Inspection on 05/05/05 for Littleover Lane Residential Care Home

This inspection was carried out on 5th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

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

Littleover Lane Residential Care... 24/11/06

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

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

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

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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 DE23 6JG Lead Inspector Claire Williams Unannounced Inspection 5th May 2005 10am 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. Littleover Lane Residential Care Home D52-C02 S1985 Littleover Lane V225484 050504 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Littleover Lane Residential Care Home Address 44 & 44a Littleover Lane, Littleover, Derby DE23 6JG 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) 01332 270154 Mencap (Homes Foundation) of Mencap Homes Foundation Acting manager - Rachael Pinks Care Home with Personal Care 9 Category(ies) of 9 service users in both gender, in the category registration, with number LD Learning Disability of places Littleover Lane Residential Care Home D52-C02 S1985 Littleover Lane V225484 050504 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 26/10/04 Brief Description of the Service: Littleover Lane is owned by Mencap. 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 separting the patio areas. Each house is run independently, in accordance with service user needs. Littleover Lane Residential Care Home D52-C02 S1985 Littleover Lane V225484 050504 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and started at 10am. The visit lasted 5 hours. The Inspector spent the majority of this time based in house number 44, and examined the records, spoke with the service users and staff, and did a partial tour of both houses. The inspector spoke with a relative who was visiting to attend a meeting at the home. What the service does well: What has improved since the last inspection? What they could do better: The staff need to ensure that support plans are reviewed and amended following a service user’s review or when there has been a change in that persons life. This is to ensure that the support plans are up to date with any changes made, and to ensure consistency of care. The communication processes with relatives could be improved to ensure that relatives are kept informed of issues relating to their relative living in the home. Both houses need some of the furniture repaired or replaced, as it looks worn and old. Some areas in both houses would benefit from being redecorated. The kitchen areas are also in need of some refurbishment. The storage of medication must be improved to prevent communal access. Littleover Lane Residential Care Home D52-C02 S1985 Littleover Lane V225484 050504 Stage 4.doc Version 1.30 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. Littleover Lane Residential Care Home D52-C02 S1985 Littleover Lane V225484 050504 Stage 4.doc Version 1.30 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 Littleover Lane Residential Care Home D52-C02 S1985 Littleover Lane V225484 050504 Stage 4.doc Version 1.30 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 Service users were assessed before moving into the home, and received information about the home in order to make an informed decision about living there. The assessments completed enabled the staff team to meet the service users individual aspirations and needs. EVIDENCE: The service users have lived at this care home for a number of years, and all individuals moved in as part of a planned admission process. The inspector examined two service users files; the initial care need assessments have been archived. However a new assessment of needs is completed following the reviews held for each service user. The service users spoken to confirmed that they still wanted to remain living at this home. The Statement of Purpose was examined during this visit. The document requires updating to include up to date information, and the details about the permanent manager appointed following the interviews that will be taking place later this month. Littleover Lane Residential Care Home D52-C02 S1985 Littleover Lane V225484 050504 Stage 4.doc Version 1.30 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 standard(s) 6,7,8,9,10 Detailed individual care plans are being developed at the home so that consistent patterns of support can be given and the welfare and safety of service users maintained. Service users are supported to make decisions in all aspects of their lives and are consulted about the running of the home. EVIDENCE: The inspector examined two files for service users who live at house number 44. The staff are in the process of updating the files and implementing new support plans for all of the service users who live there. The inspector examined one file that is currently being updated and one file that contains the ‘old paperwork’. Both files indicated that service users had a plan of care, individual to them, that was compiled as a series of ‘action plans’ and ‘risk assessments’. The areas covered within these plans were varied but included aspects of personal and health care specific to individuals. The risk assessments indicated key areas of concern and ways in which staff could minimise or eliminate any problems arising from these risks. Although support plans are being reviewed, one file contained some support plans that had not been changed and updated following the service users review. The inspector was informed that this was partially due to the keyworker for that Littleover Lane Residential Care Home D52-C02 S1985 Littleover Lane V225484 050504 Stage 4.doc Version 1.30 Page 10 individual leaving and the change over to a new keyworker. The information contained in both files confirmed that six monthly reviews were being held. There was limited evidence in the files to confirm the involvement of the service users in developing their support plans. The acting manager has started this process and was able to show the inspector a draft support plan that was completed with the involvement of the service user, and was signed by the service user in agreement. The inspector spoke with the two service users whose files were examined. During these discussions the service users confirmed that they were actively involved in making decisions about their lives, and were consulted on and participated in the daily running of the home. One service user informed the inspector that he has been invited to be part of the interview panel and will assist in the selection of new staff members. Service users have regular meetings with an advocacy representative in order to discuss issues about the running of the home. The outcomes of these meetings are then passed on to the acting manager. Service users are aware of the information stored about them and confirmed that this information is stored in a confidential manner. Littleover Lane Residential Care Home D52-C02 S1985 Littleover Lane V225484 050504 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14, 15,16 Service users have access to varied opportunities, and life experiences in order to develop independent living skills. Opportunities were tailored to individual interests and abilities. Service users were encouraged to maintain contact with families and friends and individual routines within the home were respected. Service users living at this home are unable to access employment or full time education. EVIDENCE: The service users spoken to confirmed that they do not attend any structured daily activities and that this was their individual choice, which was respected by the staff team. Both service users confirmed that they choose how they spend their day and the activities undertaken. For example one service user spends his time reading, which is his favourite activity, and another service user visits his girlfriend on a daily basis. Both service users assist in the general up keep of the house and assist in all tasks in order to maintain and develop independent living skills. These responsibilities are specified in their support plans. Littleover Lane Residential Care Home D52-C02 S1985 Littleover Lane V225484 050504 Stage 4.doc Version 1.30 Page 12 Service users confirmed that they are supported to attend a variety of leisure and community activities of their choice. One service user informed the inspector that he accessed community facilities independently, and this was supported by the staff team, who complete risk assessments to minimise any potential risks to him. Both service users confirmed that they have been encouraged to vote, as this was an election day, and one service user stated that he might exercise his right to vote later that day. Both service users confirmed that the daily routines of the home are flexible and promote their independence, choice, and freedom of movement, in accordance with their individual support needs. The inspector spoke with a relative of a service user who lives in house number 44a. The relative commented that she was concerned about the inconsistency in the delivery of care from the staff team and the deterioration in the communication processes between herself and the staff team. The relative felt that improvements could be made in these areas. The inspector discussed these concerns with the acting manager. Littleover Lane Residential Care Home D52-C02 S1985 Littleover Lane V225484 050504 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, and 20 Service users receive support in personal care tasks in a manner, which promotes their dignity and in accordance with individual support plans. Service users are monitored and access to healthcare facilities is supported to maintain service users health. EVIDENCE: Discussions with Service users, and the examination of records confirmed that service users physical and emotional health needs were being met at the home. Service users confirmed that the staff team support them in personal care tasks in a manner, which is accordance with their individual preferences. One service user informed the inspector that due to his physical immobility he couldn’t use the bathroom situated on the first floor of the house. He stated that he has been involved in discussions, and the proposals of building a shower room on the ground floor, and is currently waiting for the return of some quotes for the work. The management of medication was not fully examined on this occasion, but the health needs and medication taken by the service user case tracked was discussed. One service user requires daily injections of insulin, which is facilitated by the District Nurse. However the insulin is in a container that is stored in the communal fridge. This practice is illegal and is putting all service users at risk as they have easy access to this medication. Littleover Lane Residential Care Home D52-C02 S1985 Littleover Lane V225484 050504 Stage 4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The home has robust policies and procedures in place to protect the service users from harm. Service users feel that their views are listened to. EVIDENCE: Local multi-agency policies and procedures are in place for the protection of service users from harm and abuse. Staff records demonstrate that they receive training on how to implement these procedures, and how to respond to incidents. There has been 1 incident at the home between two service users that has been subject to investigation and the Statutory Procedures have been put into operation, involving the local Social Services Department. Strategies and risk assessments have been implemented in order to minimise any risks to both service users, and the situation is being monitored. Mencap has implemented a new complaints procedure, and a format that is accessible to the service users is currently being developed. Service users can still access the previous complaint form. Service users confirmed to the inspector that any concerns raised have been listened to by the acting manager or staff. One service user informed the inspector that he did not like the way that some staff members spoke to him and stated that they “wind him up”. The service user confirmed that he had raised this with the acting manager who had listened and responded to this concern in accordance with his wishes. The acting manager informed the inspector that no complaints have been received since the previous inspection visit. Littleover Lane Residential Care Home D52-C02 S1985 Littleover Lane V225484 050504 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25, and 30 Improvements to the environment in both houses are required in order to provide a homely and safe living environment for service users to enjoy. EVIDENCE: Both houses are homely and domestic in style. However the furniture and decoration is beginning to look worn in both houses, which creates a poor first impression of the home. A new fire alarm system has been fitted in house number 44, and no remedial action as been taken to cover the structural damage caused by removing the old system. The following areas require attention. • • • • • • The kitchen in house 44 has broken units and surfaces look worn The toilet area in house 44 has an odour and pipe work looks dirty. The carpet in house 44a looks loose due to the number of times it has been cleaned. The kitchen and surfaces in house 44a looks worn. Several pieces of furniture in both houses look worn, as the paintwork is badly chipped. Several carpets look stained and worn in both houses. Littleover Lane Residential Care Home D52-C02 S1985 Littleover Lane V225484 050504 Stage 4.doc Version 1.30 Page 16 The inspector was invited to look at two bedrooms by the service users. All rooms provided are of single occupancy. One service user had the provision of an en-suite facility, which he liked as it meant he didn’t have to share a bathroom with anyone. Both bedrooms were personalised by the service users and contained the required items. Both service users held keys to their rooms. Although service users are encouraged and assisted in the general cleaning of the home, some areas in house number 44 were not clean, for example areas in the kitchen were stained from the preparation of food. The communal areas were dusty as were service users bedrooms. The inspector spoke with a relief worker who has worked at the home for several years. She commented on how difficult it was to encourage the service users to undertake household cleaning tasks, and the time spent by staff undertaking cleaning duties rather than working directly with the service users. Littleover Lane Residential Care Home D52-C02 S1985 Littleover Lane V225484 050504 Stage 4.doc Version 1.30 Page 17 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) 31, 33, 34, 35 and 36 The home is well staffed with experienced, skilled and knowledgeable people who are receiving regular training to help them assist service users in more efficient and safe ways. New staff are recruited to the home by robust procedures so that service users are protected from harm. EVIDENCE: Although the home has 2 vacancies the staffing hours are now maintained in accordance with contractual arrangements. Improvements have been made in the recruitment checks undertaken when using relief staff from agencies. All agency staff now receive a planned induction to the home and to service users; written confirmation is obtained. The company operating this home has a well-established recruitment and selection process for staff and this was in routine operation. The files for 2 staff were examined and all the documents required by the revised Regulations were seen to be in place. Staff spoken to confirmed their access to regular training and development opportunities, and records of training supported this. Staff confirmed that they receive regular supervision from the acting manager. Staff files confirmed this although the recommended target of six sessions per year was not achieved. There was no evidence to suggest that staff are receiving an annual appraisals. Littleover Lane Residential Care Home D52-C02 S1985 Littleover Lane V225484 050504 Stage 4.doc Version 1.30 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 and 38, Service users and the home would benefit from the managers position being filled by a permanent registered manager. EVIDENCE: The home has been managed by an acting manager for over a year. The position has been advertised and the closing date is this month. This situation has caused some uncertainty for the staff and the service users as they are unsure who will be their permanent manager. Both staff and service users confirmed that the acting manager was approachable and supportive. However due to the uncertainty of the situation, the acting manager has experienced some resistance from the staff team in implementing new changes. The Acting manager is currently completing a Registered Manager’s course (NVQ4) and is experienced in working with this service user group. Littleover Lane Residential Care Home D52-C02 S1985 Littleover Lane V225484 050504 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 x x x x 3 Standard No 11 12 13 14 15 16 17 3 N/A 3 3 2 3 x Standard No 31 32 33 34 35 36 Score 3 x 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Littleover Lane Residential Care Home Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 2 3 x x x x x D52-C02 S1985 Littleover Lane V225484 050504 Stage 4.doc Version 1.30 Page 20 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 6 Regulation 15 (2) (b) (c) Requirement The registered person must ensure that individual support plans are reviewed and amended following reviews or changes in suport needs. (Previous timescale of 31/2/05 not met) The registered manager must ensure that service users are consulted and involved in the development of their care plan The registered manager must ensure that relatives are kept informed about the well-being and care of a service user living in the home The registered person must ensure that insulin is stored in a lockable fridge that is not used for communal use. The temperature of this fridge must be maintained. The areas damaged by the removal of alarm must be redecorated. The units in the kitchen in house 44 must be repaired or replaced The toilet in House 44 must be redecorated The carpet in house 44a must be Timescale for action 31st August 2005 2. 6 15 (1) 31st August 2005 31st August 2005 3. 15 16 (m) 4. 20 13 (2) 31st July 2005 5. 6. 7. 8. 24 24 24 24 23 (2) (b) 23 (2) (b) 23 (2) (b) 23 (2) (b) 31st August 2005 31st September 2005 31st September 2005 31st August Page 21 Littleover Lane Residential Care Home D52-C02 S1985 Littleover Lane V225484 050504 Stage 4.doc Version 1.30 replaced 9. 10. 11. 12. 13. 24 24 24 24 27 23 (2) (b) 23 (2) (b) 23 (2) (b) 23 (1) 8 2005 T he kitchen surfaces in house 31st 44a must be replaced or repaired September 2005 The furniture that is worn in both 31st houses must be repaired or September replaced. 2005 The carpets in both houses that 31st are stained and worn must be September replaced. 2005 A programme of decoration and 31st refurbishment must be September developed 2005 A permanent manager must be 31st August appointed and seek registration 2005 with the Commission 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. 4. 5. Refer to Standard 1 6 24 36 36 Good Practice Recommendations The statement of purpose should be updated following the appointment of a permanent manager. The registered manager should ensure that all staff are consistent in the delivery of care and support to service users. The registered manager should ensure that both houses are clean, hygenic and free from odours. The registered manager should supervise all staff at least six times per year. The registered manager should ensure all staff receive an annual appraisal Littleover Lane Residential Care Home D52-C02 S1985 Littleover Lane V225484 050504 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection South Point 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. 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