Inspection on 29/07/05 for Link House

This inspection was carried out on 29th 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 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 27/10/06

Link House 15/11/05

Link House 12/01/05

Link House 21/09/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Link House Main Road Withern Alford Lincolnshire LN13 0NB Lead Inspector Mick Walklin Unannounced 29 July 2005 @ 10:00 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. Link House C53 C04 S2378 Link House V242263 290705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Link House Address Main Road Withern Alford Lincs LN13 0NB 01507 450403 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) Boulevard Care Care Home Only (PC) 8 Category(ies) of LD (Learning Disability) - 8 registration, with number of places Link House C53 C04 S2378 Link House V242263 290705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 12/1/05 Brief Description of the Service: Link House is situated in the village of Withern, which is between the market town of Louth and the coastal resort of Mablethorpe. The village has a post office, general store and public house. Recreational facilities are accessed, via public transport, or booking the providers mini bus and are mainly in the nearby towns of Louth, Skegness and Mablethorpe. Service users choose whether to attend Boulevard Care’s day centre at Orby, where they can take part in a variety of day care activities. The home also supports service users to access community employment or education.The Boulevard Group purchased Link House in 1990. The home is registered to accommodate up to eight service users with learning disabilities, who require personal care. Link House C53 C04 S2378 Link House V242263 290705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 7 hours. The main method of inspection used was called case tracking which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. A tour of the premises was conducted with the acting manager, and documentation was inspected. What the service does well: 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. Link House C53 C04 S2378 Link House V242263 290705 Stage 4.doc Version 1.40 Page 6 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 Link House C53 C04 S2378 Link House V242263 290705 Stage 4.doc Version 1.40 Page 7 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) 2 & 4. There are satisfactory procedures for assessing residents prior to admission, ensuring that staff have adequate information to meet their needs. EVIDENCE: One resident was admitted in early June for a trial period of three months. Although no pre-admission assessment information was available in the home, an assessment had been conducted by the Support Manager, and information had been faxed from the placing social worker following admission. Prospective residents would usually be invited to visit the home prior to admission, but this particular person had been admitted as an emergency following the closure of a care home, so a visit had not been possible. Link House C53 C04 S2378 Link House V242263 290705 Stage 4.doc Version 1.40 Page 8 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, 8, 9 & 10. Residents are fully consulted in the care planning process, enabling them to express their views. EVIDENCE: Residents said that their key workers have explained their care plans to them, and they sign the care plan to confirm their agreement. All care plans inspected had been re-written recently, and are usually reviewed every three months. They contain wide-ranging assessments, with daily records and monthly progress reports from key workers. Staff demonstrated a good knowledge of how to meet the care needs of residents. Two residents described how they are fully involved in the running of the home. They said that they have regular residents meetings to discuss any issues, and have timetables for helping with household tasks. All care plans contain risk assessments, enabling residents to live as independently as possible, whilst minimising risks. At each residents meeting, residents are asked if they wish the involvement of an external advocate to promote their interests. Link House C53 C04 S2378 Link House V242263 290705 Stage 4.doc Version 1.40 Page 9 Staff sign a confidentiality agreement on appointment, and those interviewed were clear on their responsibilities. Link House C53 C04 S2378 Link House V242263 290705 Stage 4.doc Version 1.40 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) 12, 13, 14 & 17. There are a good range of activities for residents to participate in, enabling them to enjoy a stimulating and varied activity timetable. EVIDENCE: Most residents attend a day centre at Orby, run by Boulevard Care. They described a wide range of activities that they undertake there, and said that they enjoy attending. Two residents chose not to attend at present. Six residents are undertaking the ASDAN Curriculum (Award Scheme Development and Accreditation Network). This focuses on developing practical and independent living skills, leading to an accredited award. Residents said that “there is lots to do”, and the home has the use of a minibus for regular outings. A holiday in Scotland has been booked for September, which residents said that they are looking forward to. A monthly activity plan is devised with residents, and the home has a games room equipped with a pool table and darts board. Catering arrangements are of a domestic nature, and residents help in meal preparation. Menus are discussed at residents meetings, and residents said Link House C53 C04 S2378 Link House V242263 290705 Stage 4.doc Version 1.40 Page 11 that the food is good, with plenty of variety and individual choices catered for. The kitchen is well organised, with good record keeping. Link House C53 C04 S2378 Link House V242263 290705 Stage 4.doc Version 1.40 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) 19 & 20. There are satisfactory arrangements for meeting the health needs of residents, but some medication administration practices require review. EVIDENCE: All residents are registered with a local GP practice, and residents said that they receive medical attention promptly if they are ill. All are registered with a dentist, but there are problems at present in accessing routine check-ups. Psychiatric services are available through Louth Hospital. No residents self-medicate. Medication storage and administration records are satisfactory, but the administration system used must be reviewed. A system is used where staff decant four days supply of medication from original containers, into an unsealed monitored dosage system. Guidelines from the Royal Pharmaceutical Society state: - “for a care home member of staff to administer a medicine it must have a printed label containing the following information: • Service users name. • Date of dispensing. • Name and strength of medicine. • Dose and frequency of medicine. Medication should never be removed from the original container in which a Link House C53 C04 S2378 Link House V242263 290705 Stage 4.doc Version 1.40 Page 13 pharmacist or dispensing doctor supplied it until the time of administration. Medication should never be secondary dispensed for someone else to administer to the service user at a later time or date”. The home uses some non-prescription medication on an as required basis. It is recommended that individual protocols are in place for the administration of non-prescribed medication, and the GP has authorised this. Some nonprescribed medication was out of date, and it is recommended that periodic audits of medication stocks are undertaken. These medications were disposed of at the time of the inspection. Two staff stated that they had not received formal medication training, and it is recommended that all staff administering medication attend a safe handling of medication course. Link House C53 C04 S2378 Link House V242263 290705 Stage 4.doc Version 1.40 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) 22 & 23. The home has good arrangements for dealing with complaints, and adult protection issues, ensuring that residents are protected. EVIDENCE: At each residents meeting, residents are asked if they have any complaints, and this is documented. There have been two complaints since the last inspection, both of which have been resolved. Residents were clear on the action to take if they had a complaint. The homes adult protection policy is cross-referenced with Local Authority procedures, and most staff have received training in the past year. They were able to describe the correct action to take if allegations of abuse were reported to them. A record of controls and sanctions is kept, but there were no entries over the past year. Staff confirmed that they had received physical intervention training. Link House C53 C04 S2378 Link House V242263 290705 Stage 4.doc Version 1.40 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 & 30. The home is well maintained and decorated, and provides a comfortable environment for residents. EVIDENCE: Residents said that they enjoy living at the home, and are happy with their bedrooms, which they can personalise to taste. It is well decorated and homely. Staff said that the company maintenance person attends to issues promptly. Residents help with household tasks such as cleaning, and the home was clean and tidy at the time of the inspection. Link House C53 C04 S2378 Link House V242263 290705 Stage 4.doc Version 1.40 Page 16 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, 34, 35 & 36. Staffing levels are unsatisfactory, which could potentially place residents and staff at risk. Recruitment and selection procedures are robust, ensuring residents are protected, and staff have an annual training plan to enable them to fulfil their role. EVIDENCE: One resident said that the staff are “great”. Five staff are currently employed at the home. One other person has been recruited, and is awaiting preemployment checks, but the acting manager is transferring to another home at the end of the week. Staff said, “there are not enough staff” and “ we have really been struggling lately”. The home still has vacancies for three posts, although daytime staffing levels are being maintained by staff covering extra hours, and help from other company homes. Night staffing arrangements are unsatisfactory, and are potentially placing residents and staff at risk. One waking night staff is employed 3 or 4 nights on alternate weeks, and works with a senior staff sleeping-in. For the remainder of the time, there is only one sleep-in staff, and this does not take into account the gender mix of the residents. One member of staff has been recruited recently, and there was evidence that the necessary checks for the protection of residents had been conducted prior Link House C53 C04 S2378 Link House V242263 290705 Stage 4.doc Version 1.40 Page 17 to employment. The acting manager said that the company is actively trying to recruit more staff. Staff described training as “pretty good”. The company employs a training co-ordinator, and staff are undertaking NVQ training. A training plan for the year gives dates for mandatory and other training, but most staff require fire training, as some have not received this since 2002. Staff confirmed that they receive regular supervision, usually every two months. Link House C53 C04 S2378 Link House V242263 290705 Stage 4.doc Version 1.40 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) 38 & 42. Documentation was reasonable well organised, ensuring that the necessary health and safety checks are carried out for the protection of residents. EVIDENCE: Staff have regular meetings, and feel valued. Staff morale was described as “good – despite putting a lot of hours in” and “ morale is good – staffing levels affect this, but we help each other out”. Maintenance and servicing records were inspected. The fire file was well organised, with details of regular checks and practices. The five-year fixed electrical wiring certificate could not be found, but the Commission has a copy on file dated April 2001. Hot water temperatures are regularly monitored, but the temperature in the downstairs bathroom was measured at over 52 degrees, and it is recommended that residents risk assessments are reviewed to ensure that residents are not at risk. Link House C53 C04 S2378 Link House V242263 290705 Stage 4.doc Version 1.40 Page 19 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 x 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 x x 3 Standard No 31 32 33 34 35 36 Score x x 1 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Link House Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x 3 x x x 3 x C53 C04 S2378 Link House V242263 290705 Stage 4.doc Version 1.40 Page 20 no 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 20 Regulation 13(2) Requirement The registered person must review medication administration arrangements to ensure that they comply with Royal Pharmaceutical Society guidelines. The registered person must review staffing levels to ensure that staff are employed in such numbers appropriate for the health and safety of service users. The registered person must ensure that staff receive annual fire training. (This requirement is carried forward from the inspection on 12th January 2005. Action has been taken relating to other mandatory training, but not fire training). Timescale for action 30/9/05 2. 33 18(1) Immediate 3. 35 23(4) 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 20 Good Practice Recommendations It is recommended that individual protocols are in place for C53 C04 S2378 Link House V242263 290705 Stage 4.doc Version 1.40 Page 21 Link House 2. 3. 4. 20 20 42 the administration of non-prescribed medication, and the GP has authorised this. It is recommended that all staff administering medication attend a safe handling of medication course. It is recommended that periodic audits of medication stocks are undertaken. It is recommended that risk assessments be reviewed to ensure that service users are not at risk of scalding. Link House C53 C04 S2378 Link House V242263 290705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Unity House Weaver Road off Whisby Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Link House C53 C04 S2378 Link House V242263 290705 Stage 4.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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