Inspection on 16/05/05 for Loring Hall

This inspection was carried out on 16th 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

Loring Hall 06/12/06

Loring Hall 14/02/06

Loring Hall 08/02/05

Loring Hall 03/06/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Loring Hall 8 Water Lane Bexley Kent DA14 5ES Lead Inspector Keith Izzard Unannounced 16 May 2005 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. Loring Hall G51-G01 S51557 Loring Hall V227316 16-05-05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Loring Hall Address 8 Water Lane, Bexley, Kent DA14 5ES 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) 020 8302 9302 020 8302 8686 loring@oakfields.net Oakfields Care Ltd Care Home 16 Category(ies) of Learning disability (15) Learning disability over registration, with number 65 years of age (1) of places Loring Hall G51-G01 S51557 Loring Hall V227316 16-05-05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 place registered for category LD (E) relates to named service user only Imposed 27 August 2004 Date of last inspection 3 June 2004 Brief Description of the Service: Loring Hall is a large two storey, listed building set in spacious grounds. The home was registered on 27th February 2004 to provide long term care for sixteen service users who have a learning disability. At the time of inspection the home was half full, having accommodated eight service users on a staggered basis since the summer of 2004. The property is very well furnished and the accommodation of a high standard. All service user rooms are single and have en suite facilities. The home is split into two self - contained units with eight service users occupying each unit allowing for a range of occupational and recreational facilities within the overall accommodation of the building. The existing management team has a good level of experience in learning disability and the indications are that a good level of training will be provided for care staff. The proposed range of activities for service users is extensive and the grounds offer considerable potential for occupational therapy and to develop work skills. Loring Hall G51-G01 S51557 Loring Hall V227316 16-05-05 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over two days on the 16th May and 21st July 2005. A Regulation Manager accompanied the Inspector on these days, because anonymous complaints that were received by the CSCI were being investigated simultaneously. For unavoidable reasons there was a protracted delay between the two visits to do with the process of the investigation of the complaints. Complaints to do with the service provided for residents were not substantiated. However, other complaints made that do not relate to residents, are still subject to investigation and will be reported on in the next inspection report. The Inspector is satisfied that the health and welfare of residents is not affected by the allegations under current investigation. The previous registered manager resigned shortly after the previous inspection. The home has an acting manager and he has recently applied to become the registered manager for the home. The inspection provided for two interviews with residents, two interviews with care staff, and one with a senior carer and the manager. Care files were examined as were documents relating to health and safety and staffing. The building was also inspected throughout. In general terms the home was operating to a satisfactory standard and had complied with previous requirements and recommendations. Residents and staff members, both observed and interviewed, appeared to have a good rapport. Residents appeared to be contented within their home supported by caring and professional staff. What the service does well: Since the previous inspection in February 2005 the home has complied with all requirements and all but one recommendation. This recommendation is being addressed currently. All staff members are currently undergoing NVQ training and are anticipated to complete this training this year. A good level of specific training has been provided and is planned for. Loring Hall G51-G01 S51557 Loring Hall V227316 16-05-05 Stage 4.doc Version 1.30 Page 6 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. Loring Hall G51-G01 S51557 Loring Hall V227316 16-05-05 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 Loring Hall G51-G01 S51557 Loring Hall V227316 16-05-05 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) 1-5 Adequate information was provided about the service in the statement of purpose and service user guide to enable prospective residents to make a decision to the suitability of the service. Admission procedures were in place to comply with these standards. EVIDENCE: Three requirements made at the previous inspection of the home had been complied with. Firstly to ensure that a comprehensive needs assessment of a resident is produced by the placing authority, prior, to the commencement of a new placement. Secondly that pre admission visits are provided for residents, prior to their formal admission. The care file for a new resident placed was examined and showed that both requirements had been complied with comprehensively. Thirdly, the provision of written contracts for residents, signed by both the manager and the resident, or their representative, has been complied with.was complied with. Loring Hall G51-G01 S51557 Loring Hall V227316 16-05-05 Stage 4.doc Version 1.30 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 standard(s) 6-10 All four care plans examined were up to date and comprehensive in content. Residents were involved with decisions made about their lives and lifestyle. EVIDENCE: Care provided for two residents were tracked through care plans and other documents such as daily diaries and the communication book used by staff members. Both the residents said they were involved with decisions affecting their lives and staff members encourage them to give their views. Risk assessments were undertaken with resident involvement and records showed clearly how risks were managed. The two residents interviewed were aware that staff kept records about them. Both stated that they are fully consulted by staff members about decisions made about their lives. The home had a policy on confidentiality and records were seen to be safely stored in lockable cabinets. Loring Hall G51-G01 S51557 Loring Hall V227316 16-05-05 Stage 4.doc Version 1.30 Page 10 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) 11-17 It was evident that the social and recreational needs of residents was being planned for and that choices were being made by residents themselves who contribute their own ideas to the programme available. The meals provided are varied and residents contribute to choosing what should be provided for them and always have a choice available. An anonymous complaint received by the Inspector alleging that the food provided was neither adequate nor varied was not substantiated from the evidence available at this inspection. Many of the residents have been in the home for less than six months, however, the provision of occupational activities was subject to a recommendation made at the previous inspection. The manager should assess who would benefit, or otherwise, from day centre type activities and clarify to the CSCI whether these will be provided within the home or by external provision for those with an assessed need. EVIDENCE: Loring Hall G51-G01 S51557 Loring Hall V227316 16-05-05 Stage 4.doc Version 1.30 Page 11 None of the residents has been assessed as being able to sustain full time employment and none attend local day centres. An activities folder records what activities are provided for individual service users. Evidence was available that a good range of fulfilling activities and outings are provided from the care records examined and from resident’s comments received. However, an assessment of occupational needs should be conducted for residents in order to differentiate these from social activity needs and a plan produced and submitted to the CSCI to show how any identified occupational needs will be met. Restated Recommendation 1. Residents were supported to maintain positive relationships with their family or advocates. One resident did not have family and the manager had referred this person to an advocacy service. Varied and nutritious meals were provided to meet resident preferences, two residents interviewed confirmed that the food was varied and of good quality. A rota of food provided was seen covering a two- week period and evidence was available that a plentiful supply was retained within the home. Loring Hall G51-G01 S51557 Loring Hall V227316 16-05-05 Stage 4.doc Version 1.30 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,21 Resident’s needs were being met based on their assessment of need and with the involvement of the resident. Residents were supported to access health services appropriately and had these provided either in the home or attended local clinics and surgeries. The issues to do with ageing within Standard 21 must be addressed by staff within the next multidisciplinary review of residents needs. EVIDENCE: Residents have varying needs in relation to the amount of physical care they need some assistance with. This is clearly described within care plans and in some instances amounts to prompting to ensure that tasks are completed to maintain personal hygiene. There is one female resident who receives such care from female staff only and there are always females on duty. Loring Hall G51-G01 S51557 Loring Hall V227316 16-05-05 Stage 4.doc Version 1.30 Page 13 Residents were supported to access health services appropriately and these were provided either within the privacy of their own rooms within the home or by attendance at local clinics and surgeries. Not all residents have clarified in their care notes, what their wishes or those of their relatives, would be in the event of serious illness or death. Requirement 1. Loring Hall G51-G01 S51557 Loring Hall V227316 16-05-05 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22-23 No complaints have been received from residents, relatives, visitors, professionals, or staff members within the complaints procedure operated by the home. However, the CSCI has received an anonymous complaint direct. This was to do with a number of issues that are currently the subject of ongoing investigation by the CSCI. The Inspector is satisfied at this stage that none of the allegations relating to service users have been substantiated. However, other matters regarding staff and their conduct to each other, requires further investigation. Any areas found to have any impact in respect of the welfare of service users or the proper running of the home will be reported on in the next inspection report and appropriate action taken by the CSCI with immediate effect. Overall, adequate procedures were in place to ensure complaints to the home were managed and to protect residents from abuse. EVIDENCE: Allegations made that service users had limited choice of food were investigated. Menus were examined, three residents and two staff members interviewed and food supplies in the home examined. All were satisfactory and the evidence was that this was likely to have been a malicious allegation and was not substantiated. Another allegation that a resident spends all the time in the basement area was also not substantiated, although it was evident that some periods of time are spent in this way for the safety of the resident concerned and that of other service users. These matters were well documented in a risk assessment. The resident currently receives one to one supervision because of the challenging behaviour presented. A recent psychiatric assessment has recommended the resident be transferred from the home to a specialist residential assessment facility in the very near future and this placement is in hand. Loring Hall G51-G01 S51557 Loring Hall V227316 16-05-05 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24-30 The home met every Standard within this group of Standards. The home was clean and hygienic on the day of inspection. One minor shortfall identified at the previous inspection and due to be implemented within June 2004 was a recommendation to soften the appearance of the dining rooms for the benefit of residents. EVIDENCE: The existing dining rooms are rather bare and utilitarian in appearance, although of good quality size and furnishings. In all other respects the home is very comfortable and appropriately furnished and bedrooms reflect the interests and style preferred by residents. Work is in hand to comply with the recommended refurbishment of the dining rooms. Loring Hall G51-G01 S51557 Loring Hall V227316 16-05-05 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Two staff members interviewed presented as having a friendly yet professional relationship with residents and spoke knowledgably of resident’s individual needs, likes dislikes and their lives in general. EVIDENCE: Two staff members assisted the Inspector by describing the care needs of two residents. Reference was made to the care plans and the daily diaries and the communication book. The statements made by the two staff members tallied with the recorded information. The Inspector noted that all care staff are undergoing NVQ training due to be completed later this year. Loring Hall G51-G01 S51557 Loring Hall V227316 16-05-05 Stage 4.doc Version 1.30 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 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) 39,42 Records required by regulation were kept and well maintained. Management were in the process of implementing a new quality audit system. Safety records showed attention was given to ensuring a safe environment was provided for residents and others. EVIDENCE: Loring Hall G51-G01 S51557 Loring Hall V227316 16-05-05 Stage 4.doc Version 1.30 Page 18 A written monthly survey of service users is undertaken staff members assist those service users who have limited communication skills. Regular monthly visits and reports are undertaken by the responsible person and are submitted to the CSCI. A written survey of the views of professionals involved with the home has been introduced and is to be undertaken on a quarterly basis and includes the views of any advocates involved with service users. The manager agreed to place a comments book and details of the home ‘s complaints procedure by the signing in book in the entrance area of the home. A sample of the various health and safety documents and action required in terms of safety checks were examined and found to be up to date and comprehensive. Loring Hall G51-G01 S51557 Loring Hall V227316 16-05-05 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 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 2 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Loring Hall Score 3 3 x 2 Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x G51-G01 S51557 Loring Hall V227316 16-05-05 Stage 4.doc Version 1.30 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 21 Regulation 12 Requirement The Registered Person must ensure that the wishes of residents and their relatives in relation to illness and death are considered and recorded at their next formal review. Provided residents and relatives are not too distressed to do so. Timescale for action 1.12.05 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 11 Good Practice Recommendations The Registered Person should assess the occupational needs of residents as distinct from social needs and provide written confirmation to the CSCI of how these will be met for those assessed as having occupational needs. Loring Hall G51-G01 S51557 Loring Hall V227316 16-05-05 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Sidcup Area Office River House 1 Maidstone Road, Sidcup DA14 5RH 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 Loring Hall G51-G01 S51557 Loring Hall V227316 16-05-05 Stage 4.doc Version 1.30 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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