Inspection on 24/11/06 for Littleover Lane Residential Care Home

This inspection was carried out on 24th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Littleover Lane Residential Care... 18/10/07

Littleover Lane Residential Care... 19/10/05

Littleover Lane Residential Care... 05/05/05

Littleover Lane Residential Care... 26/10/04

Littleover Lane Residential Care... 10/05/04

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Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Littleover Lane Residential Care Home 44 & 44a Littleover Lane Littleover Derby Derbyshire DE23 6JG Lead Inspector Unannounced Inspection 24th November 2006 09:15 Littleover Lane Residential Care Home DS0000001985.V317923.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 Littleover Lane Residential Care Home DS0000001985.V317923.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. Littleover Lane Residential Care Home DS0000001985.V317923.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Littleover Lane Residential Care Home Address 44 & 44a Littleover Lane Littleover Derby Derbyshire DE23 6JG 01332 270154 01332 270154 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) www.mencap.org.uk Royal Mencap Society Rachael Jane Pinks Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Littleover Lane Residential Care Home DS0000001985.V317923.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th October 2005 Brief Description of the Service: Mencap lease Littleover Lane. The accommodation comprises of two houses, which provide personal care for up to 9 service users with a learning disability, aged between 18 and 65 years of age. Five service users occupy house number 44, and four service users live at house number 44a. Both houses have been furbished to reflect the style of a family home. Both houses have an accessible garden, which is segregated with a garden fence and a gate separating the patio areas. Each house is run independently, in accordance with service user needs. Littleover Lane Residential Care Home DS0000001985.V317923.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over five hours. The inspector spoke with the Registered Manager and members of staff on duty. During the site visit the inspector made a tour of the home and spoke with service users, the remaining service users were at the local day centre. The inspector observed throughout the visit how the staff were meeting service user needs. Records were examined relating to the service users and the running of the home. No family or relatives were present during this visit. Since the last inspection there has been no change in the service users living at the home. Information on weekly fees was not available. The home current makes additional charges for hairdressing, social activities, transport and holidays. Mencap make a contribution of £111.00 towards holidays for service users’ holidays. From the nine questionnaires sent out five completed ones were returned and all stated they were quite settled at the home and only one was willing to speak with the inspector. What the service does well: What has improved since the last inspection? The home has been successful in obtaining the landlord’s agreement to both houses being refurbished and to the general improvement of the home environments. Mencap have provided new furniture and carpets for both houses. Littleover Lane Residential Care Home DS0000001985.V317923.R01.S.doc Version 5.2 Page 6 The majority of the previous requirements have been met. The home has been successful in recruiting staff and now has one part time vacancy What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Littleover Lane Residential Care Home DS0000001985.V317923.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 Littleover Lane Residential Care Home DS0000001985.V317923.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): Standard 2 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Arrangements are in place to ensure that service users needs are fully assessed and met prior to admission. EVIDENCE: The majority of the service users who are admitted to the home have their needs assessed by social workers or through the care management system. The assessments then form part of the service user’s plan compiled by the home. All of the nine service users were admitted to the home prior to 1999, and their initial needs assessment have been archived. There was evidence that the placing Authority reviews the care needs assessments on a regular basis. Littleover Lane Residential Care Home DS0000001985.V317923.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a care planning and review system in place, which ensures that service user’s individual needs are met. Service users are supported to achieve an independent lifestyle and participation in all aspects of the life at the home is encouraged. EVIDENCE: During the visit care plans of two service users were examined. The care plans have been compiled by the staff on each service user and evidence was seen of care plans being reviewed on a regular basis. All files have been transferred to the new format of “ Personnel Centre Planning.” All care plans were very detailed and comprehensive including services users’ individual lifestyle preferences and choices; the interventions prescribed by outside healthcare professionals were appropriate. Daily records are also maintained on each service user. Littleover Lane Residential Care Home DS0000001985.V317923.R01.S.doc Version 5.2 Page 10 Care plans were personalised and have been complied with the service users together with friends and /or the Advocacy Service. However the service users or their representatives had not signed these. Detailed risk assessments were in place and these included actions to be taken by staff. Littleover Lane Residential Care Home DS0000001985.V317923.R01.S.doc Version 5.2 Page 11 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): Standard 12,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were arrangements in place to enable service user to maintain and develop appropriate relationships, and to participate in activities both in the home and outside in the wider community in accordance with their preferences and wishes. The home provides a well-balanced and nutritious diet. EVIDENCE: The care records of two service users provided detailed needs assessment and care planning information regarding their social, recreational, educational and occupational activities both within the home and outside in the community. Several of the service users are unable to work due to their level of disability, however some are able to attend the local day centre for adults with a learning disability for up to five days per week. The service users’ personal goals, Littleover Lane Residential Care Home DS0000001985.V317923.R01.S.doc Version 5.2 Page 12 choices and preferences were identified and there were properly recorded risk assessments in place for each service user in relation to the activities they were engaged in. The care staff have taken the service users on holiday for the first time this year to Centre Parcs, with the holiday being tailored to the individual needs and abilities of the service user. Information on service users’ records indicated that contact with family and friends were appropriate. From examination of the menus the home is providing a healthy well-balanced and nutritious diet. Service users with staff support undertake the food shopping, which is based on their individual preferences. The Registered Manager stated they are looking to develop this further as service users can not fully visualise what they are they have purchased in relation to a cooked meal. The fridge temperatures were seen and were within a safe range. Littleover Lane Residential Care Home DS0000001985.V317923.R01.S.doc Version 5.2 Page 13 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): Standards 18,19and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health needs of service users are well documented ensuring that individuals receive regular health checks. Service users receive personal support in a way that promotes their independence. EVIDENCE: During the visit it was clear that the service users’ privacy and dignity are respected, and where service users need regular supervision during personal care this is recorded in their personal centred plan From records examined and from discussions with staff, this showed that service users’ health and personal needs were being met Service users were generally healthy and records showed that staff promptly contacted the appropriated medical services. All service users attended services within the community including optician, podiatry and dentist. The home operates and monitors service users medication. None of the service users are able to administer their own medication. All staff have received training on medication dispensing procedures. Littleover Lane Residential Care Home DS0000001985.V317923.R01.S.doc Version 5.2 Page 14 The arrangements for receipt, storage, administration and disposal of medication were also examined and found to be satisfactory. There was an audit trail of medication used at the home. The medication audit trail should also include the home’s stock of paracetamol and homely remedies used. The inspector examined the temperatures of the medication fridge; these were within a safe range. Littleover Lane Residential Care Home DS0000001985.V317923.R01.S.doc Version 5.2 Page 15 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): Standards 22 and 23 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to this service. Arrangements are in place to safeguard service users’ welfare and ensure that their concerns are listened to and acted upon. All staff receiving training on the safeguarding adults would further strengthen and support this. EVIDENCE: The home has a complaints procedure with a summary and a complaints form included in the service users guide, which all service users have a copy of. Mencap have developed a format which is accessible to service users as several of the service users are not able to fully communicate their concerns. The Registered Manager confirmed that the home had good links with the Derbyshire Advocacy Service, and they support the service users in making complaints should they wish to do so. All complaints are dealt with at a formal level, which results in the home having a high number of complaints. The Commission for Social Care Inspection has received no complaints about this service since the last inspection. The procedure contains the current address of the Commission for Social Care Inspection and informs the complainants that they are able to contact the Commission at any stage of the complaint if they wish to do so. As discussed at the visit, the policy will need amending to reflect the change of procedure by the Commission for Social Care Inspection when dealing with complaints. On examination of the records the Registered Manager is not currently providing a written response to complaints received. Littleover Lane Residential Care Home DS0000001985.V317923.R01.S.doc Version 5.2 Page 16 From discussions with the care staff and from records examined there has been no reported incidents or allegations under the safeguarding of adults procedure since the last inspection. The Registered Manager reported that all but two members of staff had completed training on adult protection and are scheduled to access this training in February 2007. Littleover Lane Residential Care Home DS0000001985.V317923.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): Standards 24, 28 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The general standard of the home and the environment are good providing service users with an attractive and comfortable place in which to live. However the quality of air in one of the houses was poor. EVIDENCE: The inspector conducted a tour of the home and all communal areas were inspected together with the staff facilities. The staff are required to do sleep in duty in one of the houses, the other house have a waking night staff. The requirements from the last two inspections regarding the physical environment have been addressed. Both homes are comfortable and reflect the service users individual preferences and choice of decoration. The Registered Manager has drawn up an annual maintenance programme for renewal of the fabric and decoration of the premises. This will assist with the overall maintenance of the home. Littleover Lane Residential Care Home DS0000001985.V317923.R01.S.doc Version 5.2 Page 18 Although there were no unpleasant odours, there have been concerns raised by service users regarding secondary smoking. At present two service users smoke in one of the house, which accommodates five service users. The Derbyshire Advocacy Service held a meeting with service users and it was agreed that they could smoke in the dining room. However this does not seem to be working and smoking in the dining room is not ideal. The staff have commented that they have to close all the doors in the house as the smoke gets in all the rooms. The Registered Manager stated that they do not currently have a no smoking policy in the home. However Mencap have a duty of care to all service users and staff regarding their health, welfare and environment they live in. The National Minimum Standard 28.2 (vi) states shared space includes “ a separate smoking area if the home does not have a no smoking policy.” Following discussions with the Registered Manager during the inspection Mencap are now looking into this issues Littleover Lane Residential Care Home DS0000001985.V317923.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): Standards 32,34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has robust recruitment procedures and practices in place which ensure the safety and protect the service users. Importance is given to the staff’s developmental needs. EVIDENCE: The home operates a key-worker system and the staff spoken with during the visit where aware of the individual needs of the service users. From records examined during the visit 50 of the staff have attained or are working toward a National Vocational Qualification at level 2. There is a staff recruitment policy and procedures in place and from records examined all staff are required to have a current and valid Criminal Records Bureau check, two references and medical clearance. All recruitment records are held by the home in a secure cabinet. The inspector examined two staff records one, a long established member and the other, a newly appointed member of staff. As discussed with the Registered Manager staff recruitment records need must be line with Schedule 2 and 6 of the National Minimum Standard Care Homes for Adults (16-65) 2001. Littleover Lane Residential Care Home DS0000001985.V317923.R01.S.doc Version 5.2 Page 20 Although the home had evidence that all staff had Criminal Records Bureau clearance to an enhanced level, it was not possible to establish that they had been checked against the Protection of Vulnerable Adults/Protection of Vulnerable Children (POVA/POVCA). The Criminal Records Bureau categories on the clearance had been destroyed. The Registered Manager needs to check with the Criminal Records Bureau as to what information can be destroyed after clearance has been obtained. The inspector examined staff training records and the training matrix. The records confirmed that the staff team have attended all the mandatory training as required by the regulations. Mencap have combined the induction and foundation training for new staff, and this covers the six-month probationary period. The Registered Manager stated that additional training is planned for all staff on Personnel Centre Planning. All staff have a Personnel Development Plan. There was evidence in staff records to show that staff appraisals were being undertaken and staff were receiving regularly supervision. However staff did comment that this still gets cancelled on occasions. Littleover Lane Residential Care Home DS0000001985.V317923.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): Standards 37,39 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has systems in place to review it performance, and to ensure that service users have a voice and their views are listened to. However the situation around the transfer of managers needs to be resolved quickly as possible to ensure the overall effective management of the home. The Registered Manager has knowledge and experience in caring for adults with a learning disability and challenging behaviour. She has been successful in obtaining her registration with the Commission for Social Care Inspection, and has two units to complete before she gains her recognised mangers award. The Registered Manager is moving to another home this is an internal move within Mencap. The Commission for Social Care Inspection has not been informed officially of the transfer, the Registered Manager wanted the service users and staff to be made aware first as its only just been decided. The manager will need to register with the Commission for Social Care Inspection. Littleover Lane Residential Care Home DS0000001985.V317923.R01.S.doc Version 5.2 Page 22 The organisation has effective quality assurance systems in place. Mencap complete an internal audit/review of the service and comprehensive report with recommendations is sent to the home. The service users, relatives and stakeholders are sent questionnaires in order to obtain their views of the running of the home. However the Registered Manager was unsure as to whether the findings are made public representative from Mencap regularly undertakes monitoring visits to the home in accordance with regulation 26. A sample of service/maintenance records was examined (including gas and electricity services) and there was confirmation that all the equipment had been properly maintained. Evidence of checks having been carried out was provided to the Commission for Social Care Inspection Systems were in place for the monitoring and maintaining the hot water temperatures. All portable appliances (PAT) were tested in Sept 2005, however the Hard Wiring report was unsatisfactory following the inspection of 2004. The Registered Manager agreed to follow this up and inform the Commission for Social Care Inspection of the outcome. EVIDENCE: Littleover Lane Residential Care Home DS0000001985.V317923.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 X 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 2 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 2 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 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 2 X 2 X 2 X X 2 X Littleover Lane Residential Care Home DS0000001985.V317923.R01.S.doc Version 5.2 Page 24 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 2 Standard YA20 YA22 Regulation 12 22 Requirement The home must maintain a record of all medication recevied and administered by the home. The complaints procedure must include the current contact details for the Commission for Social Care Inspection. The home must ensure that adequate private and communal accommodation is provided for service users needs and activities. The home must develop a policy regarding smoking within the home. The Registered Person must ensure that the transfer of Managers’ takes place as soon as possible to avoid any uncertainty against the service users and staff group. The results of any reviews conducted by the Registered Person must be made public. The home must ensure have a current and valid Hard Wiring certificate. Timescale for action 31/12/06 31/12/06 3 YA28 23 31/12/06 4 5 YA28 YA37 23 8 31/12/06 31/12/06 6 7 YA39 22 23 31/12/06 31/12/06 YA42 Littleover Lane Residential Care Home DS0000001985.V317923.R01.S.doc Version 5.2 Page 25 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 YA22 YA36 YA38 Good Practice Recommendations Then Registered Manager should where possible give a written response to all complaints received. The Registered Manager should reschedule any staff supervision, which has been cancelled. The Registered Persons should consider some team building exercises to improve the communication processes, and to improve staff morale. (This is a previous recommendation.) Littleover Lane Residential Care Home DS0000001985.V317923.R01.S.doc Version 5.2 Page 26 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 Littleover Lane Residential Care Home DS0000001985.V317923.R01.S.doc Version 5.2 Page 27 - 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. 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