Inspection on 22/07/05 for Lingwell Approach

This inspection was carried out on 22nd July 2005.

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

The inspector 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lingwell Approach 06/07/07

Lingwell Approach 11/07/06

Lingwell Approach 09/02/06

Lingwell Approach 08/12/04

Lingwell Approach 18/06/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Lingwell Approach 14 Lingwell Approach Middleton Leeds LS10 4TJ Lead Inspector Stevie Allerton Unannounced 22nd July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lingwell Approach 20050722 Lingwell Approach IR Stage 4 J52 V225297 S1475.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Lingwell Approach Address 14 Lingwell Approach Middleton Leds LS10 4TJ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0113 277 8517 0113 277 8517 United Response Mrs Jackie Campell Care Home Only 4 Category(ies) of Physical Disability (4) Learning Disability (4) registration, with number of places Lingwell Approach 20050722 Lingwell Approach IR Stage 4 J52 V225297 S1475.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 8th December 2004 Brief Description of the Service: Lingwell Approach is a four bedroomed bungalow, purpose built to accommodate service users with multiple disabilities. It is situated in a fairly new development of mixed housing in the Middleton area on the southern outskirts of Leeds, with nothing to distinguish it from the other properties as a care home. The area is well served by local shopping centres, sports and leisure facilities, with good access via public transport from Leeds and Wakefield. The home accommodates up to four young women with learning disabilities and some physical disabilities, who may be wheelchair users. The property is managed by a housing association but the care service is provided by United Response, a national charity specialising in the field of learning disabilities. The Registered Manager is temporarily managing another home in York, so Susan Taylor is acting as manager at Lingwell Approach in her absence. Lingwell Approach 20050722 Lingwell Approach IR Stage 4 J52 V225297 S1475.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was the first of two inspection visits planned for this home during the year beginning 1st April 2005. The next inspection will be announced and is to take place in December. This visit lasted for two hours and was carried out by one inspector. The main purpose of this inspection was to see if improvements made at the last visit had continued. Time was also spent talking with staff and service users. What the service does well: What has improved since the last inspection? What they could do better: More could be made of the garden, a large grassed space to the rear of the bungalow, which is underused. Staff have a long history of frustrated attempts to get the landlord (a housing association) to effect repairs in the house, some of which have remained unresolved for years. Some intervention at senior organisational level should Lingwell Approach 20050722 Lingwell Approach IR Stage 4 J52 V225297 S1475.doc Version 1.30 Page 6 be seriously considered, as the comfort and well-being of service users is now being put at risk. The post of Manager needs to be resolved on a permanent basis, to allow continuity and future development to take place more readily. 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. Lingwell Approach 20050722 Lingwell Approach IR Stage 4 J52 V225297 S1475.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Lingwell Approach 20050722 Lingwell Approach IR Stage 4 J52 V225297 S1475.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards could be inspected, as the home has had no new admissions since it opened. However, following a recent death, a new referral has been made. The processes by which this new person is assessed and introduced into the home will be looked at on the next visit. EVIDENCE: Lingwell Approach 20050722 Lingwell Approach IR Stage 4 J52 V225297 S1475.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 & 8 Service users are supported to achieve their personal goals and to take an active part in all aspects of daily life. EVIDENCE: Each service user has detailed support plans, based on comprehensive assessment and knowledge of each individual. There is a structure to each daily activity. Staff work to detailed written guidelines that describe how each person prefers to be supported. Records are kept of the personal goals achieved during the day, whether that be opening and closing the bedroom curtains, carrying laundry to the washing machine, or making a “smoothie”. Also, where an activity is offered but not taken up, a record is kept. The inspector was able to observe staff interacting with service users, offering choices and giving time for preferences to be indicated, by whatever method of communication was appropriate for that individual. Service users are actively involved in everything going on in their home, not just observing from the periphery whilst staff carry out tasks. Lingwell Approach 20050722 Lingwell Approach IR Stage 4 J52 V225297 S1475.doc Version 1.30 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14 & 15 Service users are able to take part in a wide range of social and developmental opportunities, whether they be specially arranged for people with disabilities or personally fulfilling activities open to everyone in the community. Staff support service users to maintain whatever family contacts they have. EVIDENCE: Individual support plans show the range and extent of activities that service users take part in. At the staff handover between shifts mid-afternoon, the staff discussed what each person had taken part in that day and how they had reacted. For example, one woman had been horse-riding in the morning and had her lunch out, before taking part in shopping for the house. Staff were planning a barbeque for the following day for one of the service users, who was celebrating her birthday. Her family had been invited, along with some former staff members. Lingwell Approach 20050722 Lingwell Approach IR Stage 4 J52 V225297 S1475.doc Version 1.30 Page 11 Training records showed that staff have been on relevant courses to enable them to safely support service users in particular activities, for example, swimming therapy. Lingwell Approach 20050722 Lingwell Approach IR Stage 4 J52 V225297 S1475.doc Version 1.30 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 & 21 Service users receive a high degree of personal support, which ensures their physical and emotional health needs are met. The staff team have a good depth of knowledge about how each person communicates, which enables them to continuously respond to changes in well-being. Some excellent practice with regard to handling long-term illness and death had recently taken place, the team showing a capacity for giving a high level of support to the family as well as the service user concerned. EVIDENCE: Records show that personal support is tailored to each individual, with detailed support plans outlining how personal care interventions should be given. Information is passed on through the staff handovers at each change of shift, where changes in physical or emotional well-being are highlighted. Two of the service users continue to have individual support five days a week, to enable them to take part in their planned activities. The staff team recently had the experience of caring for a service user through a progressive illness until she died. Palliative care was able to be given to her at home, supported by District Nurses, who ensured that all of the correct Lingwell Approach 20050722 Lingwell Approach IR Stage 4 J52 V225297 S1475.doc Version 1.30 Page 13 medical equipment was provided to assist the staff. Extra staffing resources were also provided to ensure that someone was with her at all times. United Response were said to have been very supportive to the staff during this period, including opportunities for group counselling, which in turn helped them to support the service user’s family, who were able to be with her when she died. The remaining service users have since been supported to take flowers to their friend’s grave. Lingwell Approach 20050722 Lingwell Approach IR Stage 4 J52 V225297 S1475.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of this group of standards was looked at on this visit. EVIDENCE: Lingwell Approach 20050722 Lingwell Approach IR Stage 4 J52 V225297 S1475.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 27, 28, 29 & 30 The house is clean and decorated and furnished to a good standard, providing a homely and comfortable environment for the service users. More attention to developing the garden would improve the existing facilities. The failure of the Housing Association to effect repairs and renewals quickly enough creates a lack of choice and, in some cases, causes discomfort for service users. EVIDENCE: The lounge had new furniture and a carpet and had been redecorated since the last inspection. The kitchen had also been completely refurbished. This has been done to a very good standard, with an adjustable height sink and low level worktop included, so that service users can more easily take part in kitchen tasks. There is currently an empty bedroom, which will be decorated and furnished to the taste of the new occupant once they are ready to move in. Lingwell Approach 20050722 Lingwell Approach IR Stage 4 J52 V225297 S1475.doc Version 1.30 Page 16 Bathroom facilities remain unsatisfactory. A new bath was installed, but water collects behind it; the shower still has no tiles on the lower half whilst the damp problem awaits resolution; a bath hoist is out of action and needs renewing. The staff advised that they had already obtained two quotes for completely re-fitting the bathroom and were awaiting an Occupational Therapist to visit with another bathroom provider to give an additional quote. The staff also advised that there were still problems with the hot water system in the house. Repeated call-outs to the engineers have taken place and the problem has still not been resolved. Damage to the internal wall plaster in one of the service users’ bedrooms and the hallway, caused by the damp from the shower, has also not been made good, just painted over. The bungalow has a large rear garden, fenced and grassed over. This provides a good additional space for service users, but is under-used at present. There is scope for the development of a much more interesting and stimulating outdoor space, which the staff felt would benefit service users. Lingwell Approach 20050722 Lingwell Approach IR Stage 4 J52 V225297 S1475.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 & 36 The staff team are supported by good training opportunities and structured supervision arrangements, which ensures they maintain good care practice. EVIDENCE: The staff rota shows that there are always two or three support workers on each shift. There are regular relief staff that cover shortages on the rota. One was on duty at the start of this visit; she had previously worked at the home on a full time basis, so the service users were familiar to her. A recent recruitment drive has resulted in some appointments being offered, for general and individual support worker posts. Supervision was discussed with the two seniors on duty. Individual staff are supervised by named seniors and the sessions planned ahead on the rotas. The format covers key worker issues; training needs, including National Vocational Qualification (NVQ)/Learning Disability Award Framework (LDAF) support; delegated responsibilities; personal well-being; team issues, etc. One of the seniors had recently attended a training day on Empathic Handling, aimed at support staff experiencing what a service user experiences. At the next Team Day, she was planning to cascade the training to the rest of the staff team. Lingwell Approach 20050722 Lingwell Approach IR Stage 4 J52 V225297 S1475.doc Version 1.30 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 40, 41 & 43 The home uses a range of written policies and detailed procedures, in order to ensure that service users’ best interests are protected. Records seen during the day were well organised and reflected the practice that was observed. Management arrangements at the home are once again in a state of change, with the potential for lack of continuity for service users and support staff. EVIDENCE: The Registered Manager is still seconded to a post in York and will now be staying there. The Acting Manager was working her notice at the time of this visit. The new Service Manager, who covers both of the homes in Leeds, said she will be providing managerial support to Lingwell Approach until a Registered Manager can be appointed. Lingwell Approach 20050722 Lingwell Approach IR Stage 4 J52 V225297 S1475.doc Version 1.30 Page 19 Records seen during this inspection included: accident records; staff rotas; staff training records; service users’ care records; medication records and handover information sheets. Organisational policies were readily available for staff to refer to. Lingwell Approach 20050722 Lingwell Approach IR Stage 4 J52 V225297 S1475.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x 1 2 2 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 x x Standard No 31 32 33 34 35 36 Score x x 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Lingwell Approach Score 3 3 x 3 Standard No 37 38 39 40 41 42 43 Score x x x 3 3 x 2 20050722 Lingwell Approach IR Stage 4 J52 V225297 S1475.doc Version 1.30 Page 21 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 YA24 Regulation 12(1) Requirement The registered person must ensure the proper provision of hot water to meet the health and welfare needs of service users. (Carried over from previous reports, timescale not met.) Attention is still required to the damp problem on the internal walls. (Carried over from previous reports, timescale not met.) Service users must be provided with suitable bathing and showering facilities to meet their specialist needs. Suitable management arrangements must be agreed with the CSCI, in the absence of a Registered Manager. Timescale for action By 30.9.05 2. YA24 23(2) By 30.9.05 3. YA29 23(2) By 30.9.05 4. YA37 8 By 30.9.05 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 YA28 Good Practice Recommendations The development of the garden would provide additional recreational facilities for service users. 20050722 Lingwell Approach IR Stage 4 J52 V225297 S1475.doc Version 1.30 Page 22 Lingwell Approach Lingwell Approach 20050722 Lingwell Approach IR Stage 4 J52 V225297 S1475.doc Version 1.30 Page 23 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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