Inspection on 19/07/06 for Lifestyles

This inspection was carried out on 19th July 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lifestyles 29/07/08

Lifestyles 07/08/07

Lifestyles 02/02/06

Lifestyles 07/06/05

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

Pennine Camphill

Muston Road (70)

Grayling

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 Lifestyles 55-59 Wentworth Road Scarcroft Hill York YO24 1DG Lead Inspector Mary Slattery Key Unannounced Inspection 19th July 2006 10:00 Lifestyles DS0000062824.V304446.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 Lifestyles DS0000062824.V304446.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. Lifestyles DS0000062824.V304446.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lifestyles Address 55-59 Wentworth Road Scarcroft Hill York YO24 1DG 01904 645650 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) Dove Care Ltd. *** Post Vacant *** Care Home 19 Category(ies) of Learning disability (19), Mental disorder, registration, with number excluding learning disability or dementia (19) of places Lifestyles DS0000062824.V304446.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd February 2006 Brief Description of the Service: Lifestyles is owned by Dove Care Limited and is registered to provide personal care, support and accommodation for up to 19 service users with learning disabilities and mental disorder. The home comprises of three large terraced houses linked together with a variety of communal rooms, single and double bedrooms and a patio garden at the back of the house. The home is within walking distance of York city centre its amenities and leisure facilities. The current scale of charges is £323 to £617 per week and there are no additional charges as the service users purchase their own extras. Activities and holidays are included in the fees charged. This information was provided by the registered provider in the pre-inspection questionnaire. Lifestyles DS0000062824.V304446.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows an unannounced site visit undertaken on the 19th July 2006. This was carried out by 1 Regulatory Inspector and took six and a half hours plus 4 hours preparation time. A number of the surveys that were sent to service users, relatives and health care professionals have been returned. Service users said they are supported by the staff, treated with respect, their complaints were listened to and they make their own decisions about their daily lives. Visitors to the home felt that the environment could be better and that the telephone was not always answered. Relatives said they were happy with the care provided and the staff responded well to concerns and always kept them informed about any changes. That service users were more relaxed and the daily routines were flexible. The site visit comprised of a full inspection of the premises and facilities. The case records of six service users were looked at, which included the pre admission assessment, risk assessments, care and social plan. A selection of the homes’ records were looked at, which included polices and procedures, staff records, staff rota, menus, medication and health and safety records. Time was spent talking to ten service users, 4 members of staff and the registered provider. Time was also spent in the sitting and dining rooms observing the activity and interaction between the service users and the service users and staff. Information was also used from the Regulatory Inspectors inspection record, which detailed the history of the home and relevant information about what has been happening in the home since the previous inspection visit. The focus of the inspection was on a number of the key standards, inspecting the case records of a number of the service users to establish whether they corresponded to their experiences of life in the home. The registered provider was available throughout the site visit and the findings were discussed with her at the close of the visit. The requirement made at the previous inspection of the service has been met. Lifestyles DS0000062824.V304446.R01.S.doc Version 5.2 Page 6 Three requirements were made at this site visit. What the service does well: What has improved since the last inspection? Service users and staff have spent time making sure that the service users care plans are up to date and that action plans are in place to minimise risks to their safety. Contact has been made with care managers and health care professionals and care reviews have taken place to make sure the service users needs are addressed and the placement remains appropriate. Service users said, “They are treated with respect and consulted before any changes to the running of the home are decided and their complaints were heard and acted on”. Staff have training opportunities and all the required checks are carried out on staff before they are employed to minimise the risk of harm to service users. Lifestyles DS0000062824.V304446.R01.S.doc Version 5.2 Page 7 Some areas in the home have been redecorated and there is was information to show that there is a programme in place to make sure all parts of the home are kept safe, the required safety certificates were in place and there is a programme for the routine maintenance and refurbishment of the premises and facilities. All of the policies and procedures have been updated and are available to the staff and service users. 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. Lifestyles DS0000062824.V304446.R01.S.doc Version 5.2 Page 8 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 Lifestyles DS0000062824.V304446.R01.S.doc Version 5.2 Page 9 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 and 5. Quality in this outcome area was good. The judgement has been made using available evidence and a visit to the service. Service users are informed about what the home offers to provide and there needs are assessed before they move into the home. EVIDENCE: Service users have been given a copy of the service users guide and a new contract/terms and conditions. Service users told me that they have been spending time with the staff discussing their needs and updating their records. The assessment records of 6 service users were looked at and there was up to date information about their personal, health and social care needs and any known risks to safety. Lifestyles DS0000062824.V304446.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. The judgement has been made using available evidence and a visit to the service. Service users are supported to make decisions and take risks as part of an independent lifestyle. EVIDENCE: Service users and staff reported that they had been working together to up date the care plans and the risk assessments, to make sure all of their care needs, their safety and their future plans were recorded and action plans were in place for them support them in living their lives to the full and to remain safe. Six of the service users were case tracked and they were happy to share their care plans with me. There was up to date information about what type and level of care and support they need, their hobbies and interests and employment and education. The plans described the restrictions on choice and freedom and there were Lifestyles DS0000062824.V304446.R01.S.doc Version 5.2 Page 11 individual procedures for those service users likely to be aggressive or cause self-harm. The service users spoken with told me they have a key worker and the daily records they shared with me gave information about the support and guidance they have and what they have done each day. The service users spoken with were very clear about who could look at there care plans and that all of the records are kept secure and there is a record in their care plan about who they wish to share information with. The service users meet each day to discuss any problems, to decide the menu for the day and organise the domestic jobs. They said this meeting is a good thing and what they have talked about and agreed is now recorded. The service users a fully aware of their personal finances and some manage their own money and others have support from their key worker. Multidisciplinary care reviews have taken place for some of the service users and there were records in place of the findings and recommendations made to improve the lives of the service users. Lifestyles DS0000062824.V304446.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): 11, 12, 13, 14, 16 and 17. Quality in this outcome area was good. The judgement has been made using available evidence and a visit to the service. Service users have opportunities for personal development and to be part of the local community. EVIDENCE: Service users spoken with told me that their lives have improved that they are treated with respect and are involved in the day-to-day running of the home. They are consulted about any changes and improvements that need to be made and have the support from staff to increase their confidence, to take on new learning and enjoy wide variety of social and leisure activities. On the day of the site visit 2 of the service users assisted a member of staff who became unwell whilst they were out shopping and the service users alerted the emergency services and the staff. The member of staff was treated and recovered thanks to the responsible action taken by the service users Lifestyles DS0000062824.V304446.R01.S.doc Version 5.2 Page 13 Some have paid employment and others do some voluntary work in the local community. One service user recently admitted to the home told me that he is happy with his room, there is plenty to do the staff are very helpful both at home and in the community. Staff and service users work together in the kitchen and all have had the necessary food hygiene training. Service users also said they attend the in house fire safety training and help staff do the fire safety equipment testing. The care plans looked at gave information about what food service users like and any special dietary needs including weight reducing diets. The main meal is in the evening and service users and staff have their meals together this is a time to discuss the day and to make plans for the evening. Service users said that they keep in contact with family and friends either by visiting or by telephone. Lifestyles DS0000062824.V304446.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. The judgement has been made using available evidence and a visit to the service. Service users health and personal care needs are met in a safe way. EVIDENCE: The care plans looked at gave good information about the service users health and personal care needs and the level of support they need form their key workers. The majority of the service users are self caring and others need levels of support and guidance regarding their personal care. All choose their own clothes and what time they rise and retire. There records gave information about the contact they have with their GP, care manger, and any hospital appointments. The staff have established good relationships with psychology and psychiatric services community nurses and seek advice and guidance as required. Multidisciplinary review have been held for some of the service users to make Lifestyles DS0000062824.V304446.R01.S.doc Version 5.2 Page 15 sure their mental health care needs are being met and their behaviour is managed appropriately. The Nomad medication system is operated in the home and the service users are fully aware of what medication they are taking, what the medication is for and any side effects they may have. Some service users take responsibility for their own health care appointments and for their medication. Risk assessments are in place for those service user who self medicate and the homes medication system and facilities were in good order. Lifestyles DS0000062824.V304446.R01.S.doc Version 5.2 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 the following standard(s): 22 and 23. Quality in this outcome area was good. The judgement has been made using available evidence and a visit to the service. Service users know that their complaints will be heard and they are protected by the homes recruitment procedure. EVIDENCE: Service users said they feel confident in raising concerns with the staff and know that they will be listened to. The daily meeting they have gives them the time to discuss with each other any problems they may have and keep a record of what has been discusses. The complaints records were looked at and the complaints made against the service have been dealt with using the homes procedure. Concerns were raised with social services by a relative about a number of issues relating to care and supervision of a service user. The relatives main concern was that her son was not escorted by staff to keep hospital appointments. The homes records showed that he received full support and all the appointments were kept. A meeting with the staff and social services has taken place and the finding recorded. A meeting with the relative is planned to take place in the near future. The service users have been informed about the outcome of the abuse investigation and have been given advise and the support they need to make sure they are safe at all times. The staff said and the records confirm that staff have attended abuse awareness training and all staff have had a CRB and POVA check. Lifestyles DS0000062824.V304446.R01.S.doc Version 5.2 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 the following standard(s): 24, 25,28 and 30. Quality in this outcome area was good. The judgement has been made using available evidence and a visit to the service. Service users live in a comfortable safe environment with their personal possessions around them. EVIDENCE: An inspection of the communal parts of the house and the bedrooms of six service users were inspected. The home was clean and tidy and work was ongoing to repair one of the single toilets. There is a range of communal space where service users can meet together watch television and listen to music. The service users bedrooms were personalised and they have ample space to keep their personal possessions. They have a key to their rooms and choose who they invite in. There is a patio area to the back of the house and a small allotment just beyond the garden wall. Lifestyles DS0000062824.V304446.R01.S.doc Version 5.2 Page 18 There is a separate laundry room, and office and a designated smoking room area for the service users. The proprietor has a private area in the house, which is used as their office, and it was agreed that the main office would be a more suitable place for them to use to receive visitors and to hold meetings with other professionals. There is a recording book available for service users and staff to use to inform the proprietor that repairs and or renewals are needed, this book is looked at regularly and action taken as part of the maintenance programme. The required fire safety checks had been carried out and the required safety certificates were in place. The fixed wiring certificates, gas safety certificates and insurance certificates were in place and current. One of the service users bedroom and the main entrance hall and stairway need to be redecorated and new flooring laid. To ensure the safety of service users systems need to be put in place to test and maintain the regulation of water temperatures and to control the risk of Legionella. Lifestyles DS0000062824.V304446.R01.S.doc Version 5.2 Page 19 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): 32, 34 and 35. Quality in this outcome area was good. The judgement has been made using available evidence and a visit to the service. Service users individual and joint needs are met by the staff group. EVIDENCE: The staff rota showed that there are two members of staff on duty at all times during the day. One waking night staff and one/two members of staff sleeping in on call. Service users said they have the support they need from the staff and opportunities to go out and about in the community. A number of the service users go out independently and use public transport. The rota also showed that where extra staff are required the levels are increased accordingly. The staff and the service users work together to keep the house clean and to do the cooking and shopping. This is to enable service users to develop life skills and levels of independence. Lifestyles DS0000062824.V304446.R01.S.doc Version 5.2 Page 20 The staff records showed that all staff had a completed an application forms and the required references and CRB and POVA checks had been done. One member of staff recently appointed confirmed induction and is receiving ongoing supervision from senior staff. Staff training includes NVQ Level 2, medication, health and safety, fire safety, foundation in mental health, care planning, behaviour management and POVA. Staff would benefit from formal staff meetings, these would give them opportunities to discuss and contribute to the running of the home and to discuss their individual training and development needs. Lifestyles DS0000062824.V304446.R01.S.doc Version 5.2 Page 21 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, 41 and 42. Quality in this outcome area was good. The judgement has been made using available evidence and a visit to the service. Service users benefit from a well managed hoe where their needs and wishes are put first. EVIDENCE: The registered proprietor is a registered mental nurse and has completed the Registered Managers Award. Mrs Davies undertakes the day-to-day management of the home and also works closely with the service users. All of the policies and procedures have been up dated and are available to the staff. Service users have access to their own records and all of the records were up to date and kept in a secure place. All of the service users and staff met with during the visit said they are kept informed about what is going on and they receive the support and guidance they need form the proprietor. Lifestyles DS0000062824.V304446.R01.S.doc Version 5.2 Page 22 There is a health and safety policy and procedure and staff attend the required health and safety training. The service users are given plenty of opportunities to give their views about life in the home and these have been recorded. The quality assurance and quality monitoring system needs to be further developed to make sure that the views of relatives and other stakeholders are sought. The accident and incident records were inspected and the home reports regularly to the Commission For Social Care Inspection under Regulation 37. The record showed that the appropriate action had been taken following incidents involving service users. Lifestyles DS0000062824.V304446.R01.S.doc Version 5.2 Page 23 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 3 2 3 3 N/A 4 N/A 5 1 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 1 25 3 26 N/A 27 N/A 28 3 29 N/A 30 1 STAFFING Standard No Score 31 N/A 32 3 33 N/A 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 N/A 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 N/A 3 3 2 N/A 3 3 N/A Lifestyles DS0000062824.V304446.R01.S.doc Version 5.2 Page 24 YES 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 YA5 Regulation 5(1) (c) Requirement Timescale for action 01/09/06 2. YA24 23 (2) (d) 3 YA30 13 (4) (a) The registered person is required to provide each service user with a current terms and conditions document. The registered person is required 01/10/06 to redecorate and lay new floor covering in a service users bedroom and in the main entrance hall and stairs. The registered person is required 01/09/06 to test and maintain the regulation of water temperatures and to control the risk of Legionella. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA36 YA39 Good Practice Recommendations It is recommended that all staff have formal supervision to give them the opportunity to discuss their individual training and development needs. It is recommended that the quality assurance and quality monitoring system includes the views of relatives and other stakeholders are sought. DS0000062824.V304446.R01.S.doc Version 5.2 Page 25 Lifestyles Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Lifestyles DS0000062824.V304446.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. 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