Inspection on 10/07/08 for Lifestyles Care Home

This inspection was carried out on 10th July 2008.

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

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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lifestyles Care Home 20/07/07

Lifestyles Care Home 23/01/07

Lifestyles Care Home 06/06/06

Lifestyles Care Home 14/12/05

Lifestyles Care Home 25/08/05

Lifestyles Care Home 15/02/05

Lifestyles Care Home 09/08/04

Lifestyles Care Home 30/09/03

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 Lifestyles Care Centre For Adults With Disabilities Weeland Road Eggborough Goole North Humberside DN14 0RX Lead Inspector Jean Dobbin Unannounced Inspection 10thJuly 2008 09:30 Lifestyles Care Centre For Adults With Disabilities DS0000027965.V363890.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 Care Centre For Adults With Disabilities DS0000027965.V363890.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 Care Centre For Adults With Disabilities DS0000027965.V363890.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lifestyles Care Centre For Adults With Disabilities Weeland Road Eggborough Goole North Humberside DN14 0RX 01977 661492 F/P 01977 661492 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) Lifestyles Care (Yorkshire) Limited Post vacant Care Home 20 Category(ies) of Physical disability (20) registration, with number of places Lifestyles Care Centre For Adults With Disabilities DS0000027965.V363890.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 20th July 2007 Brief Description of the Service: Lifestyles Care Centre was originally a hotel, which has been converted into a care home with a nursing provision. It offers permanent and respite nursing care for adults with disabilities. The home is situated in Eggborough, a village 7 miles from Selby. Within quarter of a mile are a pub and some small local shops. The building is on two levels but people are currently accommodated on the ground floor only. There is ample parking at the front of the house and a secure patio area provides some outdoor space if required. Details provided in July 2008 outline the weekly fees as from £505 according to individual assessments and extra funding provided for meeting healthcare needs. This does not include hairdressing, chiropody services, complimentary therapies including physiotherapy, and activities away from the home. A Statement of Purpose is displayed in the entrance area and the latest inspection report is also available in the entrance area for people to look at. Lifestyles Care Centre For Adults With Disabilities DS0000027965.V363890.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 1 star. This means the people who use this service experience adequate quality outcomes. This is what was used to write this report. • • • Information about the home kept by the Commission for Social Care Inspection. Information asked for, before the inspection. This is called an Annual Quality Assurance Assessment (AQAA) Information from surveys, which were sent to people who live at Lifestyles, their relatives, and other professional people who visit the home. 3 were sent to people at the home, and 2 were returned. 3 were sent to people’s relatives and 2 were returned. 8 were sent to healthcare and to social care professionals and 1 was completed and returned. A visit to the home by one inspector, which lasted about 5.5 hours. This visit included talking to people who live there and their visitors, and to staff and the nurse in charge about their work and training they had completed. It also included checking some of the records, policies and procedures that the home has to keep. • Information about what was found during the inspection was given to the nurse in charge at the end of the visit. What the service does well: People are assessed properly to help make sure that the staff have the skills and knowledge to support them if they choose to move there. This process also reassures the person and their family that staff are competent to meet their needs. Staff are well trained and feel well supported so that people are more likely to receive safe, consistent care. People are treated in a respectful manner and as individuals. People are consulted in how they want to spend their day. Staff speak with people gently, even if the person has communication difficulties, and all the people living Lifestyles Care Centre For Adults With Disabilities DS0000027965.V363890.R01.S.doc Version 5.2 Page 6 there are valued. One visitor said. “I am very, very happy with the care my relative has received here”. Medication processes are monitored closely to make sure people receive their drugs properly, according to their prescription. A healthcare professional said they were ‘happy with the care provided’. What has improved since the last inspection? What they could do better: Recruitment processes could be more robust. References could be obtained before people start work there. This will help to keep people safe. Information about the home could be produced and presented in a format that is more accessible for people who are thinking of moving there. This is so that they can make an informed choice about whether to move there or not. The owner could look at improving the systems he has in place at the home to keep people and their possessions safe at all times. Someone who has no visitors could have an external advocate visit them and staff knowledge of ‘abuse’ could be reviewed. People with no close family could have their own bank accounts. The environment could be improved with some redecoration of the internal décor and attention to the outside patio area. This would enhance the day-today lives of the people living there. The owner could develop more formal ways that all people with an interest in how the home runs can provide their views and opinions about the home and how it could be improved. This will show that the home is receptive to suggestions and is keen to work with the people who use the service. The owner could provide evidence to the Commission that he is monitoring how the home runs, on a regular basis. This would help to confirm that the standard of care and support at the home is being maintained. Lifestyles Care Centre For Adults With Disabilities DS0000027965.V363890.R01.S.doc Version 5.2 Page 7 Fire safety systems could be reviewed so that the owner can demonstrate he is doing all he can to keep people safe by minimising the risk of a fire starting at the home. 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. Lifestyles Care Centre For Adults With Disabilities DS0000027965.V363890.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 Care Centre For Adults With Disabilities DS0000027965.V363890.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 People who use this service experience adequate quality outcomes in this area. Whilst people are assessed properly to make sure their needs can be met, if they move there, information about the home and the services it provides needs to be improved so that people can make an informed choice about whether to live there. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: No one has moved to the home in the last year. People’s care plans looked at showed that comprehensive assessments had been completed before people had moved there. This assessment looked at people’s social, emotional and spiritual needs and how these could be met by the home. There were signatures of the person involved, where possible, or their representative, to show that they had been consulted and agreed with the written information. There was also evidence of assessments from care management and input from specialist healthcare professionals. All this information helps the home to decide whether they can support the person properly as well as reassuring the person and their family that the home can provide the right care and environment. Lifestyles Care Centre For Adults With Disabilities DS0000027965.V363890.R01.S.doc Version 5.2 Page 10 The Statement of Purpose has recently been updated, and is displayed in a number of picture frames in the hall. However this is the only updated copy in the home. The owner needs to make sure that up to date information about the home is available for people to read. He should also consider providing this information in different formats so that people thinking of moving there, who have different communication needs may be able to find out about the home for themselves. At the last inspection one year ago it was noted that information about the home was held in different documents, making it more difficult for people thinking of moving there to understand how the home operates. This information is still not presented in a transparent way, so that people are very clear about the fees and how they are to be paid, as well as the terms and conditions about living there. Lifestyles Care Centre For Adults With Disabilities DS0000027965.V363890.R01.S.doc Version 5.2 Page 11 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 and 9 People who use this service experience good quality outcomes in this area. People are supported in expressing their views, wherever possible, and leading their lives as they choose. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Care plans and risk assessments are reviewed each month. The individual, or their family member, put their signature to them wherever possible, to confirm their agreement. The care plans are written in good detail describing people’s interests, social history and goals. There was also recognition that people wanted time when they shouldn’t be disturbed, for example when their partner visited, and this was recorded and respected. Staff spoken with, were very aware of people’s individual needs, and observations on the day of the visit showed that people were being supported in a very caring and respectful manner. There are detailed individualised risk assessments, which enable people to maintain as normal a life as possible. People choose when to get up each Lifestyles Care Centre For Adults With Disabilities DS0000027965.V363890.R01.S.doc Version 5.2 Page 12 morning, with their breakfast at a time of their choice. Some people choose to have breakfast in bed. Staff were observed asking people what they wanted to do, and where they wanted to sit. One person with communication difficulties was still consulted, with staff showing a good understanding of what their different responses might indicate. This good practice enables people to still have some control of their day-to-day lives. One person though, whilst providing generally very positive responses in their survey, said that they could not make decisions about how they spent their evenings. And could only sometimes make decisions about how they spend their day. These comments need to be explored with the individual to see if this is an area, which they feel needs looking at. Lifestyles Care Centre For Adults With Disabilities DS0000027965.V363890.R01.S.doc Version 5.2 Page 13 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 and 17 People who use this service experience good quality outcomes in this area. People are assisted to live their lives in the way they choose and receive a nutritious, varied diet. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Talking with staff, observing how they interacted with people and looking at the care records all confirmed that staff know what people’s interests and preferences are. These are well recorded in the plans of care. There are lots of photographs displayed around the home of previous activities, both at home and in the local community, however most of these relate to last year when there was an activities organiser in post. This person though no longer works at the home so it is now the carers who have to organise these events. The owner needs to be satisfied that care staff have enough available time to do Lifestyles Care Centre For Adults With Disabilities DS0000027965.V363890.R01.S.doc Version 5.2 Page 14 this, without compromising the time they need for providing care. And also that the number of leisure activities don’t diminish. The home has a well-equipped sensory room. Staff know which people enjoy this recreation and the facility is well used. Complementary therapies are also provided for a small charge and a hairdresser visits regularly. One visitor said that the home tried very hard to integrate with the local community and visits from the local vicar help to promote this. Visitors are welcomed any time and some bring their dogs with them. One person spent the day with their family on the day of the visit. There is nobody at the home available to work at this time, however staff were aware of the need to help people to look for appropriate employment if that was their wish. Similarly the people living there now either choose not to go out alone, or cannot get about independently. The care plans looked at, including assessment of ‘risk’ suggested that people would be able to go out and take acceptable risks, as part of everyday life, if that were their choice. The way the home runs allows the people living there to say what help they need and when. There is no pressure on people to get up by a set time, or indeed to accept daily care if they don’t want it. However because the staff know people very well they also know which aspects of a person’s day-to-day routines are important. Good relationships between people living there and the staff mean that discussion and compromise help to make sure people receive support appropriately. There is a two-week menu, which includes the meals that people say they like. Whilst daily records of these meals are kept, records like ‘pork chop dinner’ and ‘buffet tea’ need to be expanded so that the home can demonstrate that they are providing a varied and nutritious diet. Staff know people’s likes and dislikes very well, though it would be good practice to record these preferences so that an unfamiliar care worker would have something to refer to. The records include meals originating from other countries, like sweet and sour, curries and pizza, but there is no record of whether a formal alternative meal choice is offered each day. This would be good practice rather than providing individual alternatives for when people don’t like the main choice and would provide real choice. The menu for the day is displayed on a whiteboard, so that people can look forward to their favourite meals. One person was really looking forward to toad in the hole, which was the lunch that day. The care records provided comprehensive details including risk assessments about how people were to be supported to maintain a reasonable diet. Carers were observed assisting in an unhurried and relaxed manner, helping to make the mealtime a social occasion. The cook prepares the evening meal each day for the care staff to finish the cooking and serve it after she has gone home. Whilst not all staff have a Lifestyles Care Centre For Adults With Disabilities DS0000027965.V363890.R01.S.doc Version 5.2 Page 15 current food hygiene certificate, there is training organised in the weeks following this visit and one carer said they planned to attend this. Lifestyles Care Centre For Adults With Disabilities DS0000027965.V363890.R01.S.doc Version 5.2 Page 16 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 and 20 People who use this service experience good quality outcomes in this area. People are helped in a way that meets individualised personal care needs and they are consulted about how their healthcare needs are to be met. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Staff know people’s individual needs very well and are able to work out what people may want, even if they are unable to speak. On the visit staff demonstrated a gentle, respectful manner in the way they spoke and behaved towards the people living there. The care records detail every aspect of a person’s needs in good detail, so an unfamiliar care worker would be able to find out what support was needed by reading these records. Daily records are kept and the person or their representative signs to confirm their agreement to what is written wherever possible. There are both male and female care staff so that people have the opportunity, wherever possible to receive personal care from someone of the same sex if that is their choice. Lifestyles Care Centre For Adults With Disabilities DS0000027965.V363890.R01.S.doc Version 5.2 Page 17 There is a range of specialist equipment at the home and there is evidence of support from outside healthcare professionals, like the occupational therapist and speech therapist, to make sure that the support provided is appropriate. Nurses receive training related to individual care needs so that people receive care from nurses whose knowledge is up-to-date. One visitor said that they were ‘very, very happy with the care their relative receives’. They said they could call in any time and their relative was always ‘nicely dressed and clean’. Nobody at the home currently looks after his or her own medication. Medication practices at the home were looked at and were in good order, with records completed properly. Checks are regularly carried out to make sure that the actual number of tablets is the same as the number, expected from the individual records. This good practice helps to demonstrate that people are receiving their drugs according to their prescription. Lifestyles Care Centre For Adults With Disabilities DS0000027965.V363890.R01.S.doc Version 5.2 Page 18 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 and 23 People who use this service experience adequate quality outcomes in this area. Whilst care staff are alert to the possibility of people being ‘upset’ by something, and visitors are confident complaints will be addressed properly, people are nonetheless being put at risk because systems in place to protect them are not robust. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The complaints process is displayed in the entrance area of the home. Staff are very alert to signs that people may be unhappy about something and some of the people have regular visitors, who can also keep an eye on what is happening at the home and how staff respond to people living there. One person though rarely has visitors and the owner should consider using an external advocate/visitor who could help to make sure that the individual’s rights are always upheld. One carer spoken with understood the importance or reporting any concern that someone may raise, to the person in charge. They also recognised that if a person told them something in confidence that was a complaint or a concern, then they would have to tell the senior person about it, even if they were asked not to. One visitor said they had every confidence that a complaint would be investigated properly and that a negative comment would be received as a way of looking at how the service could be better. Lifestyles Care Centre For Adults With Disabilities DS0000027965.V363890.R01.S.doc Version 5.2 Page 19 Staff attend training in safeguarding adults and some training was planned for the weeks following the visit. Two care staff spoken with said that they would report any event that concerned them immediately, though had limited knowledge about what constitutes ‘abuse’. The owner needs to satisfy himself that following the training staff have a good knowledge and understanding of this subject so that they can contribute towards keeping people safe. The senior nurse had a good understanding of what she should do in the event of an allegation being made, and knew exactly where the policy guidance was kept in her office. People’s monies were not formally assessed on the inspection. Following the last inspection a meeting was held with the owner, where the way the home looked after these monies were looked at in great detail. These records were generally found to be satisfactory however the owner was required to make sure two named people had their own named bank account, to be administered by their relatives. He was also required to relinquish his role as appointee for two individuals, something that he said that he was keen to do. These things haven’t happened yet although the owner says that he has contacted social services about these issues. Recruitment files looked at showed that two members of staff had started work in the past year without the home obtaining two references first. One file did not contain either reference. Recruitment systems that are robust help to keep people safe, so employing people before all these checks have been completed could be placing people at risk. Lifestyles Care Centre For Adults With Disabilities DS0000027965.V363890.R01.S.doc Version 5.2 Page 20 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 and 30 People who use this service experience adequate quality outcomes in this area. The home is clean, warm and comfortable, although some redecoration is required so that it is a more attractive place in which to live. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The home is built over two floors, but all the rooms currently in use are on the ground floor, except for the treatment room, which is upstairs. Externally the building needs some refurbishment, however the flowerbeds and car parking area at the front of the building are fairly well maintained. The bell to gain access to the building is cracked and a visitor cannot tell if it is working. A new bell which could be heard when you press it, would provide a better first impression of the home. The home is clean, warm and comfortable, with no unpleasant smells. The communal areas are very spacious allowing people in wheelchairs to move easily around. There are a number of unoccupied rooms, which does make the place feel a bit empty, however there are lots of pictures to try to promote a Lifestyles Care Centre For Adults With Disabilities DS0000027965.V363890.R01.S.doc Version 5.2 Page 21 homely environment. Some redecoration is required though as some areas look tired and worn. This could put people off moving there, when the owner is trying to increase the number of people living there. Three bedrooms were looked at and all contained items chosen by the person or their family. One room had been furnished with lots of feminine items including the pink bed linen. There are no en suite rooms, but there are a number of toilets, and the main bathroom has a ceiling tracking system to help people to access the bath more easily. The damaged door to the bathroom, commented on at the last inspection has been repaired. There is an enclosed patio area and there has been some attempt by staff and people living there to grow some plants, however this outside space looks uncared for and is not an inviting place for people to sit. There is a lift at the home, which is used only for transporting the drug trolley between floors. The nurse has to use the stairs. The lift door now has a lock and is kept locked to prevent unauthorised people trying to use it. These systems protect people from harm. Staff were observed wearing aprons and gloves when these were needed and hand wash gel was sited around the home. Whilst staff are alert to the need to protect people living there from possible infection there were no aprons outside the room of one person where aprons needed to be used. The senior person said that supplies outside the room had run out, and got more aprons from the store. There was also no visible reminder to staff to wear protective items before going into the room. This was remedied during the day when small notices were put up as a reminder to staff, and particularly for staff who may not be familiar to the home. This way of working can help to keep people safe. Lifestyles Care Centre For Adults With Disabilities DS0000027965.V363890.R01.S.doc Version 5.2 Page 22 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 and 35 People who use this service experience adequate quality outcomes in this area. The home employs enough appropriately trained staff to meet people’s needs However poor recruitment practices may mean that people are being put at risk. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: On the day of the visit there was one nurse and two carers working in the morning, one nurse and one carer on the evening and one plus two carers through the night. There were also a cook, domestic and administrator at work, who all work part time hours. Whilst there are only seven people living there at this time, the cook doesn’t work over the teatime period, so care staff have to finish preparing and serve the evening meal, as well as carrying out care duties. The owner must be satisfied that that there are enough staff working to meet all the people’s needs at this time. Whilst agency staff have been used in the last year the home has now employed enough staff so that unfamiliar staff should only need to work there to cover short notice absences. Lifestyles Care Centre For Adults With Disabilities DS0000027965.V363890.R01.S.doc Version 5.2 Page 23 Staff were observed treating people with respect and tenderness. There was a lot of gentle humour. One relative said in their survey ‘I am now and always have been very impressed with the staff’. Another person said ‘I am very happy with my relative’s time here’. External trainers provide a series of training sessions, which staff are encouraged to attend. One care worker said that the owner was very supportive and encouraged people to study for their National Vocational Qualification award. More than half the care staff have achieved a Level 2 qualification in Care. This means people are more likely to receive safe, consistent care from staff who understand why they do what they do. Nurses attend training related to the people they care for. A training session had been organised on the day of the visit because one person had been discharged from hospital with new care needs and the nurses needed to check that their care practices were up to date. Two recruitment files were looked at. Whilst police checks had been completed properly, both members of staff had started work at the home without two references being obtained. No references had been obtained for one person. Poor recruitment processes can mean that people are deployed who may not be suitable to work in a care setting and as a result people living there may be put at risk. New staff complete an induction programme and are supervised properly when they start working so that they can learn about what the work entails. Staff have regular meetings with a senior person at the home so that their work can be discussed and monitored. This helps to make sure that people living there receive the right care and support all the time. Lifestyles Care Centre For Adults With Disabilities DS0000027965.V363890.R01.S.doc Version 5.2 Page 24 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 and 42 People who use this service experience adequate quality outcomes in this area. Whilst the home is generally run in the best interests of the people living there some administrative processes have not been carried out, which would help to demonstrate that people’s welfare is being protected. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: There is no manager currently at the home. The previous registered manager left in May 2008. The owner is actively looking for a replacement. In the meantime the senior nurse is in charge of the day-to -day running of the home, whilst the owner oversees the administrative side. A part time administrator also helps with some of the administrative work. Lifestyles Care Centre For Adults With Disabilities DS0000027965.V363890.R01.S.doc Version 5.2 Page 25 The care staff know the people living there very well, including their likes and dislikes. People’s comments should still be sought, wherever possible, and then written down, to show that the home is listening to what people say and changes made as a result. There is a suggestions box in the entrance area, and questionnaires for relatives and visiting professionals to complete. However the owner needs to be more pro-active in seeking out these people’s views on a regular basis. These would tell him whether people think they are doing things right and he can consider making changes to how the home runs, according to their comments. At the last inspection one year ago a requirement was made that Regulation 26 notices should be sent to the Commission each month. These are documents, which are completed by the owner to demonstrate that he is monitoring how the home is running, on a monthly basis. These can help to demonstrate that the services provided by the home are being maintained at a satisfactory level. The Commission has not received any of these records for nearly a year, which means that the requirement has not been met. This was discussed with the owner, who acknowledged that he hadn’t complied with the requirement. There are a range of health and safety policies and procedures in place. The home has generally made proper provision to ensure that there are safe working practices by providing staff training in first aid, fire, food hygiene, infection control and safe moving and handling techniques. The fire risk assessment however has not been looked at for over a year, and this needs to be completed to comply with fire safety guidelines, which will help to keep people safe. Hazardous products are stored appropriately and records are maintained as required. Monitoring arrangements are in place to ensure the delivery of safe hot of safe hot water and to maintain fire safety equipment. Lifestyles Care Centre For Adults With Disabilities DS0000027965.V363890.R01.S.doc Version 5.2 Page 26 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 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 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 1 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000027965.V363890.R01.S.doc 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 2 X X 1 2 Version 5.2 Page 27 Lifestyles Care Centre For Adults With Disabilities Are there any outstanding requirements from the last inspection? Yes 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 YA34 Regulation 19 Sched 2 Requirement Proper recruitment checks, including obtaining two references, must be carried out before a new member of staff starts working at the home in order to keep people safe. The owner needs to develop a more formal self monitoring process, which is written down, and where the views of people with an interest in how the home runs are actively sought, so that they can influence how the home runs. The fire risk assessment at the home needs reviewing so that the owner is satisfied that the home is doing all it can to minimise the risk of a fire breaking out in the home. Doing this will help to keep people safe. The owner must continue to undertake a monthlyunannounced visit to the home and send a written report of this visit to the Commission for Social Care Inspection. Any issues found must be addressed. DS0000027965.V363890.R01.S.doc Timescale for action 01/08/08 2. YA39 12(2) 16(2) 01/11/08 3. YA42 23(4) c 01/08/08 4. YA43 26 01/08/08 Lifestyles Care Centre For Adults With Disabilities Version 5.2 Page 28 Previous timescale of 6/9/07 not met 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 YA23 Good Practice Recommendations The owner should continue to pursue discussion with social services about the personal finances of two named individuals at the home so that he can give up his responsibility as appointee for these people so that their finances can be managed externally. Management should review the information given to people, who may be interested in moving there, and the format in which it is provided, to ensure that they have all information to make an informed choice about the home. The owner should consider asking an external advocate to visit the individual who rarely gets any visitors, so that someone not working at the home is making sure his or her rights are always being upheld. The owner should satisfy himself that all staff have a good understanding of what ‘abuse’ means and what their responsibilities are if they are concerned about something that has happened. The owner should re-look at his plans for refurbishment of the home and the patio, as re decoration would improve the environment for the people living there. 2. YA1 3 YA23 4 YA23 5 YA24 Lifestyles Care Centre For Adults With Disabilities DS0000027965.V363890.R01.S.doc Version 5.2 Page 29 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 Lifestyles Care Centre For Adults With Disabilities DS0000027965.V363890.R01.S.doc Version 5.2 Page 30 - 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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