Inspection on 22/05/07 for Loriner Place (49)

This inspection was carried out on 22nd May 2007.

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

Loriner Place (49) 05/01/06

Loriner Place (49) 21/10/05

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 Chris Schwarz Unannounced Inspection 22nd May 2007 09:55 Loriner Place (49) DS0000015062.V331865.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 Loriner Place (49) DS0000015062.V331865.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. Loriner Place (49) DS0000015062.V331865.R01.S.doc Version 5.2 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) The Fremantle Trust Jackie Esmond Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Loriner Place (49) DS0000015062.V331865.R01.S.doc Version 5.2 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. 5th January 2006 Date of last inspection Brief Description of the Service: Loriner Place is a home registered for seven adults with learning disabilities. 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 the city centre, 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. Fees for the service are £518.28 per week, according to information supplied in the pre-inspection questionnaire. Loriner Place (49) DS0000015062.V331865.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was conducted over the course of a day and covered all of the key National Minimum Standards for younger adults. Prior to the visit, a questionnaire was sent to the manager for completion alongside comment cards for distribution to service users, relatives and visiting professionals. Any replies that were received have helped to form judgements about the service and quality of care provision. Overall feedback was positive and reflected a well run home. The inspection consisted of discussion with staff, opportunities to meet with service users, examination of some of the home’s required records, observation of practice and a tour of the premises. A key theme of the visit was how effectively the service meets needs arising from equality and diversity. Staff and service users are thanked for their co-operation and hospitality during this unannounced visit. What the service does well: Prospective service users are thoroughly assessed prior to admission and are given opportunity to visit the home beforehand to ensure it meets their needs. Effective and detailed care plans are in place which adequately document service users’ needs and how these are to be met, within a risk assessment framework. Service users have a varied and active lifestyle which reflects their interests, provides them with nourishing meals and offers them opportunity to try new experiences and have contact with family, friends and the community. The health and personal care needs of people living at the home are well met, promoting health and well-being and ensuring that they receive medication in a safe and consistent manner. Complaints and adult protection are effectively managed to listen to views of people who live at the home and reducing the risk of harm to them. The home is clean, well decorated and adequately maintained, promoting a positive environment for the people who live there. The home provides staff cover to meet needs and undertakes thorough recruitment procedures, coupled with effective training to ensure staff have the right skills and competencies to support the people who live there. Loriner Place (49) DS0000015062.V331865.R01.S.doc Version 5.2 Page 6 The management and administration of the home promote continuity and quality of care for the people who live there and ensure that risk is safely managed to reduce the likelihood of injury or harm. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Loriner Place (49) DS0000015062.V331865.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 Loriner Place (49) DS0000015062.V331865.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): 2 Quality in this outcome area is good. Prospective service users are thoroughly assessed prior to admission and are given opportunity to visit the home beforehand to ensure it meets their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Pre-admission documents for the most recently admitted person to the home were looked at. An assessment was in place, completed by the person’s care manager which outlined relevant background information, why residential care was being considered and an outline of support needs. An assessment had also been written by the home’s manager very shortly after the service user had moved into the home. Both assessments gave a good account of care needs. One service user met during the course of the inspection said that she had been given opportunity to stay at the home and try it out before deciding to move in and was very happy there. Service user-friendly pictorial contracts were in place and information about the service and its philosophy were contained within a well written service users guide. Good use of plain text and photographs made the guide more accessible to service users, with important procedures such as how to make a complaint, protection from abuse and the fire procedure also explained in ways that service users may be able to better understand. Loriner Place (49) DS0000015062.V331865.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 & 9 Quality in this outcome area is excellent. Effective and detailed care plans are in place which adequately document service users’ needs and how these are to be met, within a risk assessment framework. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans of a sample of service users were looked at and the accompanying risk assessments. These were found to be in good order with a photograph of the service user for easy identification and detailed assessment of current care needs which also gave a good outline of independent living skills. All documents were up-to-date with signatures and dates of production. Risk assessments were also in place, again signed, dated and up-to-date, to support service users to be as independent as possible. There was evidence of service user involvement in the care plans. A key worker system was in operation to ensure continuity of care for service users. Monthly reviewing sheets were in place to check that information was still relevant to each person’s circumstances. Loriner Place (49) DS0000015062.V331865.R01.S.doc Version 5.2 Page 10 As well as the main care plan files, the home had produced service userfriendly care plans, with good use of photographs and plain text to outline care needs. These were impressive, with important details such as family and friends, health care workers involved in their care and contact addresses and telephone numbers, what the service user likes and dislikes, preferred routines and information on spiritual beliefs, political interests and funeral arrangements. The home manages service users’ money with individual bank accounts in place and individual wallets kept at the home for everyday expenses. A sample of wallets and transaction records were examined and found to be in good order, with receipts in place to explain expenditure and balances matched the records. Service users were seen to make decisions and be involved around the home, such as making themselves drinks, laying the table and helping to clear away, freedom to move around the home and sit in the garden, helping unload the dishwasher and deciding when they wished to get up. Records showed that house meetings are held at the home periodically and one of the service users takes responsibility for writing the notes. People completing comment cards expressed satisfaction with care provision at the home. A relative said that there had not been any cause for complaint and added “We are very happy with the way she’s looked after. She is really happy there. Staff have been most supportive recently when our father died.” The relative felt that one of the things the home does well is “Allows her independence when appropriate.” Another relative said the home “Meets needs at all times and the residents seem relaxed and are taken out on their home days i.e. out for lunch or shopping, which all helps to keep them happy.” Further comments from relatives included “The care home provides a happy home environment for their residents. It has a warm welcome to visitors and I have full confidence with the care home manager.” Loriner Place (49) DS0000015062.V331865.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 & 17 Quality in this outcome area is good. Service users have a varied and active lifestyle which reflects their interests, provides them with nourishing meals and offers them opportunity to try new experiences and have contact with family, friends and the community. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Some of the service users were out attending day services with three people at home. From care plans, daily notes and discussion with service users, there was evidence that service users attend local day services and make use of clubs, with one person having a work placement in a restaurant. One of the service users said that she goes swimming each week as part of attending day services and this was something she enjoyed doing. She also said that various holidays had been arranged for the coming year, which she and other service users were looking forward to. Service users who wish to can make use of churches in the area and their spiritual needs are noted in care plans. Receipts of expenditure showed that service users make use of taxis to get around and Loriner Place (49) DS0000015062.V331865.R01.S.doc Version 5.2 Page 12 use the city centre shops for clothes shopping, leisure activities and buying items such as toiletries and magazines. Service users take responsibility for keeping their rooms clean and one person had tidied her room up and vacuumed in the morning. Service users are able to keep in contact with their friends and family and some regularly stay with parents at the weekends. The information in care plans about family and friends contacts is particularly useful with addresses, telephone numbers and birthdays noted as a reminder. Details of when close relatives had died and where they are laid to rest was also recorded. There is good meal provision at the home with service users contributing to what goes on the menus. A vegetable curry with salad was freshly prepared for the lunch time meal and the dining table had been attractively set by a service user. An alternative of the person’s choice was prepared for a service user with swallowing difficulties. The meal time was relaxed and unrushed and second helpings were offered. There was plenty of fresh fruit available in the dining room for service users to help themselves to. Loriner Place (49) DS0000015062.V331865.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 & 20 Quality in this outcome area is excellent. The health and personal care needs of people living at the home are well met, promoting health and well-being and ensuring that they receive medication in a safe and consistent manner. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans contained sufficient detail of the personal care requirements for each person and what they could do for themselves to promote independence. There was evidence of liaising with other agencies such as the dietician and records of health care appointments showed that the people who live at the home have good access to community health care facilities. Weights were noted of service users and a photograph of each person was contained within their medical file, for easy identification. The majority of people who completed comment cards were satisfied with personal care provision although one relative felt that areas such as nail cutting and cleaning ears could be improved. Such issues were not apparent at the time of the inspection. Loriner Place (49) DS0000015062.V331865.R01.S.doc Version 5.2 Page 14 The home uses a monitored dose system of medication administration, with medicines securely and safely stored on the premises. Medication administration records were in good order with signatures alongside prescribed dose times. Staff on duty had received training on the administration of medication. Details of which medicines had been prescribed for each service user were noted in their care plans, with information about side effects. Staff were seen to respond sensitively and appropriately to a service user who became unwell as the day progressed, contacting the doctor, monitoring the person and seeking advice from the senior member of staff on-call for advice. Loriner Place (49) DS0000015062.V331865.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. Complaints and adult protection are effectively managed to listen to views of people who live at the home and reducing the risk of harm to them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has a complaints procedure in place which contains the contact details of the Commission for reference. People who completed comment cards were aware of how to make a complaint and indicated that the manager would be the first port of call. The Commission has not been contacted by any service users or their representatives since the last inspection regarding dissatisfaction with care provision. The pre-inspection questionnaire indicated that one complaint had been received by the service, which related to a personal care matter. Records showed that this had been responded to appropriately and measures were in place to improve practice. The home has policies in place to respond to abuse and staff have received Protection of Vulnerable Adults training. No adult protection concerns have been noted by the Commission. Service user-friendly versions of the complaints procedure and what abuse is and what to do about it are contained within the service users guide. Loriner Place (49) DS0000015062.V331865.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is excellent. The home is clean, well decorated and adequately maintained, promoting a positive environment for the people who live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is located in a residential area and blends in with other properties in the road. Accommodation for service users is on two floors with one downstairs bedroom; all bedrooms are single and have been decorated and arranged to different tastes and personalised. One person had chosen to keep her room locked whilst out. There was good use of colour co-ordination and all bedrooms were bright and airy. Bathrooms and toilets are located close to bedrooms and communal areas and were found to be well stocked with soap, toilet roll and hand towels. The lounge and dining room were homely in appearance and comfortable and kitchen and laundry areas well organised and clean. The garden was well maintained and enclosed and provided a quiet and comfortable spot to sit in. Cleaning products were kept locked away to prevent accidental injury. No maintenance issues were evident and décor looked fresh throughout. Loriner Place (49) DS0000015062.V331865.R01.S.doc Version 5.2 Page 17 People completing comment cards confirmed that the home is kept clean and well maintained. One person felt that the home, especially the lounge, was too small for seven service users. Loriner Place (49) DS0000015062.V331865.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. The home provides staff cover to meet needs and undertakes thorough recruitment procedures, coupled with effective training to ensure staff have the right skills and competencies to support the people who live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was not using any agency staff at the time of the inspection and only one person had left since that time. The rotas showed that sufficient levels of carers are on duty to meet current care needs and staff felt that the numbers were sufficient from their perspective. Staff were observed to be attentive to service users and engaged with them positively, patiently and respectfully. No new staff have started at the home since the last inspection. At that time a sample of recruitment records were looked at and found to contain satisfactory evidence of all required checks, including Criminal Records Bureau clearance. Training records of a sample of the team were looked at and showed that mandatory training was up-to-date. Nearly three quarters of the staff team have attained National Vocational Qualification level 2. Loriner Place (49) DS0000015062.V331865.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is excellent. The management and administration of the home promote continuity and quality of care for the people who live there and ensure that risk is safely managed to reduce the likelihood of injury or harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is registered with the Commission and has attained National Vocational Qualification level 4. The findings of the inspection reflect a well run service with service users’ needs paramount. Records at the home are particularly well maintained, up-to-date and easy to locate. Policies and procedures were available to staff in a care manual and an on-call system was in place for staff to seek advice from a senior member of the team. Reports were available within the home of monitoring visits by the provider to assess quality of care. These had been undertaken regularly, according to the Loriner Place (49) DS0000015062.V331865.R01.S.doc Version 5.2 Page 20 records, and showed that staff and service users had been spoken with as part of the process. Reports were also available of regular service monitoring by the external line manager. Health and safety was being given good attention at the home. Records relating to fire safety were in good order with evidence of regular checks being undertaken and a satisfactory fire officer’s report in 2006. Staff were up-todate with health and safety related training such as moving and handling, first aid and food handling. Accident records showed a very low incidence of injury at the home. Records were in place to show that equipment is routinely serviced and certificates verified gas and electrical safety at the home. Staff were routinely checking fridge and freezer temperatures and hot water temperatures and there were no unsafe readings in the sample examined. During a tour of the premises no obvious hazards were noticed which could present a risk to service users. Loriner Place (49) DS0000015062.V331865.R01.S.doc Version 5.2 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 Standard No Score 1 x 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 4 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 4 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 4 3 3 x 4 x 3 x x 3 x Loriner Place (49) DS0000015062.V331865.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Loriner Place (49) DS0000015062.V331865.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 Loriner Place (49) DS0000015062.V331865.R01.S.doc Version 5.2 Page 24 - 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. 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