Inspection on 13/10/05 for Lomack House

This inspection was carried out on 13th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lomack House 26/11/08

Lomack House 11/07/06

Lomack House 03/05/05

Lomack House 29/11/04

Lomack House 18/05/04

Similar services:

Coopers Mill Ltd

Pocklington House

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

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

CARE HOME ADULTS 18-65 Lomack House 29-33 Elstow Road Kempston Bedfordshire MK42 8HD Lead Inspector Ansuya Chudasama Unannounced Inspection 13th October 2005 14:25 Lomack House DS0000014938.V258708.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 Lomack House DS0000014938.V258708.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. Lomack House DS0000014938.V258708.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Lomack House Address 29-33 Elstow Road Kempston Bedfordshire MK42 8HD 01234 840671 01234 840671 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) Lomack Health Co Ltd Ms Susan Nott Care Home 9 Category(ies) of Learning disability (9), Physical disability (9), registration, with number Sensory impairment (1) of places Lomack House DS0000014938.V258708.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd May 2005 Brief Description of the Service: Lomack House was registered in August 2001 and provides care for nine adults with learning disabilities. The two-storey detached home was converted from two private dwellings. The home does not have a passenger lift. Lomack Health Company manages the home. The home is located in the quiet Kempston residential area of Bedford. The accommodation consisted of nine single bedrooms, a conservatory, a spacious lounge, dining room and a kitchen. There were bathing facilities and toilets on both floors. The staff and the managers office were situated on the ground floor. The home had a large, attractive garden to the rear of the home. This was well maintained and used by staff and service users. Lomack House DS0000014938.V258708.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took over three hours. The registered manager, Sue Nott, was present at the inspection. The inspection was comprised of a tour of some of the communal areas, talking to staff, and one service user. One service users’ files and other records were inspected. The home had 9 service users and no vacancies at the time of the inspection. What the service does well: What has improved since the last inspection? What they could do better: The registered person must develop a quality assurance system based on the views of the service users and produce an annual development plan for the home. This requirement has been outstanding since the last inspection. The information on managing service users finances must be recorded in their care plans. This recommendation was not met since the last inspection. The home also needs to ensure that all service users are involved in managing their finances. Lomack House DS0000014938.V258708.R01.S.doc Version 5.0 Page 6 The care plans and risk assessments had been further developed. However more work was still required to make the risk assessments more clear to understand. The care plans also needed to all the information that was assessed for meeting service users needs. 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. Lomack House DS0000014938.V258708.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 Lomack House DS0000014938.V258708.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): The home had a statement of purpose and a service user guide but both documents needed to be updated to include information about services provided for people with physical disabilities and sensory needs. Assessments on service users were undertaken but some information needed to be explained in greater detail. EVIDENCE: The home had a statement of purpose and a service user guide. However both documents needed to be updated to include information on services provided by the home for people with physical disabilities and sensory impairment. The manager stated that this information was in the process of being updated after the assessments had been completed. A service user spoken to stated that they were not aware of the service users’ guide. The home needs to ensure service users are informed of this document. This document was displayed on the notice board. The service users’ file that was case tracked showed that the home undertook assessments prior to their admission. However the information in the assessment form needed expanding. One service users assessment form had a number of risk factors recorded but no information was recorded to explain why the service user was at risk. Lomack House DS0000014938.V258708.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): EVIDENCE: One service users care plan was inspected in detail. The plan needed expanding to state how the staff were helping the service users to manage their assessed needs. The plans did not have any information in how the service user was being helped to manage their finances or how they were helped to become more independent. Information recorded in the risk assessments was not always recorded in the care plan. There were guidelines seen in the service users file to state how the home managed the person’s behaviours. However this information was not recorded in the care plan. The service user spoken to stated that they helped with cooking and with household chores but again this was not recorded in the care plan. The service user also stated that she did not buy her own cloths. It was stated that the staff bought her clothes and she wanted to do this for herself. The service users risk assessments inspected needed to be clearer and user friendly. The information on hazards needed to be clearly recorded for Lomack House DS0000014938.V258708.R01.S.doc Version 5.0 Page 10 individual risks that were identified. The name of the service user was not always recorded on the form. Lomack House DS0000014938.V258708.R01.S.doc Version 5.0 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 the following standard(s): Choices are not provided for those who do not want what is offered on the menu board and there fore their prefences are not being met. EVIDENCE: The service user spoken to that was case tracked stated that they did not want the meal that was being prepared for the evening. It was stated that they wanted an alternative choice. However they were told by staff that the food being cooked was not fattening. It was stated that the other option given was that they would have to cook their own meal. Lomack House DS0000014938.V258708.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): None EVIDENCE: These standards were not assessed on this occasion but they were assessed at the last inspection. Lomack House DS0000014938.V258708.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): The arrangements for managing service users finances required reviewing to ensure that the service users were appropriately involved. EVIDENCE: The finances of the service user that was case tracked showed that a receipt dated 14th of October 2005 was signed by a staff member of the home for £262.93. This inspection took place on the 13th of October 2005. The inspectors found that the service user had signed some of the receipts when they were given money by the staff. However there were occasions when some receipts had not been signed by the service user but only by the staff. The inspectors spoke to the service user that was being case tracked. The service user was not aware of the receipt signed by staff, dated 14th of October 05. The person was also not aware of how their finances were being dealt by the home. It was stated that the home kept their bankbook and money, and they were given money when needed. The service user was very upset because their social worker had left in July 05. Since then they felt lonely and had no one to talk to about how they felt about living at the home. Lomack House DS0000014938.V258708.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): The standard of environment within the home is good and provides service users with an attractive and homely place to live. EVIDENCE: The home was clean but the office linked to the conservatory had an offensive odour. The office had three dogs in an open pen. The dogs barking frightened the inspectors. The inspectors felt that the office was not appropriate to accommodate the dogs in the office. It was also observed that there was not enough space to move around in the office. The registered person needs to undertake a risk assessment for having the dogs in the office. Through out the inspection the inspectors noticed that there was no interaction between the service users and the dogs in the office. The home needs to provide evidence to show that the service users had agreed to the staff bringing in their pets to the home. The manager stated that the conservatory had been re-decked, new furniture had been replaced with a new settee and an arm chair, the hallways and corridors had been painted and re-carpeted, the down stairs toilet had been decorated, five service users bedrooms had also been completely redecorated, the lounge had a new carpet. Lomack House DS0000014938.V258708.R01.S.doc Version 5.0 Page 15 An assessment was undertaken by the Occupational therapist for wheel chair users in the home. The recommendations were being implemented by the home. Lomack House DS0000014938.V258708.R01.S.doc Version 5.0 Page 16 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): None EVIDENCE: None of the standards were assessed on these occasion, but they were assessed at the last inspection. However the staff were observed working well with the service users and those spoken to stated that they still enjoyed working at the home. Lomack House DS0000014938.V258708.R01.S.doc Version 5.0 Page 17 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): The home did not have an annual development plan or quality monitoring systems in place to review aspects of its performance. EVIDENCE: The standard on quality assurance had not changed since the last inspection. The home did not have an annual development plan. The manager was still completing the quality assurance audit tool. It was stated by the manager that a service users, and a relatives survey was to be undertaken this month. The inspectors were given an action plan, which was hand written by a member of staff. However the handwriting was difficult to read and there was no explanation to state what information was used to get the action plan. The one service users file inspected had a questionnaire undertaken for the administration of medication. However there was no information recorded to state what action had been undertaken to the answers given to the questions. Lomack House DS0000014938.V258708.R01.S.doc Version 5.0 Page 18 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 X X x Standard No 22 23 Score X 1 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X 2 x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X x LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 x 17 Standard No 31 32 33 34 35 36 Score X X X X X x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Lomack House Score X X X x Standard No 37 38 39 40 41 42 43 Score X X 1 X X X x DS0000014938.V258708.R01.S.doc Version 5.0 Page 19 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 YA39 Regulation 24 Requirement The registered person must develop a quality assurance system based on the views of the service users and produce an annual development plan for the home. The time scale of 31.1.05 was not met. The registered person must provide evidence to show that the service users had been consulted regarding staff bringing in their pets to the home. Provide evidence by the 2.11.05 to the CSCI. A letter was written to the responsible individual on the 25th of October 2005, requesting this information. The registered provider must provide evidence in their care plans to explain how their finances are being managed by the home. This recommendation was not met from the last inspection. The registered person must ensure that all service users risk assessments undertaken are made clear and easy for service DS0000014938.V258708.R01.S.doc Timescale for action 20/12/05 2. YA24 16 07/11/05 3. YA6 15 17/12/05 4. YA9 13 20/12/05 Lomack House Version 5.0 Page 20 users to understand. 5. YA9 13 The home must ensure that the name of service users is at all times recorded on the risk assessments. Undertake a risk assessment for the office where the dogs are kept in the pen. Risk assessments undertaken at the assessment process must be explained to state why the service user is at a risk on the assessed needs. The registered person must ensure that all service users or their representatives are involved in managing their finances. The service users must sign also all receipts when transactions are being by the home. 01/11/05 6. YA9 13 07/11/05 7. YA23 16, 13 07/11/05 8. YA23 16, 13 02/11/05 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 4 5. Refer to Standard YA1 YA18 YA2 YA17 YA6 Good Practice Recommendations The manager should discuss the service users guide with the service users. The manager needs to ensure that all service users are involved at all times in choosing their clothes. The manager needs to expand the information in the service users needs assessment. The home needs to provide service users with at least two choices at meal times. Provide advocacy services for service users who feel that they need to talk to some one who is independent from the home. Lomack House DS0000014938.V258708.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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 Lomack House DS0000014938.V258708.R01.S.doc Version 5.0 Page 22 - 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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