Inspection on 21/10/05 for Loriner Place (49)

This inspection was carried out on 21st October 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 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

Loriner Place (49) 22/05/07

Loriner Place (49) 05/01/06

Loriner Place (49) 08/02/05

Loriner Place (49) 17/01/05

Loriner Place (49) 10/02/04

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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 Loriner Place (49) 49 Loriner Place Downs Barn Milton Keynes Bucks MK14 7PU Lead Inspector Gill Gentles Unannounced Inspection 21st October 2005 9.15 Loriner Place (49) DS0000015062.V260823.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 Loriner Place (49) DS0000015062.V260823.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. Loriner Place (49) DS0000015062.V260823.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Loriner Place (49) Address 49 Loriner Place Downs Barn Milton Keynes Bucks MK14 7PU 01908 201985 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) Manager.winglodge@fremantletrust.org The Fremantle Trust Jackie Esmond Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Loriner Place (49) DS0000015062.V260823.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for 7 people with a learning disability with up to 2 people over 65 years of age. 8th February 2005 Date of last inspection Brief Description of the Service: Loriner Place is a home registered for seven adults with a Learning Disability. The home was originally built as two separate semi-detached homes and has been converted into one dwelling. Loriner Place is situated on a residential estate in Milton Keynes within easy access of central Milton Keynes, which is approximately one mile away. Milton Keynes has good public transport networks and Service Users have access to all modes of transport. The home has its own vehicle, which is utilised regularly. Service Users also use taxis and buses, as and when required. The home is equipped with all the facilities to meet Service Users needs, especially those who are less physically able. Loriner Place (49) DS0000015062.V260823.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is an unannounced inspection carried out on the morning of Friday, 21st October by Mrs. Gill Gentles. At the time of the inspection, the manager was annual leave. There were two staff on duty and three Service Users in the home. The inspector chatted to two of the Service Users and the staff and also perused a selection of records. An informal tour of the communal areas took place, but not the whole building. What the service does well: What has improved since the last inspection? What they could do better: Provide all residents with a copy of their contract/terms and conditions signed by the home and the resident or their representative. The home could begin to produce resident friendly Care Plans in a format suitable to individuals. Ensure all staff are appropriately trained in the five core areas. Improve the percentage of staff qualified in NVQ Level 2 or above. Ensure specialist training is accessed especially Dementia. Loriner Place (49) DS0000015062.V260823.R01.S.doc Version 5.0 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. Loriner Place (49) DS0000015062.V260823.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 Loriner Place (49) DS0000015062.V260823.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): 5 There were no contracts in place to ensure Service Users are receiving the service they are paying for. EVIDENCE: It wasn’t possible to find any contracts/terms and conditions for the seven Service Users living in the home. A member of staff did her best to locate them but to no avail. At the previous announced inspection, in February 2005, contracts were available and clearly identified current fees. Loriner Place (49) DS0000015062.V260823.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): 6,7,9 & 10 Care plans contain the appropriate information to ensure that Service Users’ needs are being met. Service Users appear to make decisions about their lifestyle ensuring the home works towards their goals and needs. Detailed risk assessments are in place to safeguard Service Users from harm. The home has the appropriate policies, procedures and systems in place to ensure the Service Users’ privacy and confidentiality is maintained. EVIDENCE: The home has clear procedures in place for developing appropriate care plans. Essential information is gathered from social services and families. Information about health and social care is also contained within the individual Care Plans. All residents have a personal file, which contains Care Service Orders issued from the local authority following reviews of which they attend annually. Loriner Place (49) DS0000015062.V260823.R01.S.doc Version 5.0 Page 10 The key-worker and manager review the Care Plans on a monthly basis, however, it was noted that there were some shortfalls; the three files viewed had not been reviewed since July or August 2005. All Care Plans were found to be written in the third person with Service Users’ signatures evidencing their involvement. In the plans viewed, there was clear information identifying individuals’ preferences, wishes and needs. Choices have been made regarding day-time activities, food, drink and leisure interests. During the inspection, staff were observed offering choices to individuals about what they wish to eat and drink for breakfast and what they would like to do during their day at home. There are a good range of Risk Assessments in place in relation to environment, health, safety and the activities individuals carry out. It was noted that they are all due for renewing next month (November 2005). All personal information relating to staff and residents were found to be stored in compliance with the Data Protection Act 1998. Loriner Place (49) DS0000015062.V260823.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): 14,16 & 17 The home offers a selection of leisure activities giving the Service Users the opportunities to access the local community. Service Users are encouraged to be involved in the daily running of the home, giving them opportunities for developing further independence. Good attention is paid to meal planning, which provides the Service Users with a healthy nutritious meal. EVIDENCE: Service Users are encouraged and supported to maintain their leisure activities. Care Plans and daily notes evidenced that a variety of hobbies and interests are accessed, either through the home, or the day centres. Activities include:• Dancing • Swimming • Bowling • Cinema Loriner Place (49) DS0000015062.V260823.R01.S.doc Version 5.0 Page 12 • • • Pub Cooking Arts and crafts. The daily routine of the home promotes Service Users’ independence. Individuals are encouraged to make their own decisions and take some responsibility for the running of the home, by getting involved in the household cleaning, shopping etc. It was noted that staff appeared to have relaxed, mutually respectful relationships with the Service Users in the home during the visit. Service Users are involved in selecting their daily meals and the shopping to ensure there is the correct food available. Service Users reported having good meals and from examining the menus, they appeared to be given a varied and balanced selection of food. One Service User is not eating adequately and it was evident that the staff are working hard to encourage food and fluid intake. Food and drink is available throughout the day with no restrictions being placed to limit anybody’s daily intake. All the appropriate health and safety records required by Environmental Health Officer are maintained appropriately. Loriner Place (49) DS0000015062.V260823.R01.S.doc Version 5.0 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 the following standard(s): 19 & 20 Good attention is paid to the Service Users’ health care needs, ensuring overall good health is promoted. Good medication policies are in place and staff are appropriately trained ensuring that the Service Users are protected from harm. EVIDENCE: Appropriate procedures are in place to ensure that Service Users have access to all medical professionals as and when required. Care Plans identify that all Service Users have access to and attend the dentist, optician, podiatrist etc. with regular visits recorded in their files. Medication records were examined and there were no gaps observed on the MAR sheets. Boots the Chemist supplies medication, which is a recent change as previously Cox and Robinsons supplied it. The staff were observed administering medication appropriately. The store of medication was not inspected as the majority of medication is now maintained in Service Users’ bedrooms, in locked cupboards. The supply stored in the medicine cabinet in the office was found to be adequate. All staff have been trained in safe handling of medicines by Boots recently. Loriner Place (49) DS0000015062.V260823.R01.S.doc Version 5.0 Page 14 Loriner Place (49) DS0000015062.V260823.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 The home has a proactive approach to adult protection ensuring as far as possible, Service Users are protected from abuse and harm. EVIDENCE: The home has the appropriate policy and procedure in place and a copy of the Milton Keynes Inter-agency Policy, which all staff have received training in recently (26 June 2005.) Loriner Place (49) DS0000015062.V260823.R01.S.doc Version 5.0 Page 16 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): These standards were not assessed during this inspection. EVIDENCE: Loriner Place (49) DS0000015062.V260823.R01.S.doc Version 5.0 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 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): 33,35 & 36 The appropriate amount of supported staff is rota’d effectively to meet Service Users’ needs. Some shortfalls were identified in the training and development of the staff team, which could potentially put Service Users at risk. Staff are appropriately supervised at regular intervals, to deliver good care to meet the Service Users’ needs. EVIDENCE: Staff confirmed that there was ample staff available to maintain an appropriate level of support to Service Users. The rota identified that there were two staff on duty at all times and a member of staff sleeping in overnight. Regular team meetings take place and the appropriate records were maintained in a hard-back book. It is recommended that the manager identifies any actions required and that the care staff sign that they have read and agreed the minutes. Loriner Place (49) DS0000015062.V260823.R01.S.doc Version 5.0 Page 18 Training records are maintained appropriately with some shortfalls identified during the inspection, such as: all staff are not trained in Food Hygiene, Infection Control and First Aid. There also appeared to be little or no training specifically to meet the needs of Service Users, for example, Dementia. Records also identified that only two carers have qualified at NVQ Level 2 and 3. The manager has completed NVQ Level 4. Staff confirmed that they receive regular supervision and records were viewed and found to be appropriately maintained. Loriner Place (49) DS0000015062.V260823.R01.S.doc Version 5.0 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 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): 42 There are robust health and safety checks maintaining a safe environment for Service users. EVIDENCE: There are appropriate health and safety policies and procedures in place. Good fire procedures are implemented; risk assessment in place; records of weekly tests; fire drills and servicing of the system. The appropriate servicing, such as Legionella testing, hard wire, portable appliance, gas safety and hot water checks are all carried out. The manager has also implemented a monthly visual check of the home and actions as required. Loriner Place (49) DS0000015062.V260823.R01.S.doc Version 5.0 Page 20 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 X X X X 2 Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 x 12 X 13 X 14 3 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X X 3 X 2 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Loriner Place (49) Score X 3 3 x Standard No 37 38 39 40 41 42 43 Score x X X X X 3 X DS0000015062.V260823.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard YA35 YA35 Regulation 18(1)(c) 18(1)(c) Requirement That all staff are trained in the mandatory courses required. That the manager ensures staff are trained in specific areas, such as Dementia, to meet residents needs. Timescale for action 15/01/06 31/12/05 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 Refer to Standard YA33 Good Practice Recommendations That the manager identifies, in the team meeting minutes, of any action to be taken, by whom, and to ensure staff have signed that they have read and agree with the minutes. Loriner Place (49) DS0000015062.V260823.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR 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 Loriner Place (49) DS0000015062.V260823.R01.S.doc Version 5.0 Page 23 - 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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