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Inspection on 23/02/06 for Lindale Residential Care Home

Also see our care home review for Lindale Residential Care Home for more information

This inspection was carried out on 23rd February 2006.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is comfortable, clean and nicely decorated. The people all have their own rooms, with their own belonging and effects. Most of the people were home on the day of the inspection and enjoyed talking with the inspector about life in the home. All the people have care plans that show that their current needs are met. Any risks have been assessed and guidance for staff put into place to reduce them. All care plans and risk assessments are regularly reviewed and the people who live there are encouraged to sign their individual care plans and risk assessment. Each person keeps a copy of their own care plans in their room. The home supports people with their medication, and there are procedures in place to ensure that this is done safely. Staff are supported to have regular training and refreshers on an on-going basis. People at the home, have regular weekly meetings encouraging and supporting them to make and be involved in decisions about the their daily lives. The manager sees the inspection process as positive and takes on board advice, she users the inspections to help develop the service for the people who live there. The inspector spoke with seven of the people who live there, they were all keen to talk about all the different things they do, how much they like living at Lindale and how they have know each other for a long time and are good friends.

What has improved since the last inspection?

The manager and the staff have worked really hard since the last inspection to take on board all the requirements and recommendations from the inspection last November, this is particularly pleasing to see as the last inspection was only several months ago.

What the care home could do better:

All the people need to be supported to have individual Person Centred Plans, not just the people who attend the day centre, which are currently in progress. The manger and staff support the people with health assessments and they all have access to comprehensive health support, like psychiatrists, GP, Community Nurses, psychology, the optician, chiropody and the dentist, as and when required. It is recommended that this be further developed to look at each person having a their own Health Action Plan, this would support a pro active approach to peoples health care, and support them to develop more understanding into what is good health and how to recognise changes in their own health. The manager discussed continuing to look at ways of supporting people to have their individual needs met and for each person to develop as sense of themselves, and for people to look at doing activities and holidays as individuals. The group are very well established and have lived together a long time and as a consequence of this like to do most if not all things together as a group. The manager said that she would look into developing the service users meetings, where she would explore the possibility of having an independent facilitator to chair these meetings, rather than staff. The manager has explored getting people an advocate, but this is difficult in the Birmingham area, using services of be-frienders and/or an independent facilitator in service users meetings would encourage and support an advocacy process. Any use of volunteers would be liable to the some employment checks, including a CRB check and POVA 1st.

CARE HOME ADULTS 18-65 Lindale Residential Care Home 81- 85 Wharfdale Road Tyseley Birmingham West Midlands B11 2DB Lead Inspector Alison Stone Unannounced Inspection 23rd February 2006 11:00 Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 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 Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 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. Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lindale Residential Care Home Address 81- 85 Wharfdale Road Tyseley Birmingham West Midlands B11 2DB 0121 706 3273 0121 624 5334 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) Genesis Homes (Essex) Limited Adenike Adebukanla Adenuga Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Nine residents with a learning disability under the age of 65 years. The home can accommodate one named service user over 65 years. The details regarding how the specific needs and social needs of people over 65 years will be met must be included in the service user plan. 23rd November 2005 Date of last inspection Brief Description of the Service: Lindale provides care and accommodation to nine adults who have a learning disability. The home is privately owned and had a change of owner/manager in May 2003. The home is in Tyseley, Birmingham and is a corner property, which blends in well with local housing and industrial buildings. To the front of the home there are walled gardens and to the rear there is off road parking. To the rear at either side of the property there are two small gardens. The interior of the home is decorated and furnished to an adequate standard. On the ground floor there is a communal dining room, TV lounge, quiet lounge, separate WC, a large bathroom and toilet, a kitchen, hairdressing salon, laundry and two ground floor bedrooms. On the first floor there are seven bedrooms and two bathrooms and toilets with shower facilities. The home is situated off the main A41 Warwick Road and is well served by public transport. Trains run frequently from Tyseley station to Birmingham city centre and Solihull. The home is near to local shopping facilities as well as places of worship, parks, adult education centre, library, restaurants, a leisure centre and pubs. Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 23 February 2006, between 11:00 am and 3:30 pm. The inspector, collected information to form the basis of judgements in this report in a number of ways; she spoke with the people who live there and the staff and registered manager. Service user and staff records were looked at, along with records relating to the management of the home, food menus, medication and some health and safety records. This report should be read alongside the report of the previous inspection of 23 November 2005. The inspector would like to extend her thanks to everyone who helped with this inspection. What the service does well: The home is comfortable, clean and nicely decorated. The people all have their own rooms, with their own belonging and effects. Most of the people were home on the day of the inspection and enjoyed talking with the inspector about life in the home. All the people have care plans that show that their current needs are met. Any risks have been assessed and guidance for staff put into place to reduce them. All care plans and risk assessments are regularly reviewed and the people who live there are encouraged to sign their individual care plans and risk assessment. Each person keeps a copy of their own care plans in their room. The home supports people with their medication, and there are procedures in place to ensure that this is done safely. Staff are supported to have regular training and refreshers on an on-going basis. People at the home, have regular weekly meetings encouraging and supporting them to make and be involved in decisions about the their daily lives. The manager sees the inspection process as positive and takes on board advice, she users the inspections to help develop the service for the people who live there. Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 Page 6 The inspector spoke with seven of the people who live there, they were all keen to talk about all the different things they do, how much they like living at Lindale and how they have know each other for a long time and are good friends. What has improved since the last inspection? What they could do better: All the people need to be supported to have individual Person Centred Plans, not just the people who attend the day centre, which are currently in progress. The manger and staff support the people with health assessments and they all have access to comprehensive health support, like psychiatrists, GP, Community Nurses, psychology, the optician, chiropody and the dentist, as and when required. It is recommended that this be further developed to look at each person having a their own Health Action Plan, this would support a pro active approach to peoples health care, and support them to develop more understanding into what is good health and how to recognise changes in their own health. The manager discussed continuing to look at ways of supporting people to have their individual needs met and for each person to develop as sense of themselves, and for people to look at doing activities and holidays as individuals. The group are very well established and have lived together a long time and as a consequence of this like to do most if not all things together as a group. The manager said that she would look into developing the service users meetings, where she would explore the possibility of having an independent facilitator to chair these meetings, rather than staff. The manager has explored getting people an advocate, but this is difficult in the Birmingham area, using services of be-frienders and/or an independent facilitator in service users meetings would encourage and support an advocacy process. Any use of volunteers would be liable to the some employment checks, including a CRB check and POVA 1st. Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 Page 7 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. Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 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 Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 Service users have the information they require to make an informed choice about where they want to live. Prospective service users can be confident that their individual aspirations and needs are assessed appropriately and will be met. Service users are fully supported to have the opportunity to visit and ‘test drive’ the home during an introduction process. Service users have an individual written contract and/or statement of terms and conditions; this area needs some further development. EVIDENCE: The Service Users Guide and Statement of Purpose were looked at for the purposes of this inspection. The manager had worked hard to make the service users guide an accessible, working document that supported service users with a ‘brochure like’ document of the home. More work is required in this area to make it fully accessible to all service users, future and existing. The use of a video/DVD and/or audiocassette should be considered as possible mediums of communication for people with learning disabilities. Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 Page 10 The Statement of Purpose was already symbolised to a great extent, however again the same consideration should be given to this document as the Service Users Guide. The manger talked at length about the process of how she would support a new service user to make a decision about living at Lindale, considering both their needs and aspirations and that of the other service users within the home. She also said that she would ensure, they had a full assessment of the person prior to moving in, this should be completed by the social worker and supported by other associated health care professionals as required. She would also look to engage the services of an advocate to support the individual through this process. The service users who live at Lindale have all been there a number of years and have long standing relationships with each other from other homes they have lived in. The last admission was approximately 4 years ago. However the owner is applying for planning permission to convert a spare room on the first floor into a larger room with en-suite facilities, if this is granted, the owner then proposes to apply to CSCI for a variation in their conditions of registration to become a 10 bedded care home. Three service users files were looked at for the purposes of this inspection, each service users file was found to have a contract in place, stating the service users terms and conditions and these were signed on behalf of the service users by their social workers. However these were out of date and had been put in place by the previous owner. It is required that these be updated and new contracts be put in place, these will need to detail the costs of the home per week and the service users contribution. They will also need to detail what arrangements are in place for service users holidays, including the homes contribution to any holidays and what if any staffing arrangements will be made to support the service users during this holiday and if service users are liable for any staffing costs. Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, 10 Service users are supported to make decisions about their lives with the assistance they need. Service users are consulted on, and participate in all aspects of life in the home. Service users are supported to take risks safely as part of an independent lifestyle. Service users can be confident that information is handled appropriately, and that their confidences are kept. EVIDENCE: The manager supports service users with weekly service users meetings; these are minuted and detail who chairs the meeting and which service users attend. Service users use these meetings to discuss what activities they would like to take part in, they chose their following weeks meals from recipe cards and discuss holidays and up coming birthdays. The service users spoken to said they enjoy these meetings. It was discussed with the manager that these meetings could be further enhanced, via Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 Page 12 arranging for these meetings to be independently facilitated by a volunteer befriender. The service users also have discussion meetings once a month. They are further supported by regular key worker meetings and it was pleasing to see a symbolised key worker policy on the notice board, explaining to the service users what their key worker should be doing for them. The manager said currently seven service users are being supported to have Person Centred Plans, which are being led by the day centre, the staff at the home are involved in these and help service users put information about their lives into these plans. The three service users who attend work and college currently do not have this support, it is therefore recommended that the manager and staff take up the opportunity to complete Person Centred Plans for these service users too. Service users are supported to be involved in their care plans and risk assessments, they are encouraged to sign these documents and they are supported to keep copies of their care plans in their bedrooms. It was noted during the inspection that daily entries are not made in service users notes, but regular entries are made as part of an events log. It is recommended that staff make daily records in service users notes and that as a good practice guideline these be linked to the service users individual records of care plans as well as events during their day. On the files sampled comprehensive risk assessment were found to be in place, these were regularly reviewed. However it is recommended that risk assessment formats be further developed, so that there is an area on these forms to allow for a recorded review, with details of the outcome and changes to the plans. During the inspection all information pertaining to service users was found to be appropriately stored, it was noted as a positive that service users were involved in their care plans and encouraged to hold copies of their own care plans in their rooms. Interactions with staff and service users were observed throughout the day. Service users clearly had positive relationships with the staff and enjoyed showing them things they were doing and taking part in and talked openly to the staff. Staff in turn demonstrated in their interactions, open warm and respectful interactions towards service users. Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17 Service users are encouraged and supported to take part in appropriate age, peer and cultural activities. Service users are encouraged to be part of their local community. Service users enjoy the opportunity to engage in leisure activities. Service users are supported and encouraged to have positive relationships with their friends and family. Service users rights and responsibilities are recognised in their daily lives. EVIDENCE: All the service users have regular day time activities, provided by the local day centres and colleges, one service users works on an allotment whilst another works on a farm, the service users are all supported to take part in evening classes and clubs in the evenings. The service users spoken to during the inspection said they enjoy going out in the evenings, for meals, to the pub and they liked bowling. Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 Page 14 The manager said they no longer have a vehicle and they use a local taxi firm to support outside activities and also the local bus service ring and ride. The manager said that the service users always like to go out in a group, including holidays, although she and the staff try to encourage the service users to pursue their own interests individually. The service users spoken to said they enjoy doing things together and like to go out as a group and really enjoy holidays at Butlins together. It is recommended that the manager and staff keep trying to encourage the service users to have individual activities and interests as well as doing things as a group, as this will support service users individual personal development. The service users said they enjoy shopping in the local area and seeing friends, one of the service users who used to live at Lindale, but has now moved out to supported living, still maintains his friendships with the service users in the house and visits every week. Most of the service users have strong relationships with their family and they visits them regularly and/or friends and family come to the house to see the service users, some of the service users go home for overnight and or/weekend visits. The manger said there are no visiting times at the home; families and friends are welcome at the service users convenience. The manager said parties are always popular with the service users and their families and there are always many guests at all the party’s held at the house. The manger said she has good relationships with the service users families and stays in touch with them regularly. The comment book held in the home indicated many positive responses from family members and friends about what they thought of the care their family members receive at Lindale. Comments like “It’s always a great pleasure to come to Lindale” and “I think all the staff are brilliant and the home is great” were noted. One of the service users has a boyfriend who she sees regularly at the day centre, another service users used to have a boyfriend that regularly visited the house. The service users are supported to make choices about the their meals at the weekly service users meeting, where they are supported with picture recipe cards to choose what they want to eat the following week. Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 Page 15 There is a large pleasant dinning room provided for service users to eat in, the service users spoken to say they enjoy meals times and the inspector had the opportunity to be present during lunch. An inspection of the kitchen indicated that there was some fresh fruit and vegetables present and all the cupboards, fridges and freezers were well stocked with a choice of foodstuffs. One of the service users is being supported to follow a slimmers world diet plan as she is trying to lose weight. Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21 Service users can be confident that their emotional and health needs will be met. Existing arrangements to support service users with the aging process, illness and death need some further development. EVIDENCE: The manager showed the inspector some of the health assessment forms they are developing for service users; these are not fully completed yet. Service users are supported to have an annual health check once a year with their GP, the manager also supports all the service users to have access to a variety of health care professionals to ensure service users are supported with there needs, like GPs, community nurses, opticians, dentists, chiropodists, psychiatrists and psychologists. It is recommended that in line with the Governments national strategy in learning disabilities as outlined in the white paper ‘Valuing People’, service users are supported to have individual Health Action Plans. Service users are weighed monthly and this is recorded in their files. Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 Page 17 It was discussed with the manager that, whilst there were no concerns in the area of service users being supported with their health needs, they would benefit from having individual Health Action Plans. This would ensure all service users had their health needs assessed, and that plans of care and health goals could be developed from these assessments, these could then be reviewed regularly as apart of the service users six monthly reviews. This would support service users to have proactive plans of care in respect of their health and ensure signs and symptoms of changes in health could be quickly identified. Medication was not fully inspected on this occasion as this was fully inspected in November 2005 at the last inspection, however a inspection of medication administration records indicated that there had been no admissions recently, FP10’s were kept with the prescription chats, medication were clearly labelled and in date, the staff complete self audits daily and the manager completed her own audit several times a month. It is recommended that the manager put in place individual consent forms signed by service users, indicating their agreement to have staff support them with their medication needs, including administration, a copy of this should be kept on the service users file. Work has been undertaken with individual service users to consult with them and their families about their wishes in the event of their death. Work is in progress with one service users, supporting her and offering guidance in the changes she is experiencing because of her age, which is leading to health problems. This work needs to be further developed in the area of illness and the aging process for all service users and could be something that is incorporated into well woman and well man groups, supporting service users to recognise changes in their health and how to cope with these and would be an area that forms part of the Health Action Plan process. Plans in place, in respect of service users wishes in the event of their death, need further development and should include where possible all service users wishes for their own funeral arrangements. Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Service users can be confident that they are protected from abuse, neglect and self-harm. EVIDENCE: There have been no further Adult Protection issues since the last inspection, and the last issue was satisfactory and appropriately resolved. In discussion the manager demonstrated a sound knowledge base of the actions she would need to take in the event of an Adult Protection situation. Staff have received training in the protection of vulnerable adults, a new member of staff who has just started needs to attend this course. Staff need to be supported to attend Vulnerable Adult Protection training at least every two years and within six months of being appointed into post. The appointeeship for the service users is held in the company name of Lindale. The manager has now resolved the issue from the last inspection in respect of service users paying for all the other service users to attend each other’s birthday parties and has put a procedure in place for this, which she has discussed with all the service users. All the service users have signed up to the agreement she has put in place and a copy of this is held on individual service users files. Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 Page 19 The manger discusses with service users where they would like to go for their birthdays and this includes going out for a meal or a house party, she then finds out the cost per person and takes this back to the group. The policy states that if a service user chooses to celebrate their birthday by going out for a meal, each service user that goes will pay for their own meal. Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 25, 26, 27, 28 Service users bedrooms reflect their individuality and promote their independence, however this needs some further development. Toilets and bathrooms ensure service users are provided with a pleasant private area to carry out their personal care. Shared areas provide a positive space for service users to spend time, enjoy each other’s company, but also provide quiet areas for service users to pursue their own individual activities. EVIDENCE: Five of the service users showed the inspector around their bedrooms and they were clearly very proud of their own rooms and the furniture, furnishings and their own belongings. In discussion with the manager, it was clear that not all the furnishings like carpets and curtains in service users bedrooms had been chosen by the individual service users, it is required as part of the on-going maintenance schedule within the home, that when these rooms are next decorated individual service users are supported to chose there own carpets, curtains and bedding, as this is important in terms of reflecting a persons individuality. Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 Page 21 The manager said that whilst the owner and manager provider service users with basic furniture to have in their rooms, service users are free to buy other furniture they prefer to the furniture provided, this would then go with them, as it is their furniture should they move on from the home. It is recommenced that where this takes place with service users, service users records can demonstrate that there was a discussion about this and that this furniture belongs to that service users and that they can take it with them should they move out. Service users are offered large pleasant and private bathrooms areas to carry out their personal care and bathe in. It is recommended that service users are encouraged to keep all their toiletries in their own rooms rather than the bathroom, particularly their flannels, this will promote individuality and ensure there is no confusion between each others flannels, which would be a cross infection concern. During the inspection, the majority of the service users were at home, they clearly enjoyed spending time in the lounge together doing joint activities and talking, observations indicated they were a well-established group with positive relationships with each other, who really enjoyed spending time together. It was noted that service users who enjoyed spending time doing there own thing, like writing and or reading, were able to use other shared spaces in a quieter areas like the dinning room, and or the second lounge to carry out these activities. Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36 The staff team are well supervised and supported and benefit from clear roles and responsibilities. The staff team have competent and qualified to carry out their duties and support service users effectively. More training in specialist areas would be beneficial to service users and staff. The staff team remains small, which could pose problems for covering all shifts. It is important that a process for an adequate ‘hand over’ period is created between each shift. Service users are supported and protected by the policies and procedures in recruitment. EVIDENCE: The staff files sampled indicated staff have regular supervision and as part of this their roles and responsibilities within the home were explored and any problems were dealt with in supervision. There were no staff appraisals in place. Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 Page 23 Staff have completed regular training and have regular refreshers. The manager said that over 50 of the staff team have their NVQ awards and she has her RMA. Staff would benefit from training in specialist areas, like epilepsy, dementia, challenging behaviour, Makaton and Person Centred Planning to ensure that the staff team were competent and qualified to meet all the service users needs. Staff files that were examined were found to be in a good order and met with Schedule 2 of the regulations. On discussion with the manager it became apparent, that there is no time set aside between shifts, for staff to pass on information about outstanding issues from that shift and/or important information about the service users. It is recommended that the manger look into setting up a process with ‘hand –over’ sheets where information can be passed on from one shift to another. The manger said that although it was a small staff team they were able to cover shifts, through staff helping out and the occasional use of agency. However the manager said they have few problems as staff rarely go off sick at short notice, creating staffing issues. It was recommended that service users be supported by extra staff at key times, to facilitate service users having the opportunity to go out as individuals, currently 2 staff per shift would not support service users to develop their own individual activities, particularly if the needed support to do so. Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42, 43 The service users benefits from a generally very well run home, with a consistent management lead. The manager has an open, approachable and supportive style of management. Service users can be confident that their views underpin all self-monitoring, review and development in the home The health and safety of the service users is promoted and protected. EVIDENCE: The manager demonstrated her ability to manage the home well. During the inspection, she was organised and records were easily available, assessable and in good order. Discussions with the manager demonstrated her sound knowledge base in key areas of management of the home, service users needs, managing and supervising staff, POVA, health and safety and accurate record keeping. Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 Page 25 The manger could demonstrate she had undertaken, with the owner a quality assurance process last year, which was an extensive audit of the home and its functions and had produced a report from this process. It was recommended that this be further developed to include annual questionnaires to service users, staff, relatives and other involved professionals, seeking their views on the service and these be incorporated into the quality assurance process. Some records relating to health and safety were sampled during the inspection and these were found to be in a good order, they demonstrated the manager takes appropriate action to minimise the risk presented to service users, in food hygiene, fire, COSHH, Moving and Handling, water and Legionnaires disease. It was noted on the inspection, that one of the freezer daily temperatures checks was recorded a notably higher than the guidelines of minus 18°C 22°C, on inspection the freezer was noted to be in need of defrosting. It is required that the freezer be maintained at the required temperatures to promote the safe storage of food. All action from the last fire officer report had been undertaken and there were no fire doors wedged open during this inspection. The inspector advised the manger to undertake individual risk assessments for each service users on the plan for them in the event of a fire and the home should also look into developing its own emergency plan for arrangements in the event of flood and fire. Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 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 3 2 3 3 3 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 X 25 3 26 2 27 3 28 3 29 X 30 X STAFFING Standard No Score 31 3 32 2 33 2 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 3 LIFESTYLES Standard No Score 11 2 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 2 3 2 3 3 2 X X 2 3 Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 Page 27 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA5 Regulation 5(b)(c) Requirement The registered manager needs to ensure service users contracts are updated and include details of weekly costs and holiday arrangements. The registered manger needs to ensure that daily entries are made in service users individual care notes. The registered manager needs to ensure risk assessments are in a format that allows for reviews to be recorded, including any details of changes to be made. The registered manager needs to ensure that she and staff continue to promote service users individuality and encourage their personal development through actively encouraging service users to develop individual interests and providing opportunities for service users to pursue these. The registered manager should support service users’ health needs through the development of Health Action Plans. The registered manager should support service users with DS0000047064.V283129.R01.S.doc Timescale for action 23/06/06 2. YA6 15(2) 23/03/06 3. YA9 13(4)(b) 23/03/06 4. YA11 16(2)(m) 23/08/06 5. YA19 12 23/08/06 6. YA21 Sch3 (3)(g) 23/08/06 Lindale Residential Care Home Version 5.1 Page 28 7. YA26 16(2)(c) (d) 8. YA32 18(1)(a) 9. YA33 18(1)(a) 10 YA35 18(1)(c) 11. YA39 24(1)(a) (b)(2)(3) 12. YA42 12 understanding issues around illness and the aging process, this could be facilitated via Health Action Plans. The registered manager should ensure at the earliest opportunity that service users are supported to choose their own furnishings in their bedrooms, like carpets and curtains. The registered manager should look into supporting staff to undertake training in specialist areas like, dementia, challenging behaviour, epilepsy, Person Centred Planning and healthy eating. The registered manger should ensure there is an adequate opportunity for a hand over of information between staff shifts. The registered manager should support staff to undertake specialist training in areas that would further support them to meet all service users needs. The registered manager should ensure the quality assurance process is further expanded to include the views of service users, staff, relatives and other involved professionals. The registered manager should ensure freezer temperatures remain within the guidelines range and that where this is not the case corrective action is taken. 23/08/06 23/08/06 23/04/06 23/04/06 23/08/06 23/04/06 Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 Page 29 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 YA6 Good Practice Recommendations It is recommended that the registered manager continue with the plan in place to adopt a Person Centred Approach to the assessment of the service users needs and aspirations, fore all service users. It is recommended that the registered manger develop Health Action Plans for each service users to further develop the service users annual health care assessments checks. It is recommended that service users be supported to keep their own toiletries and accessories with them in their own rooms, and be supported to take these to the bathroom as and when needed. 2. YA19 3. YA27 Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 Page 30 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Lindale Residential Care Home DS0000047064.V283129.R01.S.doc Version 5.1 Page 31 - 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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