Inspection on 06/05/05 for Link House

This inspection was carried out on 6th May 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 23/05/07

Link House 19/01/06

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 NR19 2ED Lead Inspector Ruth Hannent Announced 6 May 2005 14:00 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 Version 1.10 Page 3 SERVICE INFORMATION Name of service Link House Address Links View Sandy Lane Dereham NR19 2ED 01362 695588 01362 696888 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) Mrs Lesley Ann Adams Mrs Lesley Ann Adams Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Link House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 08/03/05 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 Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that was conducted over three and a half hours. Six resident comment cards, five relatives comment cards and a pre inspection questionnaire had been received prior the inspection. The Home was looked at both inside and out with two bedrooms shown by the Manager and then later in the day two more bedrooms shown by the residents of Link House. All six residents were spoken to and conversations were held over a two hour period. One visitor, two staff, who were on duty and one staff member who had called in to Link House were spoken to throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: The staff rotas need some changing to ensure that all staff have a regular pattern of days off and not work too many days in a row. The office should be kept locked at all times to ensure safety of keys hung inside the door. Link House Version 1.10 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Link House Version 1.10 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Link House Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2 and 3 Good, clear information is available regarding the service at Link House for prospective residents to make a choice. Care plans show good, person centred details and aims for the future as part of the assessment. The Manager has made it clear that residents will not be offered a placement if the Home cannot meet their needs. EVIDENCE: The statement of purpose and service users guide was read and the addition already written by the Manager to be added to improve the documents were discussed. The paperwork is clear, easy to read, with some pictures added to assist people who may need some help with understanding. The Manager showed clear documentation of the residents who live at Link House. The care plans are very detailed giving a holistic picture of every aspect of their needs. (All six residents have lived at Link House for a number of years). Any new prospective resident would be seen by the Manager with the existing paperwork used for the assessment to ensure the home could meet the needs. Link House Version 1.10 Page 9 On talking to the residents it was evident that they were involved with the choice and decision to move to Link House once they had talked to the Manager and were assured that their needs could be met. Link House Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,8,9 and 10 The residents at Link House have good, clear ongoing care plans that reflect their individual needs which they are actively involved with. Residents clearly make choices and decisions about their lives. Comprehensive risk assessments aid the residents in achieving tasks as part of living an independent lifestyle. The information seen shows that staff and residents understand how information should be handled. EVIDENCE: The residents care plans were seen. One was read in depth that was detailed showing how this person had developed and how involved in her own plan of care she was. On talking to this resident it was evident that the care plan was accurate and reviewed regularly to update the goals. Meetings of the residents meetings were seen. These happen regularly and are recorded. The minutes seen showed involvement of each resident and that Link House Version 1.10 Page 11 ideas that had been discussed had happened or were planned for the future such as parties and weekends away or what meals to plan for the menu. Each resident has a risk assessment completed. Seen were details of individual activities that could present a risk and all action to take to make the event as risk free as possible. All residents have a copy of the policy that explains to them about confidentiality and how it works. This policy, which was seen and discussed, has been expanded recently and is giving details on how confidential information is shared. This is to be given to professionals and families to aid the care practise in Link House. Link House Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,14,15,16 and 17, Link House offers a good lifestyle that allows opportunities for development, involvement in leisure activities and personal relationships. The meals are very wholesome and nutritious. EVIDENCE: Link House is managed like a family home with all the people who live there having very different needs. Some go to day centres, some work and some do a bit of both with outside activities as well. The Manager is involved with what each resident does throughout the day and will attend all reviews of these services. Activities are planned all the time. The whole home is about to visit Emmerdale for a holiday. One resident is training hard at swimming to take part in the special Olympics. Another is in a bowling league every week and another is getting an outfit ready to go to a Mayors function. Link House Version 1.10 Page 13 Families and friends are involved daily. One relative told how involved she was with parties and special events. One resident is in a relationship and talked about the times they have together. Each one is treated with dignity and respect. All the bedrooms have locks and no one enters anyone’s room without permission. Everyone helps with the daily running of the home. One resident discussed the food buying for meals she does weekly, another showed the garden tasks he was involved in and another stated his job was to clean the stairs and landing. All were happy to do these tasks. Residents take it in turns to choose what they would like for their meals. They then help prepare that meal. On the day of inspection a mince and onion pie was being freshly made with carrots, broccoli, cabbage and potatoes. The resident who was making the meal was chatting away about the meal preparation and how much she enjoyed cooking. All meals are freshly made and one favourite which was voiced by the residents is the homemade soup. Link House Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19and20 The Home, along with all medical professions necessary ensure that residents receive the best appropriate service. Medication is handled in the correct way and the homes policy is followed correctly to ensure safety of handling and administration is carried out. EVIDENCE: The healthcare support is carried out by the local GP practice. Specialist are involved with some of the residents. The Manager explained some of the difficulties that had occurred with one resident who was now very involved with the psychiatric service. This is being closely monitored and the Manager is reviewing with the professionals the medication to try and find the correct balance that suits the resident. In another care plan it was noted that due to the ill health of the resident an action plan was to be followed in the event of that person becoming unwell. The medication is supplied to the Home by Boots the chemist in a monitored dosage blister pack system. All the medication training for staff is offered by Boots and all staff have been trained in the safe administration of medicines. The medication is kept in a locked cabinet in the office along with the recording charts. A small concern is the position where the keys are hung for the cabinet that could be accessed by anyone entering the office. (Recommendation) Link House Version 1.10 Page 15 Link House Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not Inspected EVIDENCE: Link House Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27and 28 Link House has a very nice environment that creates a homely atmosphere. The bedrooms are seen as suitable and well liked by the residents with the bathrooms able to offer suitable privacy for the residents. The communal areas are well planned with the furnishings that are suitable for the residents EVIDENCE: The Home is bright and clean with each resident having their room painted and with soft furnishings as part of their choice. There are colour schemes in the different rooms of their favourite football team and stickers on the walls of pop stars. Each room holds adequate furniture with a hand washbasin. There are three toilets, one bathroom and one shower room which is easily accessible for a resident who can be independent with the use of a flat floor shower. The main lounge and dining room is well furnished with a large television and noted were the fresh flowers and the bowl of fresh fruit for residents to have if they so wished. The laundry/utility room houses the washing machine and Link House Version 1.10 Page 18 tumble dryer plus an extra sink for hand washing. The kitchen is well equipped with many cupboards and work surfaces allowing space for residents and staff to work alongside one another. Link House Version 1.10 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 and 35 The staff are very competent to care for the residents within their staff roles and responsibilities. The staff are well trained and experienced. The home offers a good service led approach to training. EVIDENCE: The staff at Link House are a stable established team having worked together for a few years. Throughout the inspection it was clear that residents and staff work together to establish a good working relationship. Conversations heard and tasks being performed were carried out in the best interest of the resident. Staff are trained and experienced with NVQ 2 held by two staff members and one with NVQ 3. The fourth staff member has gained a large amount of learning through LDAF with induction and foundation training and will be entering the NVQ route shortly. On talking to the staff team it was evident that they have the ability to offer the correct care for the individual residents. One concern shared with the Manager, as recorded on the rota throughout the previous month, is the length of days some members of staff work before having a day off. (Recommendation) Records of training undertaken were seen such as:Safe handling of medication Link House Version 1.10 Page 20 Managing difficult behaviour Restraint training First aid Fire Training Abuse training With a future training programme planned and seen for:Protection of vulnerable adults NVQ Food and hygiene Link House Version 1.10 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 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) 37,39,40 and 42, The Manager is a very experienced, capable, qualified person and able to run a good home. Quality is constantly being reviewed and the Home has a good ethos to ensure all people are involved in this quality assurance process. Good quality policies and procedures are in place which safeguard the interests of the residents. Health and safety of anyone involved with Link House is of clear importance to the Manager who has good practices in place to promote and protect the welfare of all. EVIDENCE: Link House Version 1.10 Page 22 The Manager has a recognised managers qualification (RMA). The certificate is seen on display in the office. She has been the Manager/Owner for a number of years. Quality assurance is measured by questionnaires sent to relatives and residents. Regular meetings with staff and service users all assist in the development of the quality delivered. Comment cards received back to CSCI have words such as “very happy with the service” and “couldn’t be better” on them. An annual report seen during the inspection of Link House was completed in 2004 giving details and opinions of the service. In the office are neat policies and procedures that are clearly written and easily accessible for staff. These policies are reviewed and updated when applicable. The inspector saw the health and safety policies, the staff training and development programmes plus the individual care plans of the residents. The whole home, which included all staff and residents, have recently undergone fire awareness training 12/07/04 and the fire officers report had just been received with no concerns reported. Items checked and dates noted for health and safety were:_ Boiler serviced 25/11/04 Portable electrical equipment Feb 05 Fire appliances serviced 7/10/04 The accident book was looked at with all recordings appropriate with no major injuries seen. Link House Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 x x Standard No 22 23 ENVIRONMENT Score x x 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 3 3 3 3 x x Standard No 11 12 13 14 15 16 17 3 x x 4 3 4 4 Standard No 31 32 33 34 35 36 Score x 3 x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 3 x 3 x Link House Version 1.10 Page 24 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 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. 1. Refer to Standard 20 Good Practice Recommendations It is recommended that the keys for the medication cupboard be locked away when no one is in the office by either always locking the office door on exit or purchasing a key cabinet. It is recommended that the staff are consulted about working rotas to ensure staff do not work too many days in a row without a day off. 2. 33 Link House Version 1.10 Page 25 Commission for Social Care Inspection 3rd Floor, Cavell House St Crispins Road Norwich Nr3 1YF 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 Version 1.10 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. 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