Inspection on 23/05/07 for Link House

This inspection was carried out on 23rd May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Link House 19/01/06

Link House 06/05/05

Link House 07/03/05

Link House 07/12/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Link House Links View, Sandy Lane Dereham Norfolk NR19 2ED Lead Inspector Debra Allen Unannounced Inspection 23rd May 2007 11:00 Link House DS0000027532.V343398.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 Link House DS0000027532.V343398.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. Link House DS0000027532.V343398.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Link House Address Links View, Sandy Lane Dereham Norfolk NR19 2ED 01362 695588 01362 696888 adamsblz@yahoo.co.uk 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) Mrs Lesley Ann Adams Mrs Lesley Ann Adams Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Link House DS0000027532.V343398.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th January 2006 Brief Description of the Service: Link House is a purpose built care home standing in a residential area within walking distance of the centre of the town of Dereham. The home is designed as a domestic house and is similar to surrounding properties. The registration allows for the care of 6 adults with a learning disability. All service users have their own bedroom and the home has a large lounge with a linked dining room. Outside there is a garden and off-street parking. Link House DS0000027532.V343398.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care Services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out, by using information from previous inspections, information from the providers, the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and the current judgements for each outcome group. This inspection was carried out over a total period of three hours, which included a second visit in order to meet with and talk to the service users on return from their day services. In addition to these discussions a number of records were inspected, a tour of the premises was undertaken and the manager and some staff were spoken with. Six service users’ and six relatives’ questionnaires were returned prior to the inspection, all of which contained very positive comments. Some of the relatives’ comments included: “All residents are treated as individuals and they all have a varied social life. Excellent choice of menu and food.” “I think the interaction between staff and residents is very good. The residents have a good social time and are often out and about.” “Link House is a friendly, caring environment. They are able to give [name] the freedom to do and achieve in a safe and supportive environment. They are not looking for a quick fix but the long term aim is to support [name] into supported living rather than residential care.” “The care given is just as good as in our own home.” “Well managed with an excellent team of support carers.” No requirements or recommendations have been made as a result of this inspection. What the service does well: Link House has a very good pre-admission process and comprehensive needs assessments are carried out. Care plans and risk assessments are all very clear and person centred and have a very positive and enabling approach – i.e. how they can do things rather than why they can’t. Link House DS0000027532.V343398.R01.S.doc Version 5.2 Page 6 The menus are varied, wholesome and nutritious and each service user takes it in turns to choose a meal for the weekly menu. Service users are encouraged and supported to self-medicate, subject to a risk assessment being carried out. Link House has a very good complaints procedure and effective quality assurance process and the manager regularly invites feedback from service users, relatives and external service by way of questionnaires. Staff spoken to have completed their NVQ2s and one person is about to commence her NVQ3. In addition to this, one member of staff has recently completed the HACCP Better Food Management Course, together with the manager. The manager is very positive and supportive of all the staff and service users and it was evident through observations and discussions that she has a genuine empowering and enabling approach with everyone. 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. Link House DS0000027532.V343398.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 Link House DS0000027532.V343398.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): 1, 2, 3, 4 & 5 Quality in this outcome area is good. Service users and their family are provided with various forms of information, to ensure they are able to make an informed choice about where to live. Full needs assessments are carried out before people move in so that they are assured that the service will meet these needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A new service user was due to move into Link House the day after the second part of the inspection and preparations had been made for their arrival. People spoken to on the day said they were looking forward to the new person living with them. The care plan was looked at in respect of the new admission and this contained good evidence of a full needs assessment having been carried out by Social Services and Link House. Notes from a transition meeting were also seen. The care plan was also seen to contain a personal profile, weekly programme for day care/college/work and detailed risk assessments. Any restrictions on choice or freedom were explained clearly and focussed on the fact that staff would work towards independence in these areas. Link House DS0000027532.V343398.R01.S.doc Version 5.2 Page 9 Evidence was also seen to confirm that the new service user had visited the service on a number of occasions prior to moving in permanently. Other care plans looked at confirmed that each service user has a written contract. Link House DS0000027532.V343398.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 & 10 Quality in this outcome area is excellent. Care plans contain assessments of needs, wants and choices and are regularly reviewed and updated as necessary. Service users are actively involved in all aspects of life in the home; their views are taken into consideration and they are supported to make decisions and take risks. Service users’ information is secure and confidentiality is maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In addition to the new admission, one other care plan was looked at on the day of inspection and this was found to contain very clear and detailed information relating to how the person needed and wanted to be supported. Regular reviews were seen to have taken place, ensuring changing needs are met. Link House DS0000027532.V343398.R01.S.doc Version 5.2 Page 11 Risk assessments were very clear, with a very positive and enabling approach, i.e. what measures needed to be taken to help someone to be able to carry out day-to-day tasks or enjoy activities as safely as possible. All the risk assessments seen on the day had been regularly reviewed and were updated as and when required. All the service users are about to start putting together a personal ‘My Health Book’ which will contain essential health information. The intention is that each person can take their book with them when they go out and any information that may be required will always be on hand, which will be especially helpful in the event of an emergency or accident. House meetings were noted to be held on a regular basis giving all the service users the opportunity to have their say and be actively involved in all aspects of life in the home. All the service users’ records and personal information was seen to be stored securely, thereby ensuring confidentiality is maintained. Link House DS0000027532.V343398.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is excellent. Service users have opportunities for personal development, are part of the local community and engage in appropriate leisure activities. Service users are supported to have appropriate personal relationships. Service users are offered a healthy diet and enjoy their meals and mealtimes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans looked at contained individual activity schedules and evidence was seen, through daily notes and other information on file, of involvement in a number of areas. Most people attend day services during the week and have a variety of choices in order to relax when they return home in the evening such as computer, cooking, craft/sewing, watching DVDs, music and gardening. Link House DS0000027532.V343398.R01.S.doc Version 5.2 Page 13 Other activities which service users are able to enjoy include clubs, pub, cinema, theatre, swimming, bowling, shopping, trips to the coast, barbecues and parties. In the section ‘what’s good about living in your home?’ the six service users’ questionnaires contained comments such as: shopping, going out for a meal, shopping, going to the pub, my keyworker, good food, nice staff going out on days off, having nice holidays and barbecues. A copy of a policy was seen on the personnel files which stated: Do not complete a resident’s daily task until they have made a good attempt – our aim is independence! There was great deal of evidence available to support the fact that service users are able to maintain personal relationships and one person responded to the relatives’ questionnaire by saying “home contact twice per week, visits on family occasions and siblings contact on a regular basis”. All six people who returned their surveys ticked ‘yes’ to say they have lots of things to do. Each service user takes it in turns to choose a meal for the weekly menu and copies of the last two weeks’ menus showed a varied diet that was wholesome and nutritious. Examples include sausage casserole, cauliflower & broccoli bake, macaroni cheese with spinach & bacon and chicken stir-fry. Alternatives were also noted on the menu, if someone didn’t want the choice of the day. On the afternoon of the inspection, one service user was observed helping to prepare the evening meal. Two people stated in their questionnaires that they go shopping for food and four said they sometimes did. All six service users ticked ‘yes’ to say they choose what to eat. Link House DS0000027532.V343398.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 20 & 21 Quality in this outcome area is excellent. Service users receive personal support in the way they prefer and their physical and emotional healthcare needs are met. Service users are protected by the home’s policies and procedures for dealing with medication. Service users are treated with dignity and respect with regard to ageing and illness. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans looked at contained very descriptive pen-pictures and gave very clear explanations with regard to how people wanted and needed to be supported with their personal care. Once again, there was evidence of an enabling approach, rather than ‘doing-things-for people’. Link House DS0000027532.V343398.R01.S.doc Version 5.2 Page 15 In respect of one service user, very clear information was seen with regard to their specific health needs. The risk assessments in this respect were excellent as they were particularly enabling and showed how the person could be supported to live life to the full, i.e. how they could do things rather than why they couldn’t. Evidence was also seen, in the care plans, of involvement and support from external professionals such as GP, community nurse, psychiatrist, chiropodist, dentist and optician. All the service users are encouraged and supported to self-medicate, but are also protected by the home’s policies and procedures for dealing with medication and staff are very well trained in this area. The medication policy states: A full record of medication is kept in the service user’s file and the service user signs to consent to the medication. Service users are encouraged to self-medicate subject to a risk assessment being carried out. If the risk is assessed as acceptable, the service user has a lockable space in which to store their medication. Staff will have access to this space, only with the service user’s permission. Observations and discussions confirmed service users are treated with dignity and respect with regard to ageing and illness. Link House DS0000027532.V343398.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is excellent. Service users feel their views are listened to and acted on and they are protected from abuse, neglect and self harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been no complaints since the last inspection. Link House has a very good complaints procedure and evidence was seen to show how the manager regularly invites feedback from service users, relatives and external services by way of questionnaires. All six service users confirmed that they felt safe at Link House and that they knew who to tell if they were unhappy and all six relatives confirmed that they knew how to make a complaint if they needed to. The house meetings, which were noted to be held on a regular basis, also give all the service users the opportunity to have their say and raise concerns or discuss issues in a group setting. The detailed risk assessments seen and evidence of good staff training in areas relating to adult protection help ensure that service users are protected from abuse, neglect and self harm. Service users’ money is stored safely and all recordings and receipts are in place as stated in the policy and procedure for handling residents’ money. This policy was seen, together with other pre-inspection documentation. Link House DS0000027532.V343398.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 & 30 Quality in this outcome area is good. Service users live in homely, comfortable and safe environment, which is clean and hygienic. Service users bedrooms, toilets and bathrooms are individual and private and shared spaces complement their individual rooms. Specialist equipment is available and provided, if required, to maximise independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises showed Link House to be clean, hygienic and very pleasantly decorated throughout. It also had a very comfortable and homely atmosphere. One person was happy to show me their room. They were very happy with it and it looked very comfortable and personal. Other service users were seen using the various communal areas and everyone appeared very relaxed and content. Link House DS0000027532.V343398.R01.S.doc Version 5.2 Page 18 The toilets and bathrooms were seen to offer sufficient privacy for people using them. Some specialist equipment was noted and it was evident that any requirements in this area would be met. Link House DS0000027532.V343398.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 & 36 Quality in this outcome area is good. Staff have clear roles and responsibilities, are well trained, competent and appropriately qualified. The home has robust recruitment policies and procedures and staff are well supported and supervised. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussions were held with two staff members and both said they felt the team worked extremely well together. They also spoke very highly with regard to the support and training received from the manager. Training records were looked at and evidence was seen of courses attended such as first aid, fire safety, health & safety, food hygiene, adult protection, moving & handling, medication, working with different behaviours and managing challenging behaviour. Link House DS0000027532.V343398.R01.S.doc Version 5.2 Page 20 Both members of staff spoken to have completed their NVQ2 and one person is about to commence her NVQ3. In addition to this, one member of staff has recently completed the HACCP Better Food Management Course, together with the manager, and is looking forward to sharing her knowledge with everyone else. The personnel files that were looked at contained all the relevant records such as application form, contract, confirmation of identification and clear, enhanced Criminal Records Bureau (CRB) disclosures, therefore confirming that the home/organisation has robust recruitment procedures. Evidence was also seen to show that staff received one-to-one support and supervision on a regular basis. Staff spoken to also confirmed this fact. Link House DS0000027532.V343398.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42 & 43 Quality in this outcome area is good. Link House is a well run home and the service users benefit from the ethos, leadership and management approach. Service users’ views underpin the self-monitoring, review and development of the home. Service users’ rights and best interests are safeguarded by the home’s policies, procedures and record keeping. The health, safety and welfare of service users are promoted and protected. This judgement has been made using available evidence including a visit to this service. Link House DS0000027532.V343398.R01.S.doc Version 5.2 Page 22 EVIDENCE: The manager is very positive and supportive of all the staff and service users and it was evident through observations and discussions that she has a genuine empowering and enabling approach with everyone. Link House has a very comprehensive and effective quality assurance process, information about which is published in their annual report. The manager also regularly invites feedback from service users, relatives and external service, by way of questionnaires. The policies and procedures were looked at and found to be up to date and in good order, with full reviews taking place annually. The atmosphere observed during the two visits was cheerful and relaxed and observations confirmed that the service users were genuinely in their own homes with their best interests, health and happiness being absolute priority. Link House DS0000027532.V343398.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 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 4 3 4 3 LIFESTYLES Standard No Score 11 4 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 4 3 3 3 4 3 3 3 3 Link House DS0000027532.V343398.R01.S.doc Version 5.2 Page 24 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 Link House DS0000027532.V343398.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Link House DS0000027532.V343398.R01.S.doc Version 5.2 Page 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!