Inspection on 03/05/05 for Lomack House

This inspection was carried out on 3rd 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Lomack House 26/11/08

Lomack House 11/07/06

Lomack House 13/10/05

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 Beds MK42 8HD Lead Inspector Ansuya Chudasama Announced 3 May 2005 rd 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. Lomack House I51 S14938 Lomack House V213998 AI 030505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Lomack House Address 29-33 Elstow Road Kempston Beds MK42 8HD 01234 840671 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) Lomack Health Co Ltd Susan Nott Care Home 9 Category(ies) of LD - Learning Disability (9) registration, with number PD - Physical Disability (9) of places SI - Sensory Impairment (9) Lomack House I51 S14938 Lomack House V213998 AI 030505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th November 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. 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. T he staff and the manager’s 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 I51 S14938 Lomack House V213998 AI 030505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was undertaken at 9.30am, and it took place over 11 hours. The registered manager, Sue Nott, was present at the inspection. The inspection was comprised of a tour of the communal areas, two service users’ bedrooms, talking to staff, and talking to two service users. The inspector did not speak to one service user because she was not happy having a stranger (inspector) in her home. Three service users’ files and other records were inspected. The home had 9 service users and no vacancy at the time of the inspection. What the service does well: What has improved since the last inspection? The home had improved the old care planning document, but further work was still required to include all the information stated in the standard. Most of the Lomack House I51 S14938 Lomack House V213998 AI 030505 Stage 4.doc Version 1.30 Page 6 requirements from the previous inspection had been met. A new risk assessment format had been developed. Documents such as the admissions assessment, individual life style agreement, risk assessments, medical appointment chart, medical records, accommodation agreement, reviews and finances were discussed with service users. 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. Lomack House I51 S14938 Lomack House V213998 AI 030505 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 Lomack House I51 S14938 Lomack House V213998 AI 030505 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) 1,2,4,5 The home’s statement of purpose and service users’ guide provided service users and their families with details of the services the home provides, enabling an informed decision about admission to the home. EVIDENCE: The home had a statement of purpose and a service users’ guide. It was stated that these documents were sent out to perspective service users and their families. The statement of purpose stated that the home was able to cater for service users who had a physical or sensory impairment. However, the document did not state what facilities and services the home provided to meet their needs. Three service users’ files inspected showed that an admissions assessment had been undertaken by the home. Some of the information in one assessment needed expanding. Relevant information from other professionals was obtained for all service users prior to their admission. Two service users had visited the home on an introductory basis but one service user was admitted on an emergency situation. This service user had been given information about the home prior to her admission. Two service users spoken to stated that they had not seen the service users’ guide. The home should display a copy of this document where all service users can view it. The guide needed to be available in a format that was userLomack House I51 S14938 Lomack House V213998 AI 030505 Stage 4.doc Version 1.30 Page 9 friendly. Two service users had a copy of the contract, which was signed by them and the manager. One service did not have a contract and the manager informed the inspector that the service user did not have one until the service user was made permanent at the home. The home did not admit service users whose needs they could not meet. Lomack House I51 S14938 Lomack House V213998 AI 030505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9,8,10 The home had care planning systems in place to adequately provide staff with the information they need to satisfactorily meet service users’ needs. EVIDENCE: The service users’ files inspected had care plans and contained information about the service users’ needs. However, they still needed to be further developed as discussed at the inspection to include all the information stated in standard 2. The care plans were linked with the service users’ individual lifestyle agreement, which contained information on how the service users were involved in how their care was to be provided by the home. The document was signed by the service user and the manager. The two service users interviewed were able to give examples of how the staff helped them met their personal, social and healthcare needs. Discussion with staff who worked with these service users showed that the staff were very aware of their care needs. The home used pictures to discuss risk assessments with service users. It was stated that this worked very well because the service users got involved in identifying and discussing ways of minimising the risks with support from staff. The home had developed a new format for undertaking risk assessments for service users. This format was Lomack House I51 S14938 Lomack House V213998 AI 030505 Stage 4.doc Version 1.30 Page 11 good and the manager stated that she had started to replace the old risk assessments with the new forms. Staff training records showed that all staff had received training on confidentiality as part of their induction and staff spoken to at the inspection confirmed this. Service users, finances checked were correct. Service users and staff signed receipts when money was given to them. The manager, on a six-monthly basis, audited all service users’ money. The service users’ care plans inspected did not state how they managed their finances. One of the service users spoken to stated that when she required money, she asked the care practice facilitator for this. Lomack House I51 S14938 Lomack House V213998 AI 030505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16,17 The dietary needs of service users were well catered for with a balanced and varied selection of food available that met service users’ choices and needs. The ethos of the home enables service users to maintain appropriate and fulfilling lifestyles in and out side the home EVIDENCE: The service users’ files inspected showed that they undertook fulfilling activities to develop their personal, social and independent living skills. The staff spoken to stated that they encouraged and supported service users to pursue their own interests and hobbies. This was observed when viewing service users’ bedrooms. The two service users spoken to stated that they attended college, adult training centres, social clubs, and shopping. They also helped with meal preparation, and undertook domestic chores in the home. They enjoyed going on outings and holidays that were chosen by them. During the summer weeks they went on an outing once a week for six weeks and enjoyed this. One of the service users stated that he was excited as he was going to vote. Service Lomack House I51 S14938 Lomack House V213998 AI 030505 Stage 4.doc Version 1.30 Page 13 users’ meetings were held on a monthly basis. They also had one-to-one discussions with their key workers. The service users’ records inspected had information on their likes and dislikes for food. They were also involved in choosing the meals for the menus. The service users stated that the meals provided were very nice, but one service user stated that he wanted to have omelette more often. The inspector observed staff supporting service users to prepare the evening meal in a positive manner. Service users’ records showed that they visited their families and friends, and the home had an open-door policy for visits. One service user informed the inspector that sometimes he opened his mail and other times the staff opened his mail. The inspector discussed this with the staff member who worked with the service user. It was stated that when staff opened a service user’s mail, it would be only done with the permission of the service user and in their presence. The reasons for opening service users’ mail by staff need to be recorded in service users’ care plans. Lomack House I51 S14938 Lomack House V213998 AI 030505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19,20, The health needs of service users are well met with evidence of good multidisciplinary working taking place on a regular basis. The medication at the home is well-managed, and therefore promotes good health for service users. EVIDENCE: One of the service users stated that her key worker bought her clothes for her, and sometimes she went out with her to choose her clothes. However, she wanted to go with staff all the time to buy her clothes. Service users’ records showed that the health services appointments attended were well recorded and signed by staff. Charts and guidelines on how to deal with service users who had behavioural problems were drawn up. The information was discussed with the relevant professionals. The home also sent reports to the GP on a six- to eight-weekly basis to keep them informed about the service user’s progress. Letters written to the relevant professionals showed that the home monitored and made early referrals to the appropriate specialist. The staff spoken to stated that they supported service users to understand their medical condition, and supported them when they attended their appointments. They also Lomack House I51 S14938 Lomack House V213998 AI 030505 Stage 4.doc Version 1.30 Page 15 demonstrated that they had a good understanding of service users’ health care needs. One of the service users stated that she went to the GP to have her injection, and she was aware why she was having this. It was stated that the home had built up good working relationships with health professionals. The home had devised a form, which contained detailed information about the service user’s needs, and this was used for providing information for hospital admissions. The staff were familiar with the medication policy, and they had all attended the medication training. The medication records checked were satisfactory. There were guidelines for service users refusing to take medication. Service users medication reviews were undertaken regularly, and this was recorded well. Lomack House I51 S14938 Lomack House V213998 AI 030505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 The staff had good knowledge and understanding of adult protection issues, which protects service users from abuse. EVIDENCE: The home had policies and procedures on adult protection. The training records of staff seen showed that all staff had attended training on adult protection, and on how to deal with physical and verbal aggression. This was also confirmed by talking to staff about the multi-agency protocol for protection of vulnerable adults, and how they dealt with service users who had challenging behaviours. The home had a complaints policy, and this was available in the service users’ guide. The home had not received any complaints since the last inspection. The two service users spoken to stated that they would speak to the manager and their key workers or staff if they were unhappy. The service users’ comment cards received stated that all the service users knew who to speak to if they were unhappy with their care. The service users spoken to stated that they had not seen the complaints procedures. Lomack House I51 S14938 Lomack House V213998 AI 030505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,29,30 The standard of the environment within this home is good, providing service users with an attractive and homely place to live. EVIDENCE: The home was clean and pleasantly decorated. The service users spoken to stated that they liked their bedrooms and enjoyed living at the home. The bedrooms seen were individualised to meet service users’ needs. All service users had single rooms, and the service users spoken to had their own keys for locking their rooms. The home had sufficient numbers of bathrooms and toilets to meet service users’ needs. The adapted bathroom and toilet were on the ground floor. The home had two service users who were wheelchair users. The inspector observed a service user in a wheelchair struggling to get out of the door of the dinning room. The home would benefit from having an assessment undertaken by a suitably qualified specialist on the environment. Lomack House I51 S14938 Lomack House V213998 AI 030505 Stage 4.doc Version 1.30 Page 18 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) 31,32,33,34,35,36 Staff morale was good, resulting in an enthusiastic workforce that works positively with service users to improve their whole quality of life. EVIDENCE: The staff files inspected had all the relevant information required in the standard. The staff spoken to had been given a job description, and they were clear about their roles. They stated that they enjoyed working at the home and with the service user group. It was also stated that they had good working relationships with service users. The staff also said that the home provided excellent training courses and this was confirmed when inspecting the staff-training programme. All staff received supervision on a regular basis and the dates for supervision and team meetings were recorded for the whole year. The staff had also received appraisals. It was stated that they worked well as a team and this was observed on the day of the inspection. The home had a very low turnover of staff, and a good ratio of staff-to-service users was being met. Records showed that 93 of the staff had achieved NVQ level 2 or above. Lomack House I51 S14938 Lomack House V213998 AI 030505 Stage 4.doc Version 1.30 Page 19 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) 37,38,39,41,42 The home is managed well and run efficiently, therefore providing a safe and stable environment for the service users living there. EVIDENCE: The registered manager was qualified and had many years’ experience working with the service user group. Evidence on the day of the inspection showed that she managed the home very well. The staff spoken to stated that the manager had an open-door policy and she was very supportive. The manager had started completing the annual quality audit, and she had completed most of the information in the document. It was stated that a service users and relatives survey was to be undertaken this month, and the outcome was going to be used for developing the annual development plan. The CSCI did receive regulation 26 visits, but these needed to be more detailed in the information that was provided. Lomack House I51 S14938 Lomack House V213998 AI 030505 Stage 4.doc Version 1.30 Page 20 Service users spoken to stated that they had fire drills and they knew what to do if there was a fire. Staff spoken to stated that they had received fire safety training, and health and safety checks were carried out on a regular basis. A service user stated that she had asked to read her notes and information in her communication book. She was told that this was not allowed. The reason why she is not able to have this information should be explained to her. Lomack House I51 S14938 Lomack House V213998 AI 030505 Stage 4.doc Version 1.30 Page 21 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 2 3 x 3 3 Standard No 22 23 ENVIRONMENT Score x x 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 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 4 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 4 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Lomack House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x 2 3 x I51 S14938 Lomack House V213998 AI 030505 Stage 4.doc Version 1.30 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 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 31.105 was not met. Timescale for action 30.8.2005 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. 6. 7. Lomack House I51 S14938 Lomack House V213998 AI 030505 Stage 4.doc Version 1.30 Page 23 Refer to Standard Ya1 Ya18 Ya 9 ya16 Ya7 Good Practice Recommendations The manager should display the service users guide where it can be viewed by all the service users. The manager needs to ensure that service users are involved at all times in choosing their clothes. The manager needs to complete the new risk assessments on all service users The manager needs to ensure when staff open service users mail, the reasons for this needs to be recorded in their care documents. The manager needs to ensure that information is recorded in the service users care plans to state how their money is being managed. Lomack House I51 S14938 Lomack House V213998 AI 030505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Clifton House 4a Goldington Road Bedford MK42 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. 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