Inspection on 14/12/05 for Lifestyles Care Home

This inspection was carried out on 14th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lifestyles Care Home 10/07/08

Lifestyles Care Home 20/07/07

Lifestyles Care Home 23/01/07

Lifestyles Care Home 06/06/06

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 09/07/2008.

CARE HOME ADULTS 18-65 Lifestyles Care Centre For The Young Disabled Weeland Road Eggborough Goole North Humberside DN14 0RX Lead Inspector Jo Bell Unannounced Inspection 14th December 2005 10:00 Lifestyles Care Centre For The Young Disabled DS0000027965.V270739.R01.S.doc Version 5.0 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 The Young Disabled DS0000027965.V270739.R01.S.doc Version 5.0 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 The Young Disabled DS0000027965.V270739.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Lifestyles Care Centre For The Young Disabled Address Weeland Road Eggborough Goole North Humberside DN14 0RX 01977 661492 01977 661492 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) Regent Life Styles Limited *** Post Vacant *** Care Home 20 Category(ies) of Physical disability (20) registration, with number of places Lifestyles Care Centre For The Young Disabled DS0000027965.V270739.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Age Range 16 years upwards Day care for 5 persons Date of last inspection 25th August 2005 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 young people with a physical disability.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. Lifestyles Care Centre For The Young Disabled DS0000027965.V270739.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The 2nd unannounced inspection of the year took place on Wednesday 14th December 2005. The provider and manager were available to assist with the inspection. The purpose of the inspection was to assess 12 standards which included some key standards and re-visiting the requirements and recommendations made at the last inspection. Issues discussed included the environment, medications, residents finances, staffing levels and quality assurance. The home has progressed well over the past 3 months, in particular the environment has been much improved through new carpets, paintwork and re-plastering. Currently the upstairs of the premises is not in use. This is due to previous environmental requirements. The provider is aware that he must inform and discuss this with the CSCI prior to admitting any residents. The home are currently recruiting for a new manager, an acting manager has been temporarily appointed and will commence her role shortly. What the service does well: What has improved since the last inspection? The lounge and dining area has had new carpets fitted, these are a huge improvement and make the environment more appealing for new and existing residents. One residents room has been decorated as required at the last inspection, this has improved the room aesthetically for the resident. Progress has been made in the area of quality assurance, this needs to continue to ensure an effective system is in place to capture views and opinions from residents, relatives and staff. Lifestyles Care Centre For The Young Disabled DS0000027965.V270739.R01.S.doc Version 5.0 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. Lifestyles Care Centre For The Young Disabled DS0000027965.V270739.R01.S.doc Version 5.0 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 Lifestyles Care Centre For The Young Disabled DS0000027965.V270739.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these Standards were assessed. EVIDENCE: Lifestyles Care Centre For The Young Disabled DS0000027965.V270739.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these Standards were assessed. EVIDENCE: Lifestyles Care Centre For The Young Disabled DS0000027965.V270739.R01.S.doc Version 5.0 Page 10 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): None of these Standards were assessed. EVIDENCE: Lifestyles Care Centre For The Young Disabled DS0000027965.V270739.R01.S.doc Version 5.0 Page 11 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): 20 Medication is administered, stored and disposed of in a safe and competent manner which protects residents. EVIDENCE: The home have a medication policy in place and guidelines from the Royal Pharmaceutical Society regarding the administration of medicines. At present no one self medicates. The medication room was examined and oxygen was stored correctly and safely. Medication charts were completed correctly and a satisfactory system was in place for checking controlled drugs. A weekly stock balance of medication does not consistently take place, this would be good practice to ensure this is carried out routinely. The manager is aware of how to dispose of medication following the latest guidance. Lifestyles Care Centre For The Young Disabled DS0000027965.V270739.R01.S.doc Version 5.0 Page 12 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): 23 The home have systems in place to minimise the risk of abuse to residents. EVIDENCE: The home has an adult protection policy in place and the manager is aware of how to care and meet the needs of individuals. Staff were observed treating residents with dignity and respect and clearly had a good rapport with them. The manager is aware of control and restraint procedures and there is a policy detailing this. Residents finances were discussed, a policy is in place regarding finances. All monies are individually stored in a locked cupboard. One resident’s money tallied with the documented amount in the record book. One resident does have a weekly cash allowance, the resident signs for this and the receipt is kept in the file. However, following discussions it was suggested that a plan is put in place to ensure there is a more robust system in place for dealing with this which the residents and staff are aware of. Lifestyles Care Centre For The Young Disabled DS0000027965.V270739.R01.S.doc Version 5.0 Page 13 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, 26,27,29 & 30 The environment has improved and residents are happy and comfortable in the home. EVIDENCE: Since the last inspection progress has been made regarding the environment. The lounge and dining area have had new carpets fitted and the walls have been painted. Plaster work and one of the residents rooms identified as needing areas of redecoration has been completed. A radiator guard has been fitted to the smoking area radiator, this will reduce the risk from scalds and burns. The home now have a plan of routine maintenance and the home is looking cleaner, odour free and more appealing for new and existing residents. Currently the home do not employ a maintenance person. This would be beneficial as currently the manager has to contact a range of people for health and safety issues. For example many of the light bulbs in the lounge needed replacing, this could not be sorted out for a number of days as a maintenance person was not available. As the environment constantly needs attention it is difficult to complete the tasks required which are detailed in the maintenance plan. Lifestyles Care Centre For The Young Disabled DS0000027965.V270739.R01.S.doc Version 5.0 Page 14 A discussion took place regarding the use of bed rails, at present there is no specific policy in place to identify when it is appropriate to use bed rails. The home do have guidance from the medical device agency. However, when inspected it was evident that potentially three residents who had been using bed rails did not require them. These should be reviewed along with the risk assessments. As discussed at the last inspection, currently there are two communal bathrooms and one shower room in use. In one of the bathrooms the water pressure is minimal and should be made adequate, as currently this bathroom is not used. There are currently 10 residents, however if this number increases this bathroom would need to be in use. The manager did state that valves have been ordered but have not been obtained and fitted yet. The home provide specialist equipment, hoists, pressure relieving mattresses and specialist beds are available. Residents were observed using wheelchairs, and one lady has a specially adapted room with tracking hoist equipment and extra padding on her bed to prevent falls. A previous recommendation was that the oxford hoist that was corroding should be repainted, this has not been undertaken but consideration should be given to ensure the safety of the equipment. Staff are aware of maintaining hygiene in the home, infection control procedures are in place and staff are aware of the use of gloves, aprons and wipes. Staff attend infection control training, and during the inspection no unpleasant odours were identified. Lifestyles Care Centre For The Young Disabled DS0000027965.V270739.R01.S.doc Version 5.0 Page 15 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): 32,33, Staff are competent, suitably qualified and in sufficient numbers to meet individual needs. EVIDENCE: The home currently has 10 residents, there are usually one registered nurse and 4 care staff on duty in the morning, then 3 care staff in the afternoon and evening and one nurse and 2 care staff overnight. One resident does require one to one care throughout the 24 hour period. The home can have a maximum of 20 residents and currently the staffing levels have not been reduced with the reduction in residents. A discussion took place with the provider regarding reviewing the current staffing notice, as it was felt that the residents needs can still be met even if the staffing levels were adjusted. The provider will review this and discuss with the CSCI. The staff are clearly competent in their roles, training is provided and staff are aware of how to meet individual needs. This was reflected in a residents questionnaire which had recently been completed. Staff morale was good and the home works as a team to ensure residents are happy with the care and staff enjoy their work. For those staff who work over 48 hours per week an opting-out form has been signed in line with the working time directive. Currently three staff members have signed this. Lifestyles Care Centre For The Young Disabled DS0000027965.V270739.R01.S.doc Version 5.0 Page 16 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, 39 & 42 Resident’s views are sought, however a more robust quality assurance system should be implemented. Health and safety in the home could be improved. EVIDENCE: The home is currently well run, however this Standard will be re-assessed when the new manager is in place (within 6 months) as the current manager leaves shortly. The home need to develop an annual development plan regarding quality assurance. Currently resident’s views are sought through a questionnaire system. Five out of ten questionnaires had been completed in the last month. All of these had positive comments regarding the food, care and environment. Staff meetings take place on a monthly basis and these are minuted. Residents meetings have not recently taken place. The manager has implemented a system for auditing meals. A meal satisfaction survey was sent out and completed, again these results were positive. Staff maintain health and safety of the residents, as previously discussed it would be beneficial if there was a designated maintenance person in the home. Lifestyles Care Centre For The Young Disabled DS0000027965.V270739.R01.S.doc Version 5.0 Page 17 At the last inspection requirements were made regarding the upstairs of the home. This related to the unsuitability of the rooms in their current state. At present the upstairs is not used by staff or residents. Therefore the previous requirements will stand, however, these will not need to be actioned until this area needs to be used. The provider must inform the CSCI in writing when this occurs. A further assessment will then be made prior to any resident been admitted. At the last inspection the home provided us with a range of health and safety certificates and the gas safety certificate was forwarded to the CSCI as requested. Lifestyles Care Centre For The Young Disabled DS0000027965.V270739.R01.S.doc Version 5.0 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 Score x 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x x x x x Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x 1 1 x 2 3 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x 3 3 x x x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x 2 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 1 x Lifestyles Care Centre For The Young Disabled DS0000027965.V270739.R01.S.doc Version 5.0 Page 19 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. 2. Standard YA24 YA26 Regulation 16 16 Requirement The two ceiling tiles at the entrance must be replaced All bedrails and the risk assessments for these must be reviewed to ensure residents require them. A policy on the use of bed rails must be implemented The water pressure in resident bathrooms must be sufficient to ensure that residents can have a bath (previous timescale of 30/09/05 not met). The provider must inform the CSCI in writing prior to using the rooms upstairs. This is due to the environmental requirements that were previously made. A further assessment of these rooms will then be made. Timescale for action 14/01/06 14/01/06 3. YA27 23 14/01/06 4. YA42 13 14/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Lifestyles Care Centre For The Young Disabled DS0000027965.V270739.R01.S.doc Version 5.0 Page 20 No. 1. 2. 3. 4. 5. Refer to Standard YA20 YA23 YA24 YA29 YA39 Good Practice Recommendations A weekly stock balance of medication should take place A plan which identifies the system for residents obtaining cash from the home should be in place (one particular resident identified) Consideration should be given to employing a maintenance person The Oxford hoist is corroded and should be painted. The home develops an annual development plan. Lifestyles Care Centre For The Young Disabled DS0000027965.V270739.R01.S.doc Version 5.0 Page 21 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 Care Centre For The Young Disabled DS0000027965.V270739.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!