Inspection on 21/11/05 for Littlemoor House

This inspection was carried out on 21st November 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Littlemoor House 22/01/09

Littlemoor House 26/01/07

Littlemoor House 16/02/05

Littlemoor House 15/09/04

Littlemoor House 22/03/04

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 Littlemoor House 70 Littlemoor Newbold Chesterfield Derbyshire S41 8QQ Lead Inspector Ray Coonan Unannounced Inspection 21st November 2005 2:00 DS0000020042.V262237.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 DS0000020042.V262237.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. DS0000020042.V262237.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Littlemoor House Address 70 Littlemoor Newbold Chesterfield Derbyshire S41 8QQ (01246) 563150 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 Hilary Inkles Mrs Hilary Inkles Care Home 5 Category(ies) of Learning disability (5) registration, with number of places DS0000020042.V262237.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st July 2005 Brief Description of the Service: The Home is a large extended corner house in a busy residential area of Chesterfield. The house is close to local amenities and on a bus route to the town centre. Accommodation is on 2 floors and all bedrooms are single. The Home has bathroom and toilet facilities on both floors and is suitably resourced with lounge and dining areas. The Home is run on domestic lines and service users are encouraged to use community facilities, including day care resources. DS0000020042.V262237.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection took place over a period of two hours on 21st November. There was the opportunity to meet three of the residents whilst two others were out on day activities. There was also the chance to talk with the member of staff on duty, who was relatively new to the Home. A variety of records and documentation was also viewed, such as care plans and Health and Safety policies and records. The Inspection continued for a further hour on the 22nd November, when the Home’s owner/manager, Hilary Inkles, was also present. During this visit there was the opportunity to meet with a visiting CPN who works with one of the residents. What the service does well: What has improved since the last inspection? What they could do better: Staff appraisals need to be kept up to date and some aspects of the recruitment process need to be firmed up. DS0000020042.V262237.R01.S.doc Version 5.0 Page 6 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. DS0000020042.V262237.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 DS0000020042.V262237.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 and 4. Prospective residents benefit from a purposeful assessment of their individual needs and they are given suitable opportunities to find out what services the Home can offer. EVIDENCE: Several care plans were examined and these demonstrated that relevant and specialist information, such as community care and behavioural assessments, is obtained prior to admission. Residents confirmed that they were able to visit the Home before coming to live on an established basis. The visiting Community Psychiatric Nurse commented very positive on the Home’s ability to work with residents who have very specific individual needs and stated that they were committed to developing flexible care strategies in conjunction with other support services. The Home has used advocacy support for residents. DS0000020042.V262237.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): 6 and 9. Resident care was planned in an organised manner and appropriately reflected their interests, abilities and potential vulnerability. However, the individual care plan of a relatively new resident could have been more developed. EVIDENCE: Two care plans were examined in detail, one for a resident long established at the Home and another for a resident who had arrived about seven weeks ago. The latter had still to be properly developed and though there was planning information from a review just prior to admission, the Home had yet to establish any written risk assessments or their own specific care plan. It was noted that there was no photograph of the resident on file. The other care plan examined was much more informative with relevant risk assessments and day and night time plans developed around daily living routines. There were clear guidance notes on resident independence and competencies as well as areas that required more supervision and support. There was also a record of the resident’s individual social activities. There was evidence of the plan being appropriately monitored and reviewed. DS0000020042.V262237.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): 11, 12, 13,14 and 17. Residents enjoyed a wide range of leisure and social activities that were appropriately linked to their individual interests and personal development. Residents were provided with satisfactory meals. EVIDENCE: Information on care plans demonstrated that residents’ emotional welfare was thoroughly considered and monitored, with the support of specialist resources such as staff from Ash Green Hospital. The behavioural patterns of residents were also clearly assessed and interpersonal and life skills were included in the activity, recreational and day care programmes developed for each resident. Any expressed spiritual interests were responded to and one resident spoke about his regular contact with a local religious organisation and trips to Church. From discussions with staff and residents together with care plan records it was clear that residents had a wide range of recreational opportunities in accordance with their interests and wishes. Residents were involved with local day care facilities to varying degrees, including day centre and luncheon club resources. Local shops and pubs were accessed as well as the town centre. Records were kept of regular day trips, mainly in the summer months and DS0000020042.V262237.R01.S.doc Version 5.0 Page 11 individual holidays were arranged on an annual basis. Within the Home there were TV and music facilities and some art and craft activities took place. One resident had a computer and printer used for keeping a journal. The Home kept satisfactory weekly menus and these were used as a guideline though records were not maintained of any variations or alternatives provided. Residents spoken to indicated they enjoyed their meals at the Home. DS0000020042.V262237.R01.S.doc Version 5.0 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 the following standard(s): 19 and 20. The physical and emotional health of residents was appropriately monitored and satisfactorily promoted at the Home. EVIDENCE: Care plans contained detailed records of residents’ contact with community health resources with suitable assessments of their physical and emotional health. There were records of regular contact with G.P., community nursing and dental, optician and chiropody services. Risk assessments covered skin integrity, nutritional and any special medication areas. Care plans also contained information and guidelines for staff relating to any particular medical needs of the resident. There were no residents administering their medication. Storage arrangements were satisfactory and secure and staff confirmed that training was provided. Records of administration were generally in order though one small error was noted when administration had been signed off in the wrong place. DS0000020042.V262237.R01.S.doc Version 5.0 Page 13 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 The Home is suitably responsive to the views of residents. EVIDENCE: The Home has complaint policies and procedures in place. During the Inspection one resident complained to The Inspector about the attitude of a voluntary supporter at one of his outside activities. This also linked in with some other comments made to the manager recently and she is following the matter up accordingly. DS0000020042.V262237.R01.S.doc Version 5.0 Page 14 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): 24, 25, 26, 28 and 30. Residents have a comfortable and clean environment that is suited to their assessed needs. EVIDENCE: Although a full tour of the premises was not undertaken, several areas were viewed such as lounges, the kitchen and some of the bedrooms. Overall the Home is run on domestic lines and was well maintained, decorated and furnished. Residents’ bedrooms were also appropriately furbished and personalised with many personal items and décor reflecting individual tastes and interests. There is domestic sized laundry equipment and clothes are laundered daily or as necessary. Residents’ clothing was observed to be of a good standard and age appropriate. Since the last inspection the manager has developed infection control policies and guidelines. DS0000020042.V262237.R01.S.doc Version 5.0 Page 15 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): 31, 32, 34 and 36. There was some shortfall in the Home’s recruitment practice and in the ongoing appraisal of staff performance. The Home satisfactorily promoted NVQ training for staff EVIDENCE: Discussions with the member of staff on duty indicated that she generally felt well supported in her work and had a good understanding of her role and responsibilities. She stated that she already knew some of the residents through her other employment in day care. She has NVQ qualifications and confirmed that she has received in house induction training. It was also noted that another member of staff is starting NVQ training. The recently appointed staff member’s file was examined and demonstrated that appropriate recruitment practices were followed, including obtaining written references. However, there were no records of induction training and a full employment contract had not been developed, whilst a fresh CRB clearance had not been obtained. The Home had systems in place for individual staff supervision though no records were maintained. Staff appraisals were not up to date. DS0000020042.V262237.R01.S.doc Version 5.0 Page 16 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): 37 and 42 The safety of residents is promoted and monitored in a structured manner. The manager had an appropriate awareness of her general role and responsibilities. EVIDENCE: The manager/proprietor has relevant practice and management experience in related care settings. She also takes up relevant training opportunities with other staff and has had considerable past practice and management training input whilst employed with social services. However, she had not enrolled on NVQ 4 training in Care Management. A suitable job description was in place and the manager demonstrated an appropriate awareness of her role and responsibilities The Home has comprehensive policies for Health and Safety and these had been recently reviewed. There are systems in place for monthly checks in such areas as COSHH, electrical fittings and water temperatures, and there was evidence of appropriate environmental assessments for any potential hazards. DS0000020042.V262237.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 3 X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 X 3 X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 3 X 2 X 2 CONDUCT AND MANAGEMENT OF THE HOME 3 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 2 X X X X 3 X DS0000020042.V262237.R01.S.doc Version 5.0 Page 18 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 YA34 Regulation 19 Requirement The manager must address the shortfalls in recruitment practice as described in the main body of the report The manager must enrol on NVQ training in management. Timescale for action 31/12/05 2. YA37 9 31/12/05 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. 2. 3 Refer to Standard YA6 YA17 YA36 Good Practice Recommendations The manager should ensure that care plans are fully developed as soon as possible. Any alternatives to the main menu should be clearly recorded. A more structured approach to staff supervision and appraisal should be developed. DS0000020042.V262237.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 DS0000020042.V262237.R01.S.doc Version 5.0 Page 20 - 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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