Inspection on 17/05/05 for 6 Lilac Grove

This inspection was carried out on 17th May 2005.

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

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

Other inspections for this house

6 Lilac Grove 24/04/07

6 Lilac Grove 01/02/06

6 Lilac Grove 06/10/04

6 Lilac Grove 07/04/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Lilac Grove 6 Lilac Grove Trowbridge Wiltshire BA14 0HB Lead Inspector Sally Walker Unannounced 17th May 2005 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 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 Stationary 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. Lilac Grove D51_D01_LILACGROVE_V195558_170505_Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Lilac Grove Address 6 Lilac Grove Trowbridge Wiltshire BA14 0HB 01225 766200 01225 777407 plintern@sensewest.org.uk Sense Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Miss Pauline Lintern Care Home Only 4 Category(ies) of LD Learning Disability (4) registration, with number PD Physical Disability (4) of places SI Sensory Impairment (4) Lilac Grove D51_D01_LILACGROVE_V195558_170505_Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. No more than 4 service users with Sensory Impairment. 2. No more than 4 service usres with a Learning Disability. 3. No more than 4 service users with a Physical Disability. Date of last inspection 6th October 2004 Brief Description of the Service: 6 Lilac Grove provides care and support to 4 younger adults with learning disabilities, sensory impairment and physical disabilities. There is one single bedroom with an en-suite shower and toilet to the first floor and three single bedrooms on the ground floor. There is a large wheelchair accessible bathroom with shower, bath and toilet to the ground floor. Also on the ground floor is a sitting room, adjacent dining room, kitchen, laundry room, separate toilet and conservatory. Miss Lintern has an office in the conservatory which will be divided off to allow more private space for residents. All the exits have level access or ramps. There is a reasonably large enclosed garden to the rear of the property. The front garden has been covered with ashphalt to aleviate the local parking problem. The interior has been decorated to take into account the needs of people with a visual impairment with dark doors and frames and light walls. The home promotes a Deaf environment with all staff signing as well as speaking. All staff are expected to obtain British Sign Language qualifications. The staffing rota provides for a minimum of 4 care staff during the waking day and 1 waking night staff with 1 staff sleeping in. This apparent reduction in night staff was agreed when a previous resident who needed extra support moved last year. Staff carry out domestic tasks as well as care and support. Lilac Grove D51_D01_LILACGROVE_V195558_170505_Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place between 9.25am and 1.55pm. Mrs Lintern was available for part of the inspection but had other appointments. Two residents and four staff were spoken with. The care records, staff records and risk assessments were examined. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Lilac Grove D51_D01_LILACGROVE_V195558_170505_Stage4.doc Version 1.30 Page 6 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 Standards Statutory Requirements Identified During the Inspection Lilac Grove D51_D01_LILACGROVE_V195558_170505_Stage4.doc Version 1.30 Page 7 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 standard(s) 2 Residents and their representatives can rely on the home to do a full assessment of need to make sure the home is right for the resident. EVIDENCE: Although no new service users had come to live at the home for some time, it was clear from files that staff had carried out a full pre-admission assessment with each resident to ensure that their needs could be met. Information was gained from a variety of sources including the family, healthcare professionals and any previous placement. The care management assessment was also taken into consideration when developing the initial care plan. Inspection reports were available in Braille and Widget. Lilac Grove D51_D01_LILACGROVE_V195558_170505_Stage4.doc Version 1.30 Page 8 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 standard(s) 6, 7 & 9 Residents and their representatives are assured that their current care needs are met with good care planning and continual assessment. Residents decide about how they live their lives as independently as possible. Residents can be involved with activities which might be risky, knowing that staff have assessed those risks and implemented strategies to minimise those risks. EVIDENCE: Each resident had a very detailed care plan showing all aspects of their care needs together with how staff should meet those assessed needs. The care plans identified social and communication needs as well as physical or medical need. Care plans were regularly reviewed and revised. The daily records showed that the care plans directed the care with staff reporting on residents mood, activities, communication, food and fluid intake, healthcare professional interventions and sleeping patterns. Staff had identified individual development goals with service users and other interested parties. Residents were encouraged to be involved in their personal care and some domestic duties; laundry or cooking. Staff had made good progress with supporting residents to be more independent and expanding their range of communication, preparing drinks, learning new sign language and experiencing Lilac Grove D51_D01_LILACGROVE_V195558_170505_Stage4.doc Version 1.30 Page 9 new activities. There was good recorded evidence that residents were making some decisions and choices about different things in their day. Care plans identified strategies for managing behaviours which had been developed with the behaviour nurse. Any risks to residents were identified together with guidance to staff to manage those risks, for example, choking, use of the kitchen equipment, swimming and going out in the vehicle. Risk assessments did not necessarily prevent residents from doing things they enjoyed or from experiencing new things to do. All residents had a link worker. Lilac Grove D51_D01_LILACGROVE_V195558_170505_Stage4.doc Version 1.30 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 standard(s) 12, 14 & 16 Staffing levels ensure residents are involved in a varied educational and social activities programme suited to their needs. Residents determine their own daily routines dependent on their activity and leisure programme. Residents’ rights were respected. EVIDENCE: Residents’ daily routines were documented and plans for the day would depend on how they were feeling or whether they had college courses. Residents got up in their own time. One of the staff said that each day’s activities were planned in the diary with support staff identified. She said they tried to take all residents out for some part of the day or evening. Staff were familiar with local facilities and venues. The home had its own ‘people carrier’. Residents’ current activities included going to the gym, shopping, out for meals, to the beach, out for walks, to the pubs and to the cinema. Any meals taken away from the home were included in the fee and paid by petty cash. One resident said they were looking forward to going on holiday the following week to the Canaries to swim with dolphins which was one of their dreams. Staff were supporting this venture with agreement from the family. Staff had Lilac Grove D51_D01_LILACGROVE_V195558_170505_Stage4.doc Version 1.30 Page 11 researched the holiday and risk assessments had been carried out for going on the aircraft, swimming and for any of the other activities associated with the water park. Other residents were going to Cornwall, Disneyland Paris and Centreparcs at different times of the year. All residents had their own separate holidays. Staff said the location for holiday would depend on the resident’s choice as well as potential for noise or crowds. Mrs Lintern said that residents had one holiday each year as part of the fee; other breaks would have to be paid for by the residents. Staff said the computer in the dining room was linked to the Internet for residents use. There was a large television in the sitting room and a collection of signed videos as well as the facility for subtitles. Lilac Grove D51_D01_LILACGROVE_V195558_170505_Stage4.doc Version 1.30 Page 12 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 standard(s) 18 & 19 Staff respected residents’ privacy, dignity and preferred routines when giving personal care. Male residents could choose to be supported by male staff. Residents were well supported with their physical and healthcare needs. EVIDENCE: The care plans identified residents preferred routines for the giving of personal care. There was clear guidance to staff on working with people who may have a visual impairment, eating difficulties or deafness. There were good records on monitoring of progress and prompt referral to healthcare professionals when concerns were noted. Some adaptations had been made to the environment for safe movement around the home. A visual rota was in the main entrance giving information about the day and which staff were on duty. Staff communicated with residents about what was happening or about to happen either in British Sign Language or hand over hand signs. Any restrictions or specialist interventions had been discussed in detail with behavioural specialist with clear guidance to staff. Male staff worked only with the male residents in personal care giving. Residents had good access to their GPs, the psychologist, neurologist, speech and language therapist and behavioural nurse. Lilac Grove D51_D01_LILACGROVE_V195558_170505_Stage4.doc Version 1.30 Page 13 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 standard(s) 22 & 23 Residents and their representatives can know that their views or concerns are addressed by the management or the organisation. Policies and procedures are in place to minimise the risk of abuse or harm and ensure that staff report any issues. EVIDENCE: The home’s complaints procedure was available in large print English, British Sign Language and pictorial format. It had been made available to service users and their representatives. Residents and their families were regularly asked to make comments about the home. Staff said they could bring up any issues or complaints either at supervision or at staff meetings. Staff said that one of the policemen from the local Vulnerable Adults Unit had recently come to the home to train staff in the policy and procedure. All staff had been given a copy of the booklet entitled “No Secret in Swindon and Wiltshire”. Lilac Grove D51_D01_LILACGROVE_V195558_170505_Stage4.doc Version 1.30 Page 14 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 standard(s) 24 & 30 Residents have a homely, domestic style environment with strategies to ensure their safety. The home was very clean and did not smell. EVIDENCE: The home was planned and decorated at its opening with deaf people and people with disabilities in mind. Although adaptations have been made to ensure good access, the home is comfortable, clean, warm, light and well kept up. Residents had free access to all the communal areas and the gardens. Risk assessments had been carried out on the environment and were regularly reviewed. There were plans to install patio doors to one resident’s room so they could access the garden directly without going through the conservatory. An ensuite toilet with wash hand basin would also be installed in their bedroom. Mrs Lintern planned to divide the conservatory which was used as an office, into her own private office and a room where residents could relax or meet with family or friends in private in addition to the main sitting room or their bedrooms. Lilac Grove D51_D01_LILACGROVE_V195558_170505_Stage4.doc Version 1.30 Page 15 The laundry dryer had broken and permission was being sought from the organisation for a replacement. Staff did the cleaning and had good supplies of protective clothing and infection control guidance. Lilac Grove D51_D01_LILACGROVE_V195558_170505_Stage4.doc Version 1.30 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Residents are supported by well trained staff with a good deal of experience either of working with Deaf people or with people with learning disabilities. Staffing levels enable service users to be involved in a range of activities as well as having individual care. Residents are protected by a robust recruitment procedure. EVIDENCE: There were 4 staff on duty on the day of the inspection with 1 waking night staff and one member of staff sleeping in. One member of staff was supporting a resident at college. Some residents had contractual arrangements for extra staffing during the day. All new staff were inducted in to post with time spent doing training and shadowing other members of staff. Staff said they had good access to training. Recent courses included managing behaviours, food hygiene, first aid, health and safety & moving and handling. Staff said they were regularly updated in core training. Six staff had NVQ Level 3 and 4 were undertaking the qualification. The 2 newer staff had NVQ Level 2. Miss Lintern said 2 other staff wanted to undertake NVQ Level 3. All staff were expected to undertake British Sign Language training. Staff also talked about their previous experience in care settings. Lilac Grove D51_D01_LILACGROVE_V195558_170505_Stage4.doc Version 1.30 Page 17 Staff said they had regular monthly supervision and monthly staff meetings. Mrs Lintern said the whole team had recently undertaken a teambuilding day with very positive results. Staff said they had time during the day to make sure the records were up to date. They also had different delegated administrative responsibilities, for example, medication, ordering supplies or fire prevention. The staff files showed that all of the required documents and information was obtained on staff prior to them starting work, including Criminal Records Bureau certificates. Staff were good communicators and interacted with residents in a respectful and friendly manner. Lilac Grove D51_D01_LILACGROVE_V195558_170505_Stage4.doc Version 1.30 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 The home is run in the best interests of the residents and organisational management systems are in place to ensure this happens. EVIDENCE: Miss Lintern said she had obtained the Registered Managers Award. She has nearly 20 years experience of working with a range of Deaf people with disabilities in care homes. She has NVQ Level 4, British Sign Language stages 1 and 2, Lip speaking and Deaf Blind communicators Level 1. Miss Lintern also has personal family experience of Deaf culture. She keeps herself up to date with current good practice in attending a range of relevant courses and conferences made available by Sense. The previous recommendations to stop using correction fluid and leave no spaces between entries in the daily reports had both been actioned. Accidents, incidents and seizures were being recorded with visual details of any wounds recorded on body maps. Lilac Grove D51_D01_LILACGROVE_V195558_170505_Stage4.doc Version 1.30 Page 19 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 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 x 3 x 4 x Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Lilac Grove Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 x x x x x x Version 1.30 D51_D01_LILACGROVE_V195558_170505_Stage4.doc Page 20 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Lilac Grove D51_D01_LILACGROVE_V195558_170505_Stage4.doc Version 1.30 Page 21 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire, SN15 2BB 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. 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