Inspection on 06/07/07 for Lingwell Approach

This inspection was carried out on 6th July 2007.

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

Lingwell Approach 11/07/06

Lingwell Approach 09/02/06

Lingwell Approach 22/07/05

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 West Yorkshire LS10 4TJ Lead Inspector Carol Haj-Najafi Key Unannounced Inspection 6th July 2007 09:45 Lingwell Approach DS0000001475.V339788.R01.S.doc Version 5.2 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 Lingwell Approach DS0000001475.V339788.R01.S.doc Version 5.2 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. Lingwell Approach DS0000001475.V339788.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lingwell Approach Address 14 Lingwell Approach Middleton Leeds West Yorkshire LS10 4TJ 0113 277 8517 0113 2778517 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.unitedresponse.org.uk United Response vacant post Care Home 4 Category(ies) of Learning disability (4), Physical disability (4) registration, with number of places Lingwell Approach DS0000001475.V339788.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Lingwell Approach is a four bedroom bungalow, purpose built to accommodate people with multiple disabilities. It is situated in a 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 physical disabilities. The property is managed by a housing association; the care service is provided by United Response. The standard fee charged by the home is £1293.94 per week. This information was provided on 6 July 2007, during the inspection. Lingwell Approach DS0000001475.V339788.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In April 2006 the Commission for Social Care Inspection (CSCI) made some changes to the way in which care services are inspected. Care services are now judged against outcome groups. The inspection report is divided into separate sections for each outcome group for example Choice of Home. An overall judgement is made for each outcome group based on the findings of the inspection. The judgements reflect how well the service delivers outcomes to the people using the service. The judgements categories are “excellent”, “good”, “adequate” and “poor”. The judgements are recorded within the main body of this report. More detailed information about these changes is available on our website – www.csci.org.uk. The last key inspection was carried out in July 2006. An annual quality assurance assessment (AQAA) was sent to the home on the 15 May 2007 for them to complete. A reminder letter was sent on the 12 June because it had not been received. At the time of the inspection it had still not been received. Information from the AQAA would have formed part of the inspection process. At the inspection, the manager said they would return the AQAA the following week, although it was too late to include any of the information in this report. At the inspection, surveys were given to the manager, who agreed to send them out to relatives and other professionals. It was agreed with the manager that the people who live at the home would not be able to complete surveys. At the time of writing the report no surveys had been returned. One inspector carried out a site visit which started at 9.45am and finished at 3.30pm. Feedback was given to the manager at the end of the visit. During the visit the inspector looked around the home, spoke to staff and the manager. People who live at the home have complex needs and communication is very limited. Only one person who lives at the home was there during the inspection; interaction between staff and the person who lives at the home was observed. Care plans, risk assessments, healthcare records and staff training records were looked at. What the service does well: Care records explained what people like and dislike, potential risks and how their needs should be met. Each file had good information about health and personal care. Daily records confirmed that care plans were being followed and people had engaged in activities that were recommended in their plans of care. Interaction between the person who was at home for the day and staff was observed. Staff were seen to offer choices and give the person time and encouragement to respond. Lingwell Approach DS0000001475.V339788.R01.S.doc Version 5.2 Page 6 People have an active lifestyle, regular family contact and involvement in daily living tasks. Recreational activities include meals out, swimming, dance class, shopping trips and different activities in the home. Staff had good knowledge about the people living at the home. They were able to talk about their past, their likes and dislikes, their family and their current needs. One person had been supported to visit the community where they had grown up. The home was very pleasant, clean and tidy. Bedrooms were very personal and careful consideration has been given to the décor to ensure it reflects the preferences of the people who live there. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Lingwell Approach DS0000001475.V339788.R01.S.doc Version 5.2 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 Lingwell Approach DS0000001475.V339788.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Previous inspections and procedures indicate that a thorough admission process is carried out to make sure the home can meet the needs of people who move into the service. EVIDENCE: The same people have lived at the home for ten years so there was very little recent evidence for many aspects of this outcome group. The admission process was looked at during previous inspections and the relevant National Minimum Standards were met. Lingwell Approach DS0000001475.V339788.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Everyone works hard to make sure people who use the service receive person centred care and are supported to achieve their personal goals, which help maintain and develop skills. EVIDENCE: Two people’s care records were looked at. There were several different documents that provided information about care needs. Records explained what people like and dislike, potential risks and how their needs should be met. For example one plan stated ‘I like to pause and have a rest’. Another plan stated ‘please direct my spoon towards my mouth by hand over hand’ and another one stated ‘I like to give my money at the cash till’. Lingwell Approach DS0000001475.V339788.R01.S.doc Version 5.2 Page 10 Daily records confirmed that care plans were being followed and people had engaged in activities that were recommended in their plans of care. Staff provided very specific details about the people who live at the home and how they looked after them. These were consistent with what had been recorded in care plans and assessments. Each person has an annual review meeting that looks at what they have done during the previous year and what they would like to do. Action plans had been written and agreed by people who had attended the review, which generally included the person who lives at the home, their family, staff from the home and other professionals. Staff and the manager talked about the action plans and were familiar with each person’s individual goals, and they gave examples of how they had supported people to achieve them. One review identified the person should engage in certain activities. Daily records and quarterly reviews confirmed the person was being supported to achieve their goals. Two senior staff had recently finished a communication training course. They were planning a communication training session that will help staff to communicate more effectively with the people living at the home. Interaction between the person who was at home for the day and staff was observed. Staff were seen to offer choices and give the person time and encouragement to respond. Daily records provided evidence that people were given choices and encouraged to make decisions. Lingwell Approach DS0000001475.V339788.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People who use the service have a varied and fulfilling lifestyle that is based on their wishes and individual needs. EVIDENCE: The daily records for two people, covering a two-week period, were looked at. There was evidence that people had an active lifestyle, family contact, health appointments and involvement in daily living tasks. Recreational activities included meals out, swimming, dance class and shopping trips. Staff said they provided a very person centred service and thought they successfully met the different needs of the people who live at the home. Lingwell Approach DS0000001475.V339788.R01.S.doc Version 5.2 Page 12 Staff had good knowledge about the people living at the home. They were able to talk about their past, their likes and dislikes, their family and their current needs. One person had been supported to visit the community where they had grown up. Since the last inspection, a contact sheet has been introduced. This enables staff to have an overview of contact with families and healthcare professionals. Two weeks menus were looked at and these were varied and nutritious. Staff said they were responsible for devising weekly menus, which are based on people’s preferences. Lingwell Approach DS0000001475.V339788.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home has good systems in place to make sure health and personal care needs are met and people receive the right support from healthcare professionals. EVIDENCE: Each file had good information about health and personal care. Health action plans outlined healthcare needs and there was information about all healthcare appointments. One sheet confirmed the person had recently seen a neurologist, specialist nurse, GP, general nurse and had a medication review. Individual weight records were also maintained. One person had lost weight; this had been closely monitored and a dietician had helped devise a more appropriate diet. Lingwell Approach DS0000001475.V339788.R01.S.doc Version 5.2 Page 14 Medication and medication records were looked at and the amount of medication and the records corresponded. Medication storage was looked at and the medication was well organised. The manager had identified a problem with the medication ordering system; a meeting to look at the issues had been arranged with the pharmacist. Lingwell Approach DS0000001475.V339788.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Systems are in place to protect the people who live at the home. EVIDENCE: The manager said the home had not received any complaints since the last inspection. Information about making complaints was available in the home. The manager and staff have attended adult protection training and they were familiar with the adult protection procedures. The whistle blowing policy was displayed in the office. Personal allowance records were looked at. All financial transactions were recorded and receipts were obtained for any purchases made. Two people’s monies were counted and the amount corresponded with the amount on the balance sheet. Lingwell Approach DS0000001475.V339788.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, 28, 29 & 30 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home is pleasant, well maintained and people who live there are very comfortable in their surroundings. EVIDENCE: A tour of the building was carried out. Communal areas, bathrooms and bedrooms were visited. The home was clean and tidy and there were no odours. The person who was at home for the day walked freely around the home and used all communal areas. Bedrooms were very personal, and careful consideration has been given to the décor to ensure it reflects the preferences of the people who live there. Each room had photographs, pictures and personal items. A lot of different equipment was available to help maintain skills and promote independence. Lingwell Approach DS0000001475.V339788.R01.S.doc Version 5.2 Page 17 The furnishings, carpets, and furniture were good quality and the home was decorated to a high standard. Since the last inspection, work has been done to improve the grounds. The garden was well maintained and new furniture had been purchased. Staff said this was an improvement that had benefited the people who live at the home. Lingwell Approach DS0000001475.V339788.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People who live at the home are supported by a skilled and cohesive staff team. Staff are well supported and everyone has opportunities to develop. EVIDENCE: Staff said the team works well together and communication was good. They have a daily handover where information is passed on to staff who are starting their shift. Staff meetings are held every month. Staff also said they received regular supervision and had opportunities for personal development. The manager talked about recent staff absences which had left the home with staff shortages. Agency staff had been working at the home on a regular basis to cover the shortfalls. Staff also confirmed that staffing levels were sometimes a problem. Lingwell Approach DS0000001475.V339788.R01.S.doc Version 5.2 Page 19 Rotas for the three weeks prior to the inspection were looked at. Only two staff had worked on shift during weekends, which does not provide opportunities to take people out. The manager said the staffing problems were only short term and a new member of staff was starting shortly which would also help the staffing situation. The Commission has agreed that United Response can hold staff records centrally; only CRB disclosure numbers were available in the home. The manager talked through the recruitment process which sounded robust because all the necessary checks were completed. One staff member talked about the recruitment process and confirmed they had completed all the relevant information before they commenced employment. They also said they had completed a good induction programme when they started. Staff said they had opportunities to attend a good range of training courses. Training records were looked at. Staff had attended various training courses including, equality and diversity training, health and safety, adult protection, challenging behaviour, autism, epilepsy and medication. Eight of the nine senior/support workers had completed NVQ level 2 or above. Lingwell Approach DS0000001475.V339788.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home is well managed and it successfully meets the needs of the people who live there but regular changes in management does not provide the home with consistency and continuity. EVIDENCE: The manager has worked at the home for eighteen months but is leaving in October. She provides strong leadership and had good knowledge about each person who lives at the home. Staff said they received good support from the manager. Lingwell Approach DS0000001475.V339788.R01.S.doc Version 5.2 Page 21 The home has not had a registered manager in post since 2004. Four people have managed the home since 2004 but they have not been registered. The current manager had sent an application for registration but this will not be processed because the manager is leaving. Previous inspections have identified that the home should have a registered manager to provide consistency and continuity. It is important that this is addressed because the management is critical to the quality of a home. Once a month the registered provider should arrange for a member of the management team to visit the home and look at the general conduct, these visits are called Regulation 26 visits. There was only one report for 2006 and three for 2007. Copies of the reports should be sent to the Commission. Important information that is used to form judgements during inspections was not available because the annual quality assurance assessment was not returned. It is important to make sure the assessment is returned to enable the Commission to make a judgement about the quality of the service. The manager said much of the assessment had been completed and agreed to make sure it was sent by 20 July. Because this shortfall was being addressed it has not been necessary to make a requirement. The home has various systems in place to monitor the quality of the service. This includes staff and relative questionnaires. The most recent questionnaires were looked at. Suggestions to improve the service had been introduced. Health and safety records were looked at. Regular checks had been carried out around the building including the hot water, medication stock, and fire systems. The Hoists were serviced in May 2007. Fire equipment was tested in November 2006. Lingwell Approach DS0000001475.V339788.R01.S.doc Version 5.2 Page 22 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 4 27 3 28 4 29 3 30 3 STAFFING Standard No Score 31 X 32 4 33 3 34 3 35 3 36 3 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 3 13 4 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 2 X X 3 X Lingwell Approach DS0000001475.V339788.R01.S.doc Version 5.2 Page 23 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 2 Standard YA37 YA39 Regulation 8 26 Requirement The home must have a registered manager in post A representative of the organisation must visit the care home at least monthly to make sure the conduct and quality of the home is properly monitored. Copies of the report must be made available to the Commission. Timescale for action 30/11/07 31/08/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Lingwell Approach DS0000001475.V339788.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Lingwell Approach DS0000001475.V339788.R01.S.doc Version 5.2 Page 25 - 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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