sure the home is the right place for them. Leyland House DS0000019446.V346646.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): Standards 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents care plans are kept up to date and have individual areas of risk identified and assessed. This enables staff in the home to support the residents to make choices about their lives and to live as independently as possible. EVIDENCE: The care plans for the three residents in the home were examined and appropriate information had been included in all records. All residents have an allocated key worker and are supported within the Care Programme Approach framework. Frequent reviews were seen documented and a variety of changing needs had been reassessed. One resident spoken with confirmed they were involved in their care planning. A resident who has additional learning disability needs had a detailed written plan in place for behaviour management. There is a rota for residents to take part in the daily running of the home including meal preparation, washing up, laying the table and shopping. Staff support the residents to take responsibility and actively manage risk as part of Leyland House DS0000019446.V346646.R01.S.doc Version 5.2 Page 10 an independent live style. A wide range of risk assessments were seen on records and each risk assessment was signed and had reviews documented. The format of the care planning is being reviewed by the proprietor and the requirements of new legislation will be incorporated into any changes made. Leyland House DS0000019446.V346646.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): Standards 12,13,15,16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents in the home are supported to maintain family links and to take a full part in their local community activities. Appropriate leisure and training opportunities are provided and meals are well balanced and enjoyed by residents in the home. These opportunities and services provided by staff in the home ensure that residents have their physical and mental well being monitored and promoted. EVIDENCE: The residents attend a variety of different day centres and colleges accessing courses suitable to their individual needs and aspirations. Individual daily programmes are displayed on the office wall and activities include art therapy, drama and music sessions. Residents can access local transport and the home also has its own vehicle. Staff support and encourage all residents to maintain and develop social, emotional, communication and independent living skills and the daily notes recorded give details of all activities undertaken. Leyland House DS0000019446.V346646.R01.S.doc Version 5.2 Page 12 Routines within the home are used to promote independence and residents have unrestricted access to all areas of the building and garden. Contact with families is promoted and one resident spends alternate weekends with relatives. One resident spoken with confirmed they chose the colour scheme in their room and said they made their own choices about how they spend their leisure time. Residents are also involved in making decisions about the daily running of the home and confirmed they also went out with the proprietor recently to choose the home’s new vehicle. Staff confirmed that relations between the residents and their neighbours in the cul de sac are very good. The residents of the home have an allotment and provide vegetables for neighbours as well as for the home. An elderly neighbour is supported by the residents in the home and is provided with meals and any help needed. During the visit, this neighbour rang to say a meal would not be needed that evening as a relative was visiting. Residents are involved in meal preparation with appropriate support provided. During the inspection one resident was deciding what meal to cook for that evening. Records of food eaten were seen listed in the home’s general diary. All residents are provided with external nutritional advice and assessments and monthly weights are recorded. Residents spoken with said they enjoyed the food provided in the home. Leyland House DS0000019446.V346646.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): Standards 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures followed in the home ensure that the health needs of all service users are identified and met in a way they prefer. The system for administering medication is robust and helps to protect service users in the home. EVIDENCE: Records examined showed that individual care needs are fully assessed and monitored and that residents make choices about any treatment received and about how any changing needs are met. Assessments and reviews are continuously completed ensuring that the approach adopted by the home is person centred and that appropriate input is provided from specialists such as community nurses, consultants, GP, dentists, opticians and dieticians. Currently the district nurse visits one resident twice each week to dress a wound and progress is written on care records. Written details were seen of a hospital admittance for a resident and of the treatment provided. Details of the progress made through art therapy are also recorded on care notes. Extra support and bereavement counselling has been provided for one resident whose Mother recently died. Staff felt this timely extra support prevented the Leyland House DS0000019446.V346646.R01.S.doc Version 5.2 Page 14 health of the resident concerned from deteriorating. Detailed care plans are in place, which reflect the individual needs, preferences and wishes of the resident. Risk assessments had been completed where restrictions were being imposed and clear documentation was available showing why this had happened. Residents are supported by named key workers. The home has a written policy for the administration, storage and receipt of medicines. All staff receive training prior to being deemed competent to administer medication. Monitoring visits from the pharmacist are recorded. No errors were found in the checks made on the records for the administration of medication. Leyland House DS0000019446.V346646.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): Standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures followed in the home ensure that residents are protected from abuse and can be sure any concerns they might have will be listened to and acted on. EVIDENCE: The home has written policies on the complaints procedure, Safeguarding Adults and Whistle Blowing, which staff said they were aware of. A record is maintained within the home of complaints made, detailing actions and outcomes as necessary. All service users have been informed about the complaints procedure. Details of this procedure are also on display in the home. Robust procedures are in place to ensure that service users are protected from abuse and harm. Staff receive training in the Protection of Vulnerable Adults (POVA), and all staff employed at the home are subject to enhanced Criminal Records Bureau (CRB) clearances. Leyland House DS0000019446.V346646.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): Standards 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures followed by staff ensure that residents live in a home which is well maintained, clean and hygienic. EVIDENCE: The home was clean and appeared well maintained at the time of the visit. The bedrooms visited were attractive and decorated to the individual resident’s taste and had fittings personal to them. A resident spoken with confirmed they had been actively involved in the choice of colours and furniture and carpets for their room and for the home. However, one bedroom appeared to have only one double electric socket. The Care Standards recommend two sockets are provided in each bedroom, and the proprietor needs to ensure enough electric sockets are provided for each resident’s needs. There is a rolling programme for refurbishment in the home. At the last inspection the kitchen had just been refitted and some flooring was due to be upgraded the weekend after this visit. Leyland House DS0000019446.V346646.R01.S.doc Version 5.2 Page 17 Soft paper towels and liquid soap were available in the bathroom as recommended in current guidelines for infection control in care homes. Leyland House DS0000019446.V346646.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): Standards 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents in the home benefit from receiving care from well trained, professional staff and are protected by the home’s thorough recruitment procedures. EVIDENCE: The staff team in the home have worked there for many years and can therefore provide consistent services for all the residents. The home has clearly defined job descriptions and person specifications in place for staff. Almost all the staff have received a series of mandatory training courses in order for them to meet the complex needs of the service users. Training includes Protection of Vulnerable Adults, food hygiene, risk assessment, challenging behaviour, first aid, mental health, personality disorder, epilepsy, foot care, loss and bereavement and feeding awareness. Training in the implications of the Mental Capacity Act has been planned. The member of staff on duty during the visit only works for a few hours each week and so had not completed all necessary training, but was aware of the need to complete all appropriate courses in the near future. Training records are maintained within the home. Over 50 of staff within the home have completed NVQ training or are registered nurses and the proprietor/manager and the deputy have completed the NVQ 4 in care and the Registered Managers Award. Leyland House DS0000019446.V346646.R01.S.doc Version 5.2 Page 19 A selection of staff recruitment files was examined and evidence was in place of all appropriate employment checks. One new member of staff was due to start work once CRB clearance was received. Recruitment practices within the home appear robust. Leyland House DS0000019446.V346646.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): Standards 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a home which is well run and where their views affect how the home functions. Procedures followed in the home ensure that the health and safety of both service users and staff is promoted. EVIDENCE: The relationship between the residents and the staff appeared very relaxed during the visit and all observed interaction was appropriate and supportive. The ethos and management approach of the home creates an open, positive and inclusive atmosphere and the staff spoken with said they feel extremely supported and feel the home is well managed. A clear commitment is made to equal opportunities within the home. Staff and the manager are adequately Leyland House DS0000019446.V346646.R01.S.doc Version 5.2 Page 21 and suitably trained and able to meet the complex changing needs of the residents. A Quality Assurance system has been developed in order to ensure that residents’ views underpin the development of the home. Residents’ meetings occur and minutes are taken. The service users spoken with felt that their views were listened to and considered. Individual risk assessments for the residents’ use of hot water have been completed. Leyland House DS0000019446.V346646.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 x 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 4 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 Leyland House DS0000019446.V346646.R01.S.doc Version 5.2 Page 23 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. 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. Refer to Standard Good Practice Recommendations Leyland House DS0000019446.V346646.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. 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