Inspection on 15/02/06 for Lingfield House

This inspection was carried out on 15th 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lingfield House 15/08/06

Lingfield House 06/09/05

Lingfield House 25/01/05

Lingfield House 28/09/04

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Southfields

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

CARE HOME ADULTS 18-65 Lingfield House Lowdells Lane East Grinstead West Sussex RH19 2EA Lead Inspector Ms J Hartley Unannounced Inspection 15th February 2006 11:30 Lingfield House DS0000014610.V275342.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 Lingfield House DS0000014610.V275342.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. Lingfield House DS0000014610.V275342.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lingfield House Address Lowdells Lane East Grinstead West Sussex RH19 2EA 01342 301782 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) Alliance Home Care (Learning Disabilities) Limited Mr William James Marlow Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Lingfield House DS0000014610.V275342.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th September 2005 Brief Description of the Service: Lingfield House is registered to provide personal care for up to six service users who have a learning disability (LD) and are aged between eighteen and sixtyfive years. Lingfield House is a detached two-storey care home situated within walking distance of East Grinstead, West Sussex. There is a well-maintained garden available to service users. Allied Home Care Limited owns the service. Mr Aslam Dahya is the responsible individual on behalf of the company. Mr William Marlow is the registered manager responsible for the day-to-day running of the home. Lingfield House DS0000014610.V275342.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out over a period of five hours. The inspector examined information held on the service file since the last inspection in September 2005, and read the previous two inspection reports, the Service User Guide and the Statement of Purpose During the inspection the inspector spoke to all the service users, and informally to members of staff on duty. The inspector undertook a tour of the premises and looked at three care plans and three staff files. Various record books, policies and procedures were also examined. This report should be read in conjunction with the report of the unannounced inspection held on 6th September 2005. All the key standards, which should be inspected in a twelve-month period, are covered in these two reports. What the service does well: What has improved since the last inspection? What they could do better: During the inspection a fire door was seen wedged open. This practice is unsafe and needs to be addressed. Steps need to be taken to ensure that fifty per cent of care staff in the home achieve an NVQ Level Two in care. It would be good practice to record the dates of actions taken in dealing with complaints. Lingfield House DS0000014610.V275342.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. Lingfield House DS0000014610.V275342.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 Lingfield House DS0000014610.V275342.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): 2 Prospective service users have their needs assessed prior to admission. EVIDENCE: There have been no new service users admitted since the last inspection. Service user files examined showed evidence that current service users had their needs assessed prior to admission. All service users have been referred from the local authority, no one is self-funding. All service users have an individual plan of care that has been developed from a needs assessment. Any restrictions on choice or freedom are clearly documented with the reasons for the restrictions recorded. Lingfield House DS0000014610.V275342.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Service users assessed and changing needs are reflected in their individual care plans. Service users are encouraged to make decisions about their lives with assistance if they require it. Service users are also able to take risks as part of their lifestyle. Reviews and risk assessments are now clearly recorded. EVIDENCE: Each service user has an individual care plan in place that reflects their needs. The care plans at Lingfield House are good at focusing on positive behaviour and what the resident is able to do. Care plans clearly identify what assistance is needed with which tasks and what service users are able to do themselves. Individual procedures for dealing with aggressive behaviours or self-harm are clearly recorded. Reviews of care plans are now clearly recorded. It was clear from the records and what service users said that they are encouraged to make choices about their lives. For example, what food they eat, what clothes they wear, where they go on holiday, how their rooms are decorated etc. Lingfield House DS0000014610.V275342.R01.S.doc Version 5.1 Page 10 Service users are supported in taking risks in their lives. One resident goes carriage driving, and appropriate risk assessments have been made regarding this. Some staff have received Makaton training to assist them in communicating with one of the service users. Staff were witnessed communicating and interacting positively with service users throughout the inspection. Due to the level of difficulties experienced by residents, none of them are able to look after their money completely. Service users are assisted and encouraged by staff to count out their money and pay for things themselves in shops. The home has recently experienced a problem when it was discovered that an amount of money belonging to service users had gone missing from the safe. The manager made an appropriate referral to Adult Protection regarding this incident. An internal investigation has also taken place. Certain policies and procedures have been implemented following this, and the inspector is satisfied that the home has done all it can to avoid this happening again and to protect service users. The company reinstated the missing amount of money to the affected service users. Lingfield House DS0000014610.V275342.R01.S.doc Version 5.1 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 the following standard(s): 15, 16, 17 The home provides a very good level of support in enabling service users to maintain contacts with family and friends. Service users have responsibilities within the home, that they are supported in undertaking. The menu at Lingfield is wholesome and nutritious. Service users say that they enjoy the food provided. Standards Twelve and Thirteen were inspected during the last inspection and were found to have been met. EVIDENCE: It was clear from records and talking with service users that they are well supported by the home in maintaining links with friends and family. One service user told the inspector that he visits his friend regularly and that his friend is also welcomed into the home. Lingfield House DS0000014610.V275342.R01.S.doc Version 5.1 Page 12 The home holds parties to celebrate birthdays. Friends and family are invited to join in with these celebrations. Independence is promoted through supporting residents in daily living tasks. For example, setting the table, tidying bedrooms and loading the washing machine. The inspector witnessed staff encouraging and supporting service users with some of these tasks. All bedroom doors have locks but only one service user chooses to have a key to his room. Residents have unrestricted access to the house and grounds, apart from the cellar due to health and safety risks. The home is no-smoking throughout. The inspector witnessed lunch being prepared and eaten. There was a choice of sandwiches on offer with salad. The mealtime was a relaxed and happy occasion with staff and residents sitting down together chatting and enjoying their meal. The evening meal menu was seen and contained a wholesome variety of food with plenty of fresh vegetables. Residents help plan and prepare some meals. They also go food shopping with staff. Food for the evening meal is bought every day so that it is fresh. There is a list of individual residents likes and dislikes on the kitchen wall. The weight of service users is monitored regularly. For those that have eating or weight problems, weight and nutrition are monitored more frequently. Lingfield House DS0000014610.V275342.R01.S.doc Version 5.1 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 the following standard(s): 18, 20 Personal support is provided in a sensitive and flexible way. The home has robust policies and procedures regarding medication. Due to the level of need of service users, no one is able to self-medicate. Standard Nineteen was inspected at the last inspection and was found to have been met. EVIDENCE: Service users are given guidance and support by staff for person hygiene. The level of support required by each service user is clearly recorded in individual care plans. Service users said that they choose what they want to wear each day. They said that they have a choice about bed times and what time they get up. One resident had lunch prepared for her later in the day as she had been out at lunchtime. Additional support is provided by community health services, for example dentists, opticians and GP’s. One resident has speech therapy. All health needs are clearly recorded in care plans. All service users have designated keyworkers and co-keyworkers. Lingfield House DS0000014610.V275342.R01.S.doc Version 5.1 Page 14 Policies and procedures regarding medication were examined and were found to be robust. The recording of the administration of medication was seen to be accurate. A photograph of each resident is kept with their individual medication sheets to minimise the risk of medication being administered to the wrong person. There is also an explanation of each medication that includes possible side effects. Staff receive training in the administration of medication before they are allowed to administer. The records of medication taken showed no apparent overuse of PRN medication. Lingfield House DS0000014610.V275342.R01.S.doc Version 5.1 Page 15 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, 23 The home has a clear complaints procedure that is also available in picture format. It is recommended that the dates that action has been taken in addressing complaints be recorded in the complaints book. Service users are protected from abuse by the homes’ policies, procedures, training and recruitment process. EVIDENCE: It was noted that the home has a clear complaints procedure in place. This is available for service users in picture format. The complaints book was inspected; one complaint had been recorded since the last inspection. The complaint had been successfully resolved. The recording of the complaint did not include the dates of when action was taken. It is recommended that this is included in the complaints record in future. Service users said that the staff and manager listen to what they have to say, and feel that they are taken seriously. The home’s policies and procedures regarding recruitment, service users’ money, adult abuse and whistle blowing were seen to be thorough. Staff training records and certificates seen on the day of the inspection showed that staff have received training in Adult Protection. There is a copy of the West Sussex Multi Agency Policy and Procedure for the protection of vulnerable adults available to staff. The acting manager recently made an appropriate referral to Adult Protection. See section entitled Individual Needs and Choices. Lingfield House DS0000014610.V275342.R01.S.doc Version 5.1 Page 16 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, 28 Lingfield House has a homely environment that is comfortable and safe for service users to live in. The practice of wedging a fire door open is unsafe and needs to be addressed. Communal areas are well maintained. Standard Thirty was inspected at the last inspection and was found to have been met. EVIDENCE: Lingfield House is suitable for its stated purpose. It is a detached house in a residential road, close to local amenities. It is set in it’s own grounds, which are well maintained and have pleasant seating areas. The inside of the home is well decorated. Furniture and fixtures are domestic in character and are of good quality. All the radiators and pipe work are covered, and water temperatures are regulated. Windows have restrictors fitted to them. The home is bright and cheery with adequate lighting. A fire door to a service user’s bedroom was seen to be wedged open, which is a safety hazard. A fire service assessment should be made regarding the safety of this practice or the door should be fitted with an automatic door closure. Lingfield House DS0000014610.V275342.R01.S.doc Version 5.1 Page 17 Communal areas are welcoming and comfortable. The kitchen and laundry facilities are domestic in scale and clean. No offensive odours were present in the home. The house and gardens are no-smoking areas. None of the residents smoke. Lingfield House DS0000014610.V275342.R01.S.doc Version 5.1 Page 18 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, 34 The staff at Lingfield House are competent in their work and support service users well. The home has not met the target of having fifty percent of care staff qualified to NVQ Level Two. The home’s recruitment policies and practices are robust and protect service users. Standard Thirty-Five was inspected during the last inspection and was found to have been met. EVIDENCE: Staff were seen communication and interacting well with service users. Staff receive training in areas that are specific to the needs of the current residents, including, learning Disabilities, Autism, Makaton and Challenging Behaviour. Staff training records and qualifications seen indicate that the staff team are competent and qualified to support the residents. The home has not yet achieved the requirement that fifty per cent of care staff have an NVQ Level Two. Lingfield House DS0000014610.V275342.R01.S.doc Version 5.1 Page 19 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 The registered manager post at Lingfield House is vacant. There is an acting manager in post who will apply to be registered. Standards Thirty-Nine and Forty-Two were inspected at the last inspection and were found to have been met. EVIDENCE: The post for registered manager at Lingfield House is currently vacant. There is an acting manager in post who will be applying for registration in the near future. Lingfield House DS0000014610.V275342.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 3 29 X 30 X STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 3 X 2 X X X X X X Lingfield House DS0000014610.V275342.R01.S.doc Version 5.1 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 YA24 Regulation 13 (4) (a) Requirement Fire doors should not be wedged open. The door should be fitted with an automatic closure, and/or a safety assessment should be sought from the Fire Service. Fifty per cent of care staff (including agency staff) in the home achieve a care NVQ (by 2005). Timescale for action 15/04/06 2. YA32 19 (5) (b) 15/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA22 Good Practice Recommendations It is recommended that a record be kept of the dates that actions are taken regarding dealing with complaints. Lingfield House DS0000014610.V275342.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Lingfield House DS0000014610.V275342.R01.S.doc Version 5.1 Page 23 - 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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