Inspection on 13/12/06 for Longacre Neurological Support Unit

This inspection was carried out on 13th December 2006.

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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Longacre Neurological Support... 16/01/09

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Longacre Neurological Support Unit Howletts Loke off Station Road Salhouse Norwich Norfolk NR13 6EX Lead Inspector Mr Pearson Clarke Unannounced Inspection 13th December 2006 09:30 Longacre Neurological Support Unit DS0000066006.V324460.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 Longacre Neurological Support Unit DS0000066006.V324460.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. Longacre Neurological Support Unit DS0000066006.V324460.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Longacre Neurological Support Unit Address 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) Howletts Loke off Station Road Salhouse Norwich Norfolk NR13 6EX 01603 721365 01603 721618 acornhomes@ukf.net Beeshaw Care Ltd Mrs Jane Shaw Care Home 3 Category(ies) of Learning disability (3), Physical disability (3) registration, with number of places Longacre Neurological Support Unit DS0000066006.V324460.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 01/02/06 Brief Description of the Service: Longacre is a care home offering personal care and accommodation to 3 service users. The service cares for adults who may have a number of needs, with particular specialisation in people who have had some brain damage. The service is privately owned and was established by the current proprietor a number of years ago. The home is situated in the village of Salhouse which is a few miles outside of Norwich and close to the town of Wroxham on the Norfolk Broads. The service operates from a domestic detached bungalow set in its own grounds. Service users have their own bedrooms and share other facilities. The current fee levels range between £565 and £950. Longacre Neurological Support Unit DS0000066006.V324460.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care services are judged against outcome groups which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out by using information from previous inspections, information from the providers ,the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home and this report gives a brief overview of the service and current judgements for each outcome. What the service does well: What has improved since the last inspection? What they could do better: Longacre Neurological Support Unit DS0000066006.V324460.R01.S.doc Version 5.2 Page 6 The service needs to ensure that care plans are appropriately organised and updated on a regular basis. As such service users should be fully involved in the process and the service must demonstrate that plans are regularly reviewed. The service is small and as such has difficulty in obtaining feedback from survey of interested parties. However there are a good number of health and social care professionals who have an interest in the service and more effort should be made to seek their views in support of the homes quality system. Although the home is generally appropriately managed, the provider needs to ensure that in her absence there is a clear understanding of the providers legal responsibilities. This is particularly the case in respect of regulation 37 notifications. 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. Longacre Neurological Support Unit DS0000066006.V324460.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 Longacre Neurological Support Unit DS0000066006.V324460.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. EVIDENCE: The site visit confirmed that there is still the same settled group of service users and as such there is no likely prospect of admissions to the service. However the home does have a formal admission process based on assessment and discussion with the manager indicated a good level of understanding of the importance of appropriate admission. The service user guide has been updated and is available in the hall, with service users holding their own copies. Longacre Neurological Support Unit DS0000066006.V324460.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): 6,7 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the site visit the Inspector spent time looking at all of the service user plans. The last inspection of the service resulted in a requirement to ensure that the service had adequate risk assessments in place at all times. It was apparent that this requirement had been met, however there were still areas of weakness in respect of the care planning process. As such the plans showed little evidence of structured regular review, with review dates set, but no indication of whether reviews actually took place. Although significant amounts of relevant information is held the plans would benefit from refinement to ensure that they are easily accessible to those who use them. There is also a need to ensure that any actual change in a service users condition results in a speedy change to the care plan/risk assessment. The service is small with a small staff team and as such there is relatively easy day to day communication within the staff team about change in residents, however care plans need to Longacre Neurological Support Unit DS0000066006.V324460.R01.S.doc Version 5.2 Page 10 reflect this change and as such a requirement is made. It was apparent from discussion with service users and staff and inspection of records that people are being enabled to develop independence within the context of measured risk and as such people are supported to make decisions about their lives. See requirement Longacre Neurological Support Unit DS0000066006.V324460.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): 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. EVIDENCE: During the site visit the inspector observed service users cooking and carrying out household tasks. Residents told the inspector about adult education classes that they were attending and also described a range of other social activity. There have been a variety of outings which were detailed in a journal kept by service users. The approach to food is such as might be found in a small household, with a loose menu subject to change on the day. Service users are supported to shop, prepare food and cook as their abilities allow. The nature of the disabilities cared for has meant that some restrictions in the ability of service users to exercise choice, however these restrictions have been agreed with all of the professionals involved in care and this was able to be tracked through care records held. Staff spoken felt that the closure of the companies day service had not had a detrimental effect on the provision of stimulation and activity. Longacre Neurological Support Unit DS0000066006.V324460.R01.S.doc Version 5.2 Page 12 Longacre Neurological Support Unit DS0000066006.V324460.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): 18,19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care records inspected indicated a thorough and appropriate approach to the meeting of health care needs. Those accommodated have little in the way of direct personal care needs, however the approach of staff seen and spoken to showed a good awareness of the importance of privacy, dignity and choice. There is significant involvement with health agencies concerned with head injuries and these are well detailed in records held. Currently no one self medicates although this is being worked towards for one service user. The home has a monitored dosage system and medicine management arrangements were satisfactory with secure storage and clear and accurate records. Longacre Neurological Support Unit DS0000066006.V324460.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service manager confirmed that no complaints have been received since the last inspection. The complaints process at the service is in line with the expectations of the standards and as such is made available. Records examined on the day of the visit confirmed that staff have received recent adult protection training in support of the services policies and procedures in this area. Discussion with the member of staff on duty indicated that there is an understanding of appropriate practice and that service users are well treated and kept safe. Longacre Neurological Support Unit DS0000066006.V324460.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the site visit the inspector toured the premises and service users showed him their bedrooms. All areas seen were clean, comfortable, in good decorative order and suitable for purpose. Longacre Neurological Support Unit DS0000066006.V324460.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the site visit the inspector looked at records relating to staffing and spoke to staff, management and service users. The manager acknowledged that the closure of the day service had had some impact on staffing, but that things had now settled. This was confirmed by the staff member on duty. The staffing rota seen showed a satisfactory level of staffing and there were no indications that need was not being met. Employment records were seen and as such a safe system has been maintained. Relevant staff training is in place although none of the current staff hold an NVQ. This was discussed with the manager who provided evidence that all staff will shortly be commencing NVQ level 2, with the expectation that all staff will be qualified in by the latter part of 2007. Longacre Neurological Support Unit DS0000066006.V324460.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussion took place with staff and the service manager on the day of inspection. The staff member spoken to felt well supported and managed and felt that the closure of the day service allowed the manager to concentrate her energies on the service. The manager has substantive experience and confirmed that she is near to the completion of the registered managers award. The service has established an internal quality auditing system involving a regular review of all areas of policy and practice. Although the service is small the inspector feels that more work needs to take place to survey the views of all stake holders in the service. Whilst there are relatively few relatives, to contact a formal system for seeking the views of professionals who have input should be developed. Based on records seen the service has an Longacre Neurological Support Unit DS0000066006.V324460.R01.S.doc Version 5.2 Page 18 appropriate approach to health and safety. It was noted that the service failed to discharge its responsibilities to notify the commission of a period in the last year when the manager was absent in hospital. This was discussed on the day of the site visit and a requirement is made to ensure that Regulation 37 is complied with at all times. See requirement Longacre Neurological Support Unit DS0000066006.V324460.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 x 3 x x 3 x Longacre Neurological Support Unit DS0000066006.V324460.R01.S.doc Version 5.2 Page 20 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 YA6 Regulation 15 Requirement That the service review its service user plans to ensure that the information maintained is current, relevant and subject to review. In so doing they should evidence the involvement of the service users in the creation of their plan. That the provider ensure that there is a system to ensure that all necessary reporting and notifications as required by regulation 37 is in place. Timescale for action 31/01/07 2 YA37 37 31/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA39 Good Practice Recommendations That the provider survey all stakeholders in the service are subject to survey as part of the homes quality system. Longacre Neurological Support Unit DS0000066006.V324460.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Longacre Neurological Support Unit DS0000066006.V324460.R01.S.doc Version 5.2 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!