Inspection on 26/01/07 for Littlemoor House

This inspection was carried out on 26th January 2007.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 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 21/11/05

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 Denise Bate Key Unannounced Inspection 26th January 2007 02:00 Littlemoor House DS0000020042.V327792.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 Littlemoor House DS0000020042.V327792.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. Littlemoor House DS0000020042.V327792.R01.S.doc Version 5.2 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 Littlemoor House DS0000020042.V327792.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st November 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. The homes current charges are £320.40 per week and residents pay for their own hairdressing, toiletries, and holidays. Littlemoor House DS0000020042.V327792.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place at the home over an afternoon. Additionally, time was spent in preparation for the inspection, looking at previous reports and other documents. Care planning documentation and other records were seen e.g. medication records and reports, CRB checks and financial records. A tour of the building was made and discussions took place with the proprietors, one of whom is the registered manager. The inspector met the current five residents. One resident has communication difficulties and one resident did not want to talk in detail about the service. Three other residents were spoken to and some their views about care at the home are reflected within this report. Two residents were case tracked and their care planning documentation looked at in detail. The manager had completed a pre inspection questionnaire prior to the visit. What the service does well: What has improved since the last inspection? What they could do better: Littlemoor House DS0000020042.V327792.R01.S.doc Version 5.2 Page 6 Due to personal reasons the manager has not yet undertaken formal management training, although she plans to do so. A number of good practice recommendations have been made relating to first aid training and updating the home’s safeguarding adult procedure. 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. Littlemoor House DS0000020042.V327792.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 Littlemoor House DS0000020042.V327792.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is available to ensure residents can make an informed choice about where they live. EVIDENCE: A copy of the home’s statement of purpose was given to the inspector. The document gives clear information about the home and its facilities. It includes information about activities, spiritual needs, catering, laundry, as well as the complaints procedure, consultation arrangements, accommodation, staff details and experience. Matters relating to privacy, dignity, choice and residents’ rights are emphasised and clearly expressed in the home’s mission statement and philosophy of care. Admission procedures are outlined, which include prospective residents visiting the home. The manager said that it was always important to get the views of current residents when considering any new admissions. Two residents were case tracked, and copies of assessments were seen on their care files. Some resident’s histories were discussed in detail, and residents had responded to the clear boundaries set and the commitment Littlemoor House DS0000020042.V327792.R01.S.doc Version 5.2 Page 9 shown by staff. Residents’ needs and preferences were clearly identified in care plans seen. Copies of individual contract are held on individual files. The ‘service user guide’ outlines extras for which residents have to pay, which are generally services from outside (hairdressing, chiropody, holidays, toiletries). Littlemoor House DS0000020042.V327792.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, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care plans and risk assessments relating to personal and social care needs of residents are completed in sufficient detail to direct and inform staff on how individual needs should be met. EVIDENCE: The two care records examined indicated that residents have an individual care plan, which included aspects of personal and health care activity. There were a photos, front sheets with basic information, individual care plans, copies of assessments and reviews, daily routines broken down into care routines and the management of particular problems, e.g. incontinence, nutrition assessments and choices, risk assessments and details of medication and contact with health professionals. Some residents have communication Littlemoor House DS0000020042.V327792.R01.S.doc Version 5.2 Page 11 problems but the home and staff know residents well and pick up non-verbal cues which indicate when there may be problems. There was evidence of the plans being appropriately monitored and reviewed. The three residents spoken to appeared relaxed, secure, and happy. They indicated that they liked living at the home and they got on well together. They were observed interacting with the proprietor in a relaxed and friendly manner. Littlemoor House DS0000020042.V327792.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): 12. 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides outings, activities and individual and group support which enhance the quality of life of residents. 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 attended church regularly. Littlemoor House DS0000020042.V327792.R01.S.doc Version 5.2 Page 13 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. Within the home there were TV and music facilities and residents sometimes went out together. The home kept satisfactory weekly menus and these were used as a guideline. Residents spoken to indicated they enjoyed their meals. It had been a resident’s birthday the day before the inspection and a party had been held which everyone enjoyed. Littlemoor House DS0000020042.V327792.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Healthcare records were documented and the home is pro-active in seeking help with health concerns ensuring that service users health needs are met. 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. An example was given where the home had worked closely with the Community Psychiatric Nurse for the benefit of a resident. This had been particularly successful and the home had received a letter of thanks from health professionals. Littlemoor House DS0000020042.V327792.R01.S.doc Version 5.2 Page 15 There were no residents administering their own medication. Storage arrangements were satisfactory and secure and training for staff was provided. Records of administration were in order. There was a record of staff signatures. There are no residents currently taking eye drops or controlled drugs. Littlemoor House DS0000020042.V327792.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 good. This judgement has been made using available evidence including a visit to this service. Clear and accessible complaints and safeguarding adults procedures are in place to ensure residents can be confident that any issues raised would be acted on effectively and promptly. EVIDENCE: The home has a comprehensive complaints policy and procedure that is included in the Service Users Guide, which is given to residents and their representatives. The manager reported that there had been no formal complaints made by anyone within the past 12 months, but that the size of the home is small enough for residents to be able to raise concerns that are usually dealt with immediately. The home had a copy of the local authority protection of vulnerable adults procedures and had attended locally organised briefing sessions on safeguarding adults. No issues regarding safeguarding adults have been raised with the CSCI. The subject had been discussed with staff and the home had an adult abuse procedure that covered staff responsibilities. The manager indicated that she would be updating the adult abuse procedure to update the terminology and ensure it complied with current local authority guidelines. Littlemoor House DS0000020042.V327792.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, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well appointed and maintained providing a high standard of accommodation in both individual and communal areas enhancing the quality of life for residents. EVIDENCE: The home is on a domestic scale and maintains a good standard of accommodation in both individual and communal areas. There is a comfortable lounge which residents can use at all times. Residents’ bedrooms are large, bright and comfortable, and personalised to reflect their interests. Most people have a television and/or music centre in their bedrooms. There are two bathrooms, each with bath and shower. Littlemoor House DS0000020042.V327792.R01.S.doc Version 5.2 Page 18 The kitchen small, well equipped and there are plans for further improvements by replacing the kitchen cabinets. The home have recently had a new cooker. There is a garden with a pleasant area to sit out in fine weather. There is domestic sized laundry equipment and clothes are laundered daily or as necessary. Standards of cleanliness and hygiene are good and the residents were all well dressed in clean and appropriate clothing. Littlemoor House DS0000020042.V327792.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): 32, 34, 35, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Trained and competent staff meet the dependency needs of residents currently accommodated within the home. EVIDENCE: The inspector was informed that there is a good staff team and that everyone works well together. Residents indicated that they got on well with the staff and manager. Copies of certificates are kept to provide a record of training. Moving and handling training had recently been updated. Over 50 of staff have NVQ2 training. The manager is planning to arrange first aid training for those members of staff who do not yet hold an appropriate current qualification. The home have recently obtained new induction training material that complies with Skills for Care and is considering implementing this for all staff as a ‘reflesher’. Littlemoor House DS0000020042.V327792.R01.S.doc Version 5.2 Page 20 Because there is a small staff team the manager is able to see each member of staff each week informally and ‘thorough conversations’ take place. In addition a formal annual appraisal is done and an example was shown to the inspector. The Communications book was seen which guided staff on any outstanding issues relating to residents or the day to day running of the home. One staff file was seen which contained copies of the application form and references. The CRB records were seen and found to be satisfactory. However, the manager indicated that she would be revising the application form so that it is more detailed and give space for applicants to provide a detailed employment history. Littlemoor House DS0000020042.V327792.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, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a suitably qualified and experienced manager in post and staff have an awareness of their roles and responsibilities, thus ensuring the home is run in the best interests of residents. 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 delayed her enrolment on NVQ 4 training in Care Management for personal reasons, and Littlemoor House DS0000020042.V327792.R01.S.doc Version 5.2 Page 22 plans to enrol in the near future. A suitable job description was in place and the manager demonstrated an appropriate awareness of her role and responsibilities Because of the size of the home and the way that it is run, the proprietors are in constant contact with the residents who routinely give feedback about how they are getting on. However, the manager may consider how to formally record feedback from residents, which might be done at reviews or at residents meetings. Minutes of residents meetings were seen which were mainly used for taking comments and suggestions, e.g. menus and planning future activities The Home has comprehensive policies for health and safety and these had been recently reviewed and were seen by the inspection. 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. Certificates seen by the inspector were up to date, and information supplied by the home prior to inspection indicated that all matters relating to health and safety were in order. Littlemoor House DS0000020042.V327792.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 X 4 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 x Littlemoor House DS0000020042.V327792.R01.S.doc Version 5.2 Page 24 yes 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 YA37 Regulation 9 Requirement The manager must enrol on NVQ training in management. Timescale for action 31/12/07 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 YA23 YA34 YA35 YA39 Good Practice Recommendations 1. 2. 3. 4 The home’s safeguarding adults policy should be updated and incorporate the latest local authority guidelines. The home’s job application forms should be updated to provide more space for previous employment details. Arrangements should be made for all staff to update first aid training. Formal quality assurance recording should be implemented. Littlemoor House DS0000020042.V327792.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Littlemoor House DS0000020042.V327792.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. 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