Inspection on 06/02/06 for Lingdale Road (7)

This inspection was carried out on 6th 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lingdale Road (7) 11/02/09

Lingdale Road (7) 18/10/06

Lingdale Road (7) 22/09/05

Lingdale Road (7) 06/10/04

Lingdale Road (7) 21/04/04

Lingdale Road (7) 23/05/03

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Lingdale Road (7) 7 Lingdale Road West Kirby Wirral CH48 5DG Lead Inspector Beate Roth Unannounced Inspection 6th February 2006 11.50 Lingdale Road (7) DS0000018908.V282307.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 Lingdale Road (7) DS0000018908.V282307.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. Lingdale Road (7) DS0000018908.V282307.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lingdale Road (7) Address 7 Lingdale Road West Kirby Wirral CH48 5DG 0151 632 4845 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) www.mencap.org.uk Royal Mencap Society Pamela Crebbin Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Lingdale Road (7) DS0000018908.V282307.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Only 5 adults with a learning disability (aged 18-64 years) Two named adults aged over 65 with a learning disability (not falling into any other category) may be accommodated Date of last inspection 22nd September 2005 Brief Description of the Service: Lingdale Road is registered to provide personal care for 7 adults with a learning disability. The home is a three storey, detached property located in a residential area of West Kirby. Lingdale Road is close to local shops and to public transport services. All bedrooms are single. There is a shower room on the ground floor and a bathroom on the first floor. On the ground floor there is a kitchen, two lounges and a separate dining room. There is a large garden to the rear of the home. There is a preparation for independent living flat situated on the third floor for two service users, which has cooking facilities and a shared bathroom. Parking is available at the front of the home and on the road outside. Lingdale Road (7) DS0000018908.V282307.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over an afternoon. During the inspection time was spent in the office examining records and policies and procedures and talking to the acting manager. Service users were spoken with. A member of staff was spoken with. A tour of the home was undertaken. Staff were observed delivering care to service users. What the service does well: What has improved since the last inspection? What they could do better: Prospective service users and their representatives would benefit from having an up to date service users guide and statement of purpose. The contracts/statement of terms and conditions could better support the interests of service users. Care plans, including risk assessments need to be reviewed in order to ensure that accurate information is provided to staff around the support that service users require. Service users could be better supported by the home’s practices for managing medication. Improvements need to be made to the fire safety systems at the home. Service users would benefit from staff completing a National Vocational Qualification in caring for adults with a learning disability. A copy of the monthly responsible individual’s representative reports on visits to the home is to be sent to CSCI. Lingdale Road (7) DS0000018908.V282307.R01.S.doc Version 5.1 Page 6 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. Lingdale Road (7) DS0000018908.V282307.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lingdale Road (7) DS0000018908.V282307.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 5 An appropriate assessment would take place to ensure that a service user’s needs could be met. Prospective service users and their representatives would benefit from having an up to date service users guide and statement of purpose. The contracts/terms and conditions could better support the interests of service users. EVIDENCE: A statement of purpose and a service user guide are available. These documents cover the required information. As there has been a change to the manager and staff, both documents will need to be amended. The acting manager is advised to review the inclusion of the names of the current service users in the statement of purpose and the service user guide as these documents are available to prospective service users and their representatives. Service users have access to inspection reports. All current service users have been given a copy of the service user guide. No new service users have come to live at the home since the last inspection. New service users are assessed by the manager and by the Mencap schemes manager. The manager and schemes manager visit prospective service users where they are living. Information is gathered from the service user, the service users’ carers, social worker and any other relevant agencies. The information gathered during the assessment is recorded. Lingdale Road (7) DS0000018908.V282307.R01.S.doc Version 5.1 Page 9 The service users, staff and records indicated that service users’ assessed needs are met by close liaison with appropriate health and social care agencies. Induction and foundation training are provided to all new staff around the operation of the home and meeting the needs of the service users. In addition, Mencap offers a variety of further training opportunities for staff. The support of advocacy services is elicited where appropriate. The home is leased from New Era Housing. Service users pay rent direct to New Era Housing. A licence agreement is available for service users. The contracts/statement of terms and conditions between Mencap and service users provides information on the service to be provided. The period of notice and the costs payable by service users is not included. This information was available in other records seen, but as previously recommended, should be included in the contract/statement of terms and conditions. Lingdale Road (7) DS0000018908.V282307.R01.S.doc Version 5.1 Page 10 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 and 9 Care plans and risk assessments do not provide up to date guidance to staff around the needs of the service users. Service users are consulted with and they participate as far as possible, in life at the home. Lingdale Road (7) DS0000018908.V282307.R01.S.doc Version 5.1 Page 11 EVIDENCE: A sample of service user plans were examined. The service user plans are in need of a review. The plans seen did not accurately reflect the current needs of the service users. The acting manager reported that all the service users care plans are due to be reviewed. There is evidence of service users being involved in the development of service user plans. A record of the wellbeing of service users and the progress of the care plan is made daily. It was discussed with the acting manager that the support provided to a service user to ensure that they are aware of appropriate boundaries with people when outside of the home, be documented. Discussion with the staff and the service users and an examination of service user plans indicate that service user’s rights to live as independently as possible, in accordance with their abilities, is promoted by the home. Risk assessments are available which indicate why a service user’s rights need to be limited in order to safeguard their wellbeing. Some risk assessments have been identified by the acting manager as needing to be updated as these are no longer accurate or as there has been a change in circumstances. All aspects of the service users care plans, including risk assessments, must be regularly reviewed in order to ensure that these are up to date and staff, have the information needed to support service users. The records and a discussion with staff indicated that service users are assisted to make decisions about their lives in accordance with their abilities. Records of service users likes and dislikes and preferences around daily living, such as what time they like to get up and the activities they enjoy helps to ensure service users choices are respected. Where appropriate service users are provided with communication aids to assist their decision-making and to enable them to communicate their needs and feelings to staff. Service users are encouraged to contribute towards the running of the household in accordance with their abilities. Residents’ meetings are held. Service users’ views are also obtained through their individual key workers. Some of the home’s policies and procedures have been made available in formats that are more readily understandable for some service users. Further policies and procedures could be made available in formats that are accessible to service users. Lingdale Road (7) DS0000018908.V282307.R01.S.doc Version 5.1 Page 12 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 and 15 Service users are provided with opportunities for personal development and appropriate activities that ensure they are part of the local community. The arrangements for promoting relationships with family and friends, support service users. EVIDENCE: Records show that there are a range of opportunities for service users to maintain and develop social, emotional, communication and independent living skills. An activities programme sheet is held on service users files and provides an indicator as to a service user’s participation in activities. Therapeutic services are provided, by making a referral to an appropriate organisation. Service users are provided with work experience and attend college courses in accordance with their abilities. Records and a discussion with staff and service users indicated that there are opportunities for service users to become involved in the local community in accordance with their wishes. Lingdale Road (7) DS0000018908.V282307.R01.S.doc Version 5.1 Page 13 Staff and records indicated that family links and friendships are promoted. The arrangements for contact with family are written into the service users’ care plans. Service users have the opportunity to meet people and make friends with people who do not have their disability, through attendance at social clubs and through community activities. Lingdale Road (7) DS0000018908.V282307.R01.S.doc Version 5.1 Page 14 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 and 20 The health needs of service users are well met. Service users could be better supported by the home’s practices for managing medication. EVIDENCE: Records and a discussion with service users indicated that service users have access to medical/health care professionals as needed. Service users are supported to attend health care appointments. Staff are provided with training in order to support service users in meeting their medical needs when this is required. Lingdale Road (7) DS0000018908.V282307.R01.S.doc Version 5.1 Page 15 A medication procedure is available. Medication is stored in a lockable cabinet secured to the wall. A fridge with a lock has been made available for medications requiring refrigeration. No service user self – administers their own medication. A risk assessment would be carried out before this, were to occur. No homely remedies are in use at the home. The acting manager reported that MENCAP has a policy and procedure regarding the use of such medications. All staff are provided with training around the administering of medication as part of their induction. It is planned that all staff will attend a further training course in the handling and administration of medication, this year. A sample of medication administration record sheets and corresponding medication were inspected. These were in general accurately maintained. There were two tablets more of one medication, than records indicated should have been available. The acting manager was advised to address this issue. The records of medication must clearly indicate the whereabouts of all medications. Lingdale Road (7) DS0000018908.V282307.R01.S.doc Version 5.1 Page 16 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): 22 Staff training and policies and procedures are in place to ensure that service users views and those of their family/advocates are heard and appropriate action taken. EVIDENCE: Staff reported that they elicit the views of service users in accordance with their abilities. Information is available to enable a complaint to be made by a service user or on their behalf, by an advocate. The complaint procedure includes the timescales for dealing with each stage of a complaint. The procedure is available in different formats to reflect the abilities of service users. A record is kept of any complaints made. A discussion with the acting manager indicated that a complaint made since the last inspection was investigated by the schemes manager. The record of this investigation was at the Mencap regional office and not available at this inspection. No complaints have been made to CSCI since the last inspection. A service user who spoke to the inspector said that if they wanted to complain or comment about any aspect of the care they receive at the home they would know who to approach. Staff were aware of how to respond to a complaint. Lingdale Road (7) DS0000018908.V282307.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26 and 30 The home is clean and generally well presented, providing a comfortable and pleasant environment for service users. Improvements need to be made to the fire safety systems at the home. EVIDENCE: The home is in general well decorated and provides a comfortable, homely environment for the service users. Although adequate, the dining room carpet and the decoration in the hall and stairways continues to show some signs of wear and tear. The decoration in the ground and first floor bathrooms is also looking worn. It is recommended that this be addressed. A sample of the service users bedrooms were seen. These are well decorated and personalised in accordance with the service users’ tastes. The service users interviewed at a previous inspection confirmed that they are consulted regarding the decoration of their bedrooms and the communal areas. This is also indicated in the records of residents meetings. A tour of the home showed that the home was clean. It is clear the staff are working hard to ensure good standards of cleanliness are maintained. There are procedures for staff to refer to about hygiene and infection control. Lingdale Road (7) DS0000018908.V282307.R01.S.doc Version 5.1 Page 18 A sample of safety certificates and records of safety checks indicated that these are in general, occurring at the recommended frequencies. The records of fire alarm tests are not occurring weekly on a consistent basis. The records of up to date fire alarm and emergency lighting maintenance tests were not available. Water is temperature controlled. All radiators are guarded. Lingdale Road (7) DS0000018908.V282307.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35 There are sufficient numbers of staff to meet the needs of service users. Service users are supported by the training staff have received, however, service users would benefit further, if 50 of staff had completed formal training. The recruitment records demonstrate that service users are protected by the homes recruitment practices. EVIDENCE: Induction and foundation training are provided to all new staff around the operation of the home and meeting the needs of the service users. In addition, Mencap offers a variety of further training opportunities for staff. None of the care staff have completed an NVQ. As indicated in previous inspections, service users would benefit from staff undertaking this training. The staffing rota and discussions with the acting manager and staff indicated that there are enough staff available to meet the needs of the service users. Staff are deployed in accordance with their skills and abilities. Bank staff and the current staff team cover any staffing shortfalls. The same bank staff are employed in order to ensure consistency for service users. Lingdale Road (7) DS0000018908.V282307.R01.S.doc Version 5.1 Page 20 At the last inspection, there was insufficient information in the recruitment records for a new member of staff. This has been addressed. No new staff have been employed since the last inspection. Lingdale Road (7) DS0000018908.V282307.R01.S.doc Version 5.1 Page 21 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 and 39 The quality assurance systems in general promote the wellbeing of service users. EVIDENCE: An application to CSCI to register the acting manager has been made. A discussion with the acting manager indicated that she has previous managerial experience in a care setting. The acting manager does not hold an NVQ 4 qualification (or equivalent) in care or management. At the time of the inspection the acting manager was making attempts to enrol on these courses. It continues to be recommended that the acting manager undertake training around providing supervision to staff. Lingdale Road (7) DS0000018908.V282307.R01.S.doc Version 5.1 Page 22 There are a number of quality assurance systems in place. The views of service users are obtained through in – house meetings and individually through key workers. The views of staff and relatives are obtained. Service users were informed about this inspection and were encouraged to meet with the inspector. The schemes manager visits the home monthly and carries out an audit of service users’ health and welfare, accidents, risk assessments both personal and environmental, and staffing levels. However copies of the audit report are not sent to the CSCI office as per regulations. A copy was available at the home for inspection. Lingdale Road (7) DS0000018908.V282307.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 3 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 X ENVIRONMENT Standard No Score 24 2 25 X 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 2 X 2 X 2 X X X X Lingdale Road (7) DS0000018908.V282307.R01.S.doc Version 5.1 Page 24 Yes 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 YA1 Regulation 6 Requirement The registered person must review the service user guide and the statement of purpose to ensure both documents are up to date. The registered person must ensure that there is evidence that all aspects of the service user plans, including risk assessments, are being kept under regular review (previous timescale of 22/09/05 not met). The registered person must document all the support that is to be provided to a service user in order to safeguard their wellbeing and the wellbeing of others. The registered person must ensure that the records of medication clearly indicate the whereabouts of all medications. The registered person must ensure that the fire alarms are tested on a weekly basis. The registered person must ensure that evidence is available that fire alarm and emergency lighting maintenance tests have been undertaken. DS0000018908.V282307.R01.S.doc Timescale for action 06/05/06 2. YA6YA9 15 06/02/06 3. YA6 15 06/02/06 4. YA20 13 06/02/06 5. 6. YA24 YA24 23 23 06/02/06 06/02/06 Lingdale Road (7) Version 5.1 Page 25 7. YA39 26 The registered person must ensure that a copy of the monthly responsible individual’s representative reports on visits to the home is sent to CSCI. 06/02/06 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. 2. 3. Refer to Standard YA1 YA5 YA8 Good Practice Recommendations The registered person is advised to review the inclusion of the names of the current service users in the statement of purpose and the service user guide. The service users contact/terms and conditions with the home are to provide clear information about notice periods and about charges to service users. It is recommended that where possible, further policies and procedures be made available in formats that are more suitable for the people for whom the home is intended. The dining room carpet should be replaced and the decoration in the hall and stairways and in the ground and first floor bathrooms should receive attention. A minimum of 50 of staff are to have an NVQ level 2 by 2005. It is recommended that the acting manager undertake training around providing supervision to staff. The registered manager is to hold an NVQ Level IV in both care and management by 2005. 4. 5. 6. 7. YA24 YA32 YA37 YA37 Lingdale Road (7) DS0000018908.V282307.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Lingdale Road (7) DS0000018908.V282307.R01.S.doc Version 5.1 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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