Inspection on 27/04/05 for Lilas House.

This inspection was carried out on 27th April 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

Lilas House. 03/05/07

Lilas House. 27/09/05

Lilas House. 11/10/04

Lilas House. 12/05/04

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Coopers Mill Ltd

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Paradise Lodge

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Upaya Ananda

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Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Lilas House 5 Cadogan Road Cromer Norfolk NR27 9HT Lead Inspector Lella Andrews Unannounced 27 April 2005 10:00 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. Lilas House I55 s27466 Lilas House v222491 (un) 270405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Lilas House Address 5 Cadogan Road Cromer Norfolk NR27 9HT 01263 511210 01603 279529 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) Jeesal Residential Care Services Limited Mrs Sam Wiseman Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Lilas House I55 s27466 Lilas House v222491 (un) 270405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11 October 2004 Brief Description of the Service: Lilas House is a three storey end of terrace property situated in the centre of Cromer. It is registered as a Care Home for up to six adults with a learning disability. Each service user has their own bedroom. There are two bedrooms, with a shared ensuite bathroom, on the ground floor and four bedrooms on the first and second floors. There is a shared lounge and dining room on the ground floor. The Home does not have a garden but there is a small patio area to the side of the Home. The Home is very close to the shops, seafront and other facilities in the town of Cromer. Lilas House I55 s27466 Lilas House v222491 (un) 270405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Inspection was unannounced and took place between 10am and 1.15pm on Wednesday 27th April 2005. The Inspector was accompanied by Ruth Burrell, a member of the Commissions administration staff. The Manager was not present on the day of the Inspection. The Senior support worker on duty liased with the Inspector. There were five service users living at the Home and one service user who is in currently in hospital. The Inspector spoke to four of the service users and to two of the staff as well as observing staff working with the service users. One of the service users showed the Inspector around the Home. records were seen in the course of the Inspection. Several What the service does well: What has improved since the last inspection? The Managers hours are now additional to those provided by the care staff to meet the needs of the service users. This means that the Manager has more time to undertake management tasks and also to still work with staff and service users in a monitoring role. The three service users who are shortly going to move into a more independent service has been supported to gain additional skills with regard to Lilas House I55 s27466 Lilas House v222491 (un) 270405 Stage 4.doc Version 1.30 Page 6 independent living, such as looking after their own medication, checking the identity of callers. Staff have also provided emotional support to the service users with regard to their move. The communication needs of the service users who do not use verbal communication are now being met more effectively. Staff take time and make a lot of effort to ensure that the service users are offered choices in as many aspects of their lives as possible. 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. Lilas House I55 s27466 Lilas House v222491 (un) 270405 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Lilas House I55 s27466 Lilas House v222491 (un) 270405 Stage 4.doc Version 1.30 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 standard(s) None of these standards were inspected EVIDENCE: N/A Lilas House I55 s27466 Lilas House v222491 (un) 270405 Stage 4.doc Version 1.30 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 standard(s) 7,8, 9 and 10 Staff receive training and support to ensure that they assist the service users to make their own decisions and choices about as many areas of their lives as possible, even when verbal communication is not easy. The written risk assessments are detailed and thorough, therefore, providing the staff with clear guidance about how to manage risks. Service users feel that they are involved in decisions affecting the running of the Home. EVIDENCE: The service users gave a lot of examples of situations where they have been given support to make their own decisions and to take control of their own lives. Three service users will shortly be moving to a flat with reduced staff support and so have been receiving support to ensure that they have the independent living skills to be able to do so successfully. This has included preparing meals for themselves and everyone else in the Home, shopping and looking after and administering their own medication. The service users said that they feel much more confident now about their ability to live more independently. During the Inspection four of the service Lilas House I55 s27466 Lilas House v222491 (un) 270405 Stage 4.doc Version 1.30 Page 10 users prepared their own lunch and one went shopping alone for the ingredients for the evening meal. Staff routinely asked the service users for their opinion about issues and encouraged them to make their own choices. Staff have received training with regard to alternative forms of communication and gave examples of how objects of reference, photos, symbols and signing is used with two of the service users who do not solely use verbal communication. Staff were observed taking a lot of time in order to ascertain the choices of meals for one of the service users. Service users described the recent visits to the Home by candidates from the three main political parties and the kind of questions that they asked the visitors. These visits had been organised by one of the staff following discussions in the Home about the forthcoming election. Two of the care plans were looked at in relation to communication, choice and risk assessments. These showed that there is clear guidance for staff to follow and that risks have been assessed appropriately. The written information was consistent with verbal information received from staff and with the care practice observed during the Inspection. Service users now maintain their own daily diaries and are supported by staff, as needed, on an individual basis to complete these. Staff complete written information at the end of each shift to “handover” to the next shift. This record was seen and showed that the service users are encouraged to read and sign the entry about them, where possible. Currently this information is being kept for all service users in one bound book. It is recommended that, to ensure confidentiality of information, each of the service users has their own individual record. These could all be kept together in one folder whilst in use and then filed in individual care plan folders. The minutes of the daily tenants meetings show that the service users take turns to chair these meetings and that a range of issues are discussed, including menus for the next week, any events taking place in the Home and service users views about things that have happened in their lives. Lilas House I55 s27466 Lilas House v222491 (un) 270405 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13 and 16 Service users feel that they receive the support that they individually need which enables them to feel that they a part of the local community. The philosophy of the Home is clearly understood by the staff and this means that the service users feel that their rights are respected. EVIDENCE: The service users have lived in the Home for several years and all know the local area well. On the day of the Inspection one of the service users went to work, one went shopping alone and another was supported to use the local library. There are leaflets on the message board about local facilities and forthcoming events. A service user said that they had been able to ask the political candidates questions about issues affecting themselves and the local area in which they live. The service users who are moving soon are pleased to be staying in the local area as they feel confident about going out alone there and are knowledgeable about the services available. Service users and staff advised that the staffing levels enable the service users to access leisure and work opportunities in the community. The rotas seen confirm this information. Lilas House I55 s27466 Lilas House v222491 (un) 270405 Stage 4.doc Version 1.30 Page 12 Risk assessments are present with regard to the individuals ability to have their own front door and bedroom door keys. The majority of the service users do have their own and staff were heard to ask permission before going into a bedroom. Service users said that they are able to spend time in their rooms if they wish or in the communal areas. During the Inspection the majority of the service users moved freely around the Home. The staff frequently consulted the service user who requires staff support to move around as to where they wished to spend time. Lilas House I55 s27466 Lilas House v222491 (un) 270405 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 The training provided to staff and the organisations procedures relating to medication administration mean that service users receive appropriate medication as required, with the minimum disruption to their lives. EVIDENCE: The medication administration charts were seen, as was the medication cupboard. Discussion was held with staff about the procedures and training that they receive. Medication is being stored appropriately and the records were up to date. Appropriate procedures are followed for the ordering and returning of any medication. Staff feel confident due to the training that they have received with regard to the administration of everyday medications as well as additional training with regard to the epilepsy and diabetes. It is important that all staff receive training so that the service users activities are not restricted due to not enough staff being competent to administer medication. The service users who are moving described the process that was in place to enable them to learn to be responsible for their own medication. Appropriate storage is provided and records kept. One of the risk assessments was seen and this clearly provides guidance to manage the risks and confirms the procedure in place as described by staff and service users. Lilas House I55 s27466 Lilas House v222491 (un) 270405 Stage 4.doc Version 1.30 Page 14 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) None of these standards were measured EVIDENCE: N/A Lilas House I55 s27466 Lilas House v222491 (un) 270405 Stage 4.doc Version 1.30 Page 15 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, 25, 26, 27, 28 and 30 The service users benefit from living in a homely, well furnished, comfortable Home which provides a choice about where they can spend their time. EVIDENCE: One of the service users showed the Inspector around the Home. Only one of the bedrooms was seen. The organisation has an ongoing refurbishment and redecoration programme. As a result of this the Home has had new carpets recently and there are plans for all of the bedrooms and the majority of the communal areas to be redecorated as well as for the kitchen to be replaced. This work is due to take place once the three service users move. One of the service users has chosen the style and colour of the new kitchen and expects to be involved in choosing the colour scheme for the other communal areas of the Home due to be redecorated. Lilas House I55 s27466 Lilas House v222491 (un) 270405 Stage 4.doc Version 1.30 Page 16 Radiators are covered to reduce the risk of harm to the service users. Ramps have been provided to enable the service user who has limited mobility to move around the Home freely. All areas of the Home were clean and free from offensive odours. Service users said that they are do their own laundry if they are able to. Staff advised that a handbasin is going to be put into the small laundry room to reduce the risk of cross infection for both service users and staff. Service users said that they are able to able to decorate and furnish their room as they wish to. The bedroom seen showed clear evidence of the service user having been encouraged to develop their own sense of style. All of the service users have television and music systems in their room. Some also have drink making facilities. Lilas House I55 s27466 Lilas House v222491 (un) 270405 Stage 4.doc Version 1.30 Page 17 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) 32 Staff are knowledgeable about the needs of individuals and work positively with service users to improve their whole quality of life and increase independence. EVIDENCE: Staff are clear about their role within the team and were able to describe accurately how to meet the needs of the individual service users. Staff talked about the philosophy of the Home being that of supporting service users to maximise their quality of life through making their own choices and increasing their independence. One member of staff commented that the Home is “run for the service users”. Another comment was that service users and staff all “feel valued”. Staff spoke positively and respectfully about the service users and were observed to work in a calm, kind and friendly way. Service users commented that “the staff are great, they really help us” and that “the staff help me if I need it”. The induction programme for new members of staff is detailed and includes formal training as well as shadowing other members of staff. The induction includes information about attitudes and values as well as more practical skills. Lilas House I55 s27466 Lilas House v222491 (un) 270405 Stage 4.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 and 38 The Home is well managed with an open, inclusive style of management which enables service users and staff to feel that their views are important. EVIDENCE: The Manager was not present during the Inspection. A senior support worker and three support workers were on duty. The senior support worker worked positively and helpfully with the Inspector throughout the Inspection. The Manager is working towards the NVQ Level 4 in management but already has completed other management training such as NVQ Assessors award. She has managed the Home for several years. Staff said that staffing levels have improved and so the Manager is now not included on the staffing rota. The rota confirmed this. This change enables the Manager to undertake management tasks rather than be a part of the staffing rota. Staff and service users said that the Manager still works directly with the service users alongside staff but that this is as an additional member of staff which is more beneficial. Lilas House I55 s27466 Lilas House v222491 (un) 270405 Stage 4.doc Version 1.30 Page 19 Staff said that the Manager and Deputy Manager are approachable and that they feel confident about discussing any issues with them. They said that issues affecting them are discussed either at team meetings or in supervisions and that they feel included and kept up to date. Service users know who the General Manager and the Proprietors are and how to contact them if they wish to. They said that they see the General Manager on a regular basis and would take any issues to him if they needed to. Lilas House I55 s27466 Lilas House v222491 (un) 270405 Stage 4.doc Version 1.30 Page 20 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 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 x x 3 x x 3 x Standard No 31 32 33 34 35 36 Score x 3 x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Lilas House Score x x x x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x x x I55 s27466 Lilas House v222491 (un) 270405 Stage 4.doc Version 1.30 Page 21 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 Lilas House I55 s27466 Lilas House v222491 (un) 270405 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 3rd Floor - Cavell House St Crispins Road Norwich NR3 1YF 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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