Inspection on 09/02/06 for Lingwell Approach

This inspection was carried out on 9th February 2006.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Lingwell Approach 06/07/07

Lingwell Approach 11/07/06

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 Stevie Allerton Announced Inspection 09:30 9 February 2006 th Lingwell Approach DS0000001475.V259974.R01.S.doc Version 5.0 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.V259974.R01.S.doc Version 5.0 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.V259974.R01.S.doc Version 5.0 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) None United Response Mrs Jackie Campbell Care Home 4 Category(ies) of Learning disability (4), Physical disability (4) registration, with number of places Lingwell Approach DS0000001475.V259974.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22 July 2005 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. There is a new Manager in post, who has not yet gone through the registration process, and there is good line management support from the regional office in York. Lingwell Approach DS0000001475.V259974.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was originally arranged for December, but was delayed until the newly appointed Manager was in post. It was conducted by one inspector over the course of one day, and was the second of two inspections scheduled to take place during the year commencing 1st April 2005, the previous being an unannounced visit in July 2005. Comment cards were sent out to the home in advance of the inspection, to distribute to relatives, health care professionals and others who have contact with the service. None had been returned at the time of writing this report. The previous Registered Manager left to take up an appointment elsewhere in the organisation and the last acting Manager also recently left. The new Manager, Paulette Hamilton, is new to United Response but has a lot of experience in this type of care setting. Discussions were held with the Manager and one of the Senior Support Workers. Two of the service users were seen as they came home from their daytime activities. Some records, policies and procedures were looked at, as well as the building. What the service does well: The philosophy of the home places the service user at the centre of everything that happens. They have free access to any part of the house or garden with sufficient staff to support them and ensure their safety and well-being. Staff actively support the service users, which ensures their inclusion in all aspects of daily life. The written plans are extremely detailed outlining how the active support will be delivered, which enables staff consistency. Some good examples were seen of how the service works well in partnership with parents and with other professionals, to ensure that physical and emotional health care needs are met and the appropriate resources obtained. The staff team have the benefit of a wide-ranging training plan, to equip them with the skills needed for the work they do, supported by a structured programme of supervision. Lingwell Approach DS0000001475.V259974.R01.S.doc Version 5.0 Page 6 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. Lingwell Approach DS0000001475.V259974.R01.S.doc Version 5.0 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.V259974.R01.S.doc Version 5.0 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&3 The detailed information gathered by the home enables the service to identify the resources that will be needed to care for service users and to secure these resources prior to admission. EVIDENCE: A new service user had been accepted for care since the last inspection, coming for periods of respite each weekend. Her referral information and Social Services Assessment was available for inspection, as were assessment and review records from a previous respite care provider. It was evident that the service user’s family members had been involved in developing appropriate support plans and risk assessments. These included detailed moving and handling plans and the management of a PEG feeding regime. The care records showed the gradual admission process, visits made to the home to introduce the person to the other women living there; the person’s family had also made visits to meet the staff. Review notes reflected good feedback from family and fellow professionals, about the staff team’s ability to take on the challenges presented by complex care needs and then deliver the appropriate support. Lingwell Approach DS0000001475.V259974.R01.S.doc Version 5.0 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): 9 The staff team have a healthy approach to risk, demonstrating good awareness of the balance to be achieved between the duty of care to service users and supporting them to enjoy stimulating activities. EVIDENCE: In both of the care files that were looked at in depth, there was evidence that risk is discussed and assessed for a wide range of activities. For example, there was a detailed risk assessment for moving and handling using the overhead hoist. There was also evidence that risks had been minimised so that a service user could still enjoy potentially risky, yet stimulating, activities, such as trampolining. Service users continue to be involved in all aspects of the household, including food preparation and other domestic tasks, being closely supported by the staff. Lingwell Approach DS0000001475.V259974.R01.S.doc Version 5.0 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 the following standard(s): 16 & 17 The philosophy of care promotes and reinforces rights and respect. Service users are supported to have a healthy and varied diet. EVIDENCE: Support plans are written in the first person, which reinforces each individual’s rights, encouraging them to make choices by the use of picture cards or objects of reference. Each service user has their own front door key, which their support worker takes with them when going out together. The menus and daily food diary showed a good variety of meals being provided. Support staff get to know likes and preferences for each person and can offer choices by use of picture cards. Weight records show that support staff closely monitor nutrition. Two of the senior staff have had training in enteral feeding and can train staff in the correct procedures. Lingwell Approach DS0000001475.V259974.R01.S.doc Version 5.0 Page 11 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): 20 There are appropriate policies and procedures in place for the safe management of medicines in the home. EVIDENCE: All of the existing staff have had accredited medicines training through Boots’ and new starters will also go on this course. One of the Senior Support Staff went through the medication procedure: ordering, storage, administration and recording were all carried out according to the home’s written policies and no deficiencies were observed. One of the service users has medication prescribed on a PRN basis (as necessary) and the use of this was explored further. There is a specific support plan for the use of this medication, given for self-harming behaviour. There was a good degree of protection built in to the service user’s support plan, certain behaviour dictating what action is offered, i.e., attempting to distract or remove to a quieter area of the home, before medication is administered. The records showed that this does not appear to be over-used. Lingwell Approach DS0000001475.V259974.R01.S.doc Version 5.0 Page 12 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 Information on complaints and adult protection is now available in a form that can be used more readily with service users. Training on adult protection is given to staff. Behaviour management plans and risk assessments take account of protection issues. EVIDENCE: The organisation’s complaints procedure is displayed and is also covered in a more “user friendly” booklet called “No More Abuse”. The Manager said that she had read this to the new service user, who had indicated some level of understanding and had been able to respond to questions about abuse. The Manager plans to get some agreed questions to ask of service users on a regular basis, to help them understand their rights to protection. Care records showed good levels of awareness of protection and restraint issues, with regard to self-harming behaviour. A behaviour management plan in place was seen to be reviewed on a weekly basis and amended appropriately. Staff receive training on adult protection during their induction period and through specific courses afterwards. Lingwell Approach DS0000001475.V259974.R01.S.doc Version 5.0 Page 13 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): 27, 28 & 29 Service users live in a comfortable and well-equipped environment that meets their needs. EVIDENCE: Decorators were working in the home at the time of inspection. The lounge, dining room and office had been repainted and the hall and corridor were being done; this was to be followed by all of the service users’ bedrooms. Ceiling tracking had been installed; an airglide mattress and other mobility equipment was also in place, aiding the staff when supporting a service user with severe disabilities. The bathroom that had had long-standing problems with damp on the walls is now fully operational; the shower area has been completely re-tiled and the staff report no further problems. The Manager reported that some funds have been made available to develop more facilities in the rear garden. Lingwell Approach DS0000001475.V259974.R01.S.doc Version 5.0 Page 14 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): 33 Staffing levels meet the needs of current service users. Support staff receive the training and skills they need to provide appropriate care. EVIDENCE: The care records of the new service user show that there were specialist skills that the staff team needed to acquire before they could offer her a place at the home. This has been achieved, the staff training records showing the specialist training, such as PEG feeding and postural management, which has been given to the whole team. Extra funding was obtained initially from the authority responsible for her care, to allow for additional staffing whilst this specialist training took place; there were two waking night staff funded initially, now reduced as positional turns, etc, can be safely done by one person with the right equipment and training. Review meeting notes demonstrated that the other health care professionals involved in this service user’s care package have been satisfied with the high levels of support that the home’s staff have been able to give. Lingwell Approach DS0000001475.V259974.R01.S.doc Version 5.0 Page 15 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): 38 & 42 The organisation’s ethos and values have always ensured that the service runs for the benefit of its’ users, but the lack of stability within the staff team has sometimes made continuity harder to achieve. The new manager is enthusiastic and has leadership skills. Health and Safety is given a high profile and staff are trained in this area. EVIDENCE: The home has been through a lengthy period of uncertainty with no registered manager in post. The newly appointed manager takes a proactive view to working with families and health care professionals. She is new to United Response as an employer and expresses a high regard for the organisation’s values, feeling that she will be able to translate these into practice. The organisation has well established systems, training and supervision for its’ staff, as was seen from the records. Supervision notes for a fairly new support Lingwell Approach DS0000001475.V259974.R01.S.doc Version 5.0 Page 16 worker confirmed what had been covered already during induction and how the worker was progressing towards greater competency. Discussion took place with one of the senior support workers, recently promoted from night shifts onto days and taking a lot more responsibility for staff supervision, attending review meetings and other managerial tasks. She was receiving training to help her gain new skills. The Health and Safety records showed that checks and tests are carried out routinely and appropriate action taken to resolve deficiencies. Records provided evidence of mandatory training for staff, in manual handling, food hygiene, first aid, fire safety and health and safety. The home notifies CSCI of serious accidents and incidents occurring to service users. Lingwell Approach DS0000001475.V259974.R01.S.doc Version 5.0 Page 17 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 3 3 X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X 3 3 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X X 3 X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Lingwell Approach Score X X 3 X Standard No 37 38 39 40 41 42 43 Score X 3 X X X 3 X DS0000001475.V259974.R01.S.doc Version 5.0 Page 18 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. Standard Regulation Requirement Timescale for action 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.V259974.R01.S.doc Version 5.0 Page 19 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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