Inspection on 12/08/08 for Lorne House

This inspection was carried out on 12th August 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lorne House 14/08/07

Lorne House 19/06/06

Lorne House 05/01/06

Lorne House 08/08/05

Lorne House 25/10/04

Lorne House 31/08/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

Extracts from inspection reports are licensed from CQC, this page was updated on 17/12/2008.

CARE HOME ADULTS 18-65 Lorne House 66 Yarm Road Stockton-on-Tees TS18 3PQ Lead Inspector Michaela Griffin Key Unannounced Inspection 12th August 2008 9:30 Lorne House DS0000000011.V371358.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 Lorne House DS0000000011.V371358.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. Lorne House DS0000000011.V371358.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lorne House Address 66 Yarm Road Stockton-on-Tees TS18 3PQ 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) 01642 617070 lorne_house@ntlbusiness.com Lorne House Residential Home Trust Limited Mr James Dunbar Leslie Care Home 14 Category(ies) of Learning disability (14) registration, with number of places Lorne House DS0000000011.V371358.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of persons shall not exceed 14 adults with learning disabilities including 3 with mental and physical disability 14th August 2007 Date of last inspection Brief Description of the Service: Lorne House is a home that provides residential care for up to 14 adults with learning disabilities, including 3 adults who also have physical disabilities. The home has been developed from a large Victorian end terraced house. It has been extended substantially, with new bedrooms and communal rooms added. There is a car park at the front, which provides safe, off street parking for staff and visitors. There is a large, private, back garden with lawned area, flower beds and garden furniture. People can also enjoy the garden from a large modern conservatory that overlooks it. There are enough bathrooms, shower rooms and shared living areas, to meet the needs of the people living at the home, with accessible bedrooms and bathrooms on the ground floor. The home is on a busy road that runs into Stockton Town Centre. There is a regular bus service and there are shops and churches within walking distance. Lorne House DS0000000011.V371358.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The home was not told when this inspection would take place until the day before. An ‘Expert by Experience’ helped. An ‘Expert by Experience’ is a person who, because of their shared experience of using services, and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. Before the inspector visited the home, she sent survey forms to people who live and work in the home to ask them what they think about the service. Four service users returned surveys, but no staff did. On the day the inspector and the expert visited the home they had a look around. They talked to three people who live there and the manager and two other staff. The inspector also looked at paper work. The inspector was at the home for six hours and the expert was there for three hours. After the visit to the home, the inspector talked to four health and social care professionals about the service provided. What the service does well: What has improved since the last inspection? The home has been re-decorated since the last inspection and the repairs that were needed have been carried out. All the service users now have a plan that tells the home what needs to be done to keep them as healthy as they can be. Staff have had more training, so they know more about the special health and care needs that some people with learning disabilities have. Lorne House DS0000000011.V371358.R01.S.doc Version 5.2 Page 6 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. Lorne House DS0000000011.V371358.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 Lorne House DS0000000011.V371358.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): Standards 1,2 and 5. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People find out if they like the home and the home makes sure it will be able to meet peoples needs before they move in. Everyone has an individual contract. EVIDENCE: The home provides people who are interested in living in the home with a copy of a service user guide, which describes the service. It is clear and written in a way that is easy to understand, with pictures. This is so that they know what to expect and what the staff and service can offer them. The information is provided in English only. The home should provide all information in alternative forms for people who can not or do not read English fluently. It should also let people know that the information can be provided, on request in other languages and Braille. Two people have moved into the home in the last year. They had trial visits before they moved in. This gave them a chance to see if they liked the home and the manager to find out if the service could meet their needs. But there were no details of the introductory visits and trial periods on individual files, they were recorded in the home’s daily diary. The manager obtained assessment information from other professionals about the people, before offering them places. Lorne House DS0000000011.V371358.R01.S.doc Version 5.2 Page 9 The inspector checked four people’s files. They all had contracts that explained the terms and conditions. Three contracts were signed by the person’s relative. And there was a letter on file to confirm that a contracts officer from Stockton council had seen the fourth person’s contract, as he did not have a family member to represent him. This showed that people are supported by a relative or another independent representative when the contract is agreed. The home does not collect contributions from service users. This is done by the Stockton Borough council, which is the authority that funds their care. The manager is working with the council to improve these contracts and the way that charges are explained to service users. Lorne House DS0000000011.V371358.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 & 9. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People have care plans outlining what they need and want, but they are not well organised. People can make choices in their daily lives. People are encouraged to lead full lives, with support to protect them from harm. EVIDENCE: The home does not have its own assessment process yet. Two people have moved into the home in the last year. Copies of single assessment documents and community care plans had been obtained from care managers and other professionals in the community learning disability team and were held on the individuals’ files. Progress has been made on the development of care plans. The guidelines they provide to staff on how to care for people and keep them safe now need to be brought together. This is so that information can be found and referred to easily and quickly. This will be particularly important when the home employs bank and agency staff who do not know the service users personally and starts to recruit new support workers. Lorne House DS0000000011.V371358.R01.S.doc Version 5.2 Page 11 A professional commented on how the two people who have moved into the home in the last year have become much more independent and said ‘Their lives have improved by 100 .’ The expert by experience who talked to the people who live in the home commented on how they are encouraged to make choices about how they spend their time, what they eat and how their rooms are decorated. She noted that the home uses displays of pictures and photos to help keep people informed and recommended that more picture and choice boards are used to support people in making decisions. There are regular ‘residents’ meetings’ when service users are consulted about plans and changes and encouraged to express their views and to make suggestions. People are supported to take risks that enable them to lead full lives as members of their community. For example two people go out in the community by themselves. Assessments on file showed that the home has agreed with their care managers that it is safe for them to go out in the very local area, within walking distance of the home. But one person is currently learning to use the bus independently and will be encouraged to, once it has been agreed that it is safe for her to develop her independence and control over her life in this way. Lorne House DS0000000011.V371358.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 and 17. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People are involved in activities they enjoy, in and outside the home but these are sometimes limited by the availability of staff to support them individually. People enjoy choice at meal times and eat in pleasant surroundings. EVIDENCE: The home has a weekly activity plan, which offers people the opportunity to take part in a variety of activities inside and outside home. It has a mini bus, which can take small groups of service users and staff out together. Some people can go out on buses individually, with staff, and others use taxis. The staff have worked with the local Methodist church and community members to raise money to fund a wider range of activities. The home now has paid for membership of a local gym, but this is shared amongst all the people who want to use it so individuals can only go once every two weeks. Some people have season tickets for Middlesbrough football club and staff accompany them to all the home games. Other regular activities include the Lorne House DS0000000011.V371358.R01.S.doc Version 5.2 Page 13 local pub, eating out at night, going shopping, visiting relatives and a popular disco. The home also has a weekly ‘games night’ and a ‘pamper night’. Special treats have included a trip to see a pantomime and a visit to the television studios to see an episode of Countdown being filmed. Most of the service users were at home on the day of the inspection, because the day centres they usually attend were closed for the holiday. So the inspectors could see what they were doing and how the staff behaved with them. It was a cold, wet day and the staff were busy trying to organise activities and outings that were suitable in bad weather. Staff chatted and joked with individuals and they all seemed to get on well together. One person said that she had been asked if she would like to go to the cinema and what she would like to see. Some people were sitting together in the communal lounges watching television and some were in their own rooms. Service users go on holiday in small groups, from two to four, to a variety of places, depending on their interests. They have the opportunity to meet new people and enjoy the same sorts of holidays as other members of the community. For example planned holidays include Centre Parcs, the Hotel Metropole, Blackpool and a coach trip to Torquay. Half the people who live in the home have relatives and the home supports them to keep in touch. Family members are welcomed to visit and encouraged to be involved in people’s lives. Some people are taken to visit their families regularly and some choose to stay overnight with them. At the time of the inspection, one service user was away on holiday with her parents. There were twelve people living in the home at the time of the inspection. Staff levels had been reduced because vacancies meant that the home’s funding has been cut. So there are now only three staff on shift to provide care and support at any time. Staff commented that three people can meet everyone’s care needs but the amount of amount of outings and activities that they can support people to do individually has been limited. A professional suggested that some people who live in the home would prefer to go out more. Three service users who returned surveys wrote that they can do what they want to at weekends and one wrote ‘most times’. Meals are served in a very pleasant dining room, or people can eat in their rooms if they prefer. Service users can be involved in shopping for food, drawing up menus and helping to prepare meals, as they wish. The weekly meal plans are based on what people say they would like. The meal choices were displayed on a blackboard on the day of the inspection. There were no pictures of the choices offered, to help people who cannot read English to decide. But staff were available to ask people what they would prefer. Lorne House DS0000000011.V371358.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The home has not yet developed person centred plans to ensure that people get all their care and support in the way that they need and prefer. Health action plans are now used to ensure that people’s physical and emotional needs are met. People are protected by the home’s policies and procedures for the safe handling of medication. EVIDENCE: The home has not yet introduced person centred planning but is working towards this. The people who live in the home are involved in discussions about the introduction of person centred plans, but only as a group. The individuals interviewed did not know that they have care plans and did not say that they have been involved in discussions about how their own support is provided. The home has worked with the health care coordinator, from the community learning disability team, to develop health action plans for all the people who live there. The home has appointed a senior support worker to take a lead on this. A health care professional said that the work she has done, with the support of another senior, has been ‘fantastic’. The individual health action Lorne House DS0000000011.V371358.R01.S.doc Version 5.2 Page 15 plans must be integrated into the person centred planning process, as it is developed around each person’s needs and preferences. The need for staff to have more specialist training, when they care for people with more complex needs, has been recognised by the home’s management. The home has worked hard and well to improve the way that people’s health needs are met. Staff have had extra training from health care professionals, so that they understand more about the special needs and syndromes associated with learning disabilities and know how to monitor the health and meet the health related needs of particular individuals. Some staff are more skilled than others and some are not able to report on people’s care needs confidently to other professionals. Health action plans are currently kept in a separate file from other care planning information about individuals. Assessments that identify the risks associated with caring for and supporting particular individuals and how they can be minimised are filed together with general risk assessments and management plans related to activities and outings. The way that information about people’s health and social care needs is recorded and kept must be improved, so that it is available and together for consultation and presents a picture of the individual as a whole person. This will help ensure that all staff understand all the needs and wishes of each person they care for and know where to find this information when it is required. People’s files should be clearly structured, so that information can be recorded and retrieved easily. Important information should be recorded on a front sheet- for example concerning medication that the person must have with them and contraindicators, allergies and contact details of next of kin and any instructions regarding known risks. The home has a policy and procedure that enables service users who want to and are able to, to manage their own medication. All staff involved in the administration of medication have had training and understand how to do this safely. Medical records are clear and completed fully and there are photos of service users to ensure that staff give the right medication to the right people. There is also clear guidance and a recording system for the administration of PRN medication, that is medication like painkillers that are not taken regularly but only when required. The home has a controlled drugs policy, which has been recently reviewed to check that it is up to date with the latest department of health guidance. It has been signed and dated. Staff should continue to have training about the sorts of conditions that the people they care for may experience or develop, so that they are able to respond appropriately. For example, this should include training on the risks of people with Down’s Syndrome developing dementia. Lorne House DS0000000011.V371358.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 & 23. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People are encouraged to express their views about the service and they are confident that they will be taken seriously. The home’s policies and procedures protect people from abuse and harm. EVIDENCE: People are encouraged to express their views individually, to their key workers who know them well and as a group through regular meetings. All of the service users who returned surveys said that they know who to speak to if they are not happy. The home has a clear and simple complaints procedure. A picture version of this is given to everyone who moves into the home, with the easy to read service user guide. The complaints procedure on the notice boarding the entrance hall should be up dated. Picture based information on fire and health and safety issues should also be on display. The home has an up to date safeguarding policy and procedure and all staff have training on how to keep people safe. A support worker demonstrated in interview that she would know what to do if she suspected that someone had been abused or neglected. An allegation of financial abuse was recently reported and investigated and the home acted appropriately and cooperated with the investigation. The allegation was not found to be true. The home’s recruitment policies and procedures also protect people by ensuring that the home does not employ people who have something in their background that could make them unsuitable to work in a care situation. Lorne House DS0000000011.V371358.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 25, 28 and 30. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The home provides a safe, clean, comfortable place to live, with communal space and individual rooms that meet people’s needs including people who use wheelchairs. EVIDENCE: Lorne House is on a busy main road, within a short bus ride of the town centre. There are community facilities nearby, like pubs, churches, shops and bus services. The home has its own small car park and blends in with the mix of properties in the area. The home has been extended to ensure that each person has a spacious comfortable room, furnished and decorated to suit their taste and interests. There are ample bathroom and toilets and they include adapted and accessible rooms and equipment for people with mobility problems, or who need help with personal care, on the ground floor. Outside there is a lovely sheltered garden, which can also be enjoyed from a large conservatory. Lorne House DS0000000011.V371358.R01.S.doc Version 5.2 Page 18 The home has undergone a refurbishment and redecoration programme and the repairs required at the last inspection have been completed. There is an annual maintenance programme and there is evidence on file that routine checks and services are carried out by qualified contractors. The management team are currently considering improving and developing the accommodation further, to provide a separate flat with its own kitchen for people who want to be more independent. All the service users who returned surveys said that the home is clean and hygienic and the expert by experience who looked around the home reported that she found it all clean, comfortable and well furnished. Lorne House DS0000000011.V371358.R01.S.doc Version 5.2 Page 19 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): Standards 32, 33, 34 and 35. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The home has robust recruitment policies and procedures that protect people. It employs enough staff to meet people’s care needs and they have the basic training they need to care for people safely and to promote their independence. EVIDENCE: Staff levels have been reduced because there are two vacancies, which means that the weekly funding has been cut. There are enough to meet the care needs of the people who live there currently within the home. But opportunities to support individuals in activities are more limited. Staff rotas take into account the needs and routines of the people who live in the home. The home is currently trying to recruit more staff to improve the situation and the manager is trying to negotiate more funds to increase the staff levels. A senior support worker said that staff are usually willing to work extra hours to cover for absences and vacancies : ‘Morale is high. We’re a close knit team and we pull together’. Another support worker said: ‘I am happy to muck in’. Lorne House DS0000000011.V371358.R01.S.doc Version 5.2 Page 20 Unfortunately staff did not return surveys to give their views on the support, supervision and training they get and supervision records were not complete and up to date. The two staff interviewed were very experienced and well qualified and felt that they have the knowledge and skills to do their jobs well. They were clear about what is expected of them and said that they work well together as a team. They both said that they have regular one to one meetings with a supervisor, when they can discuss their work and any support or training they need. The home has a recruitment procedure that meets the regulations and National Minimum Standards. Due to recent staff reductions, only one person has been appointed in the last year. She is a domestic assistant and the records showed that the recruitment procedure had been followed and all the necessary checks had been carried out to protect service users from the appointment of an unsuitable person. Professionals commented that the skill and confidence level of staff varies. All staff have the core training that covers the basic knowledge they need to care for people safely and that meets statutory requirements. Eleven of the eighteen care staff currently employed by Lorne House already have the National Vocational Qualification in Care at level two or above, and three more are working towards this. This means that the national minimum standard of 50 care staff with a suitable qualification has been exceeded. The home tries to organise cost effective training, to avoid diverting money and staff time from the direct provision of care. It makes full use of distance learning opportunities that staff can access electronically, through the internet. The manager has recognised that staff need extra specialist and practical training to meet the more complex and health related needs of some service users. Since the home started to introduce health action plans earlier this year, staff have had additional training from health care professionals, for example about caring for people whose behaviour challenges services and with autistic spectrum disorders. The home must continue to cooperate with suitably qualified professionals and trainers to arrange for staff to have this health related training, so that they have the skills and knowledge to meet the care needs of all the people they care for. All the people who live and work in this home are white British. There is a good mix of ages and women and men amongst the staff group but no evidence of diversity in other areas. All staff should also have training on equality and diversity issues. So that they can discuss their policies and working practices and consider the ways that they can let more people know that they offer a supportive and welcoming environment to all potential service users and employees. Lorne House DS0000000011.V371358.R01.S.doc Version 5.2 Page 21 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): Standards 37,39, 41 and 42. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The home has a suitable manager who knows the service and service users well. The health, safety and welfare of service users are promoted and protected. The home seeks users’ views on how the service is run, informally. EVIDENCE: The manager is well qualified and suitably experienced to manage this home. Four senior support workers and an administrator assist him. The home opened in 1995 and was originally developed on the initiative of local parents of people with learning disabilities. It is the only one provided by a small charitable trust and the directors take a personal interest in the service. There have been many improvements to the home and the service it provides since the last inspection. The manager recognises that further improvements need to be made and some are already being planned in consultation with the directors, staff, service users and representatives of Stockton borough council, the funding authority. The management team and board are currently Lorne House DS0000000011.V371358.R01.S.doc Version 5.2 Page 22 considering ways of developing the service and accommodation to support people who wish to live more independently. Record- keeping is still a weakness that means that it is not always straightforward and easy for the manager to provide evidence to show that standards and requirements are being met, for example with regard to staff supervision and training. The home must improve the way that it records and organises information about the care needs of individuals and ensures that important information is communicated to all staff. This is to ensure that all the information that is required is recorded accurately and in enough detail, and that it can be retrieved by any staff who need it to care for people safely and to share appropriately. Service users and their representatives must also be able to read information held about them and be confident that it is stored securely and kept in good order. Residents are consulted on the running of the home through regular meetings. The home should continue to develop its quality assurance system and systematically collect and record the views of service users and their representatives. The home protects service users and staff by having a clear health and safety policy and procedures. The manager carries out regular checks to make sure that these guidelines are followed. There is evidence that qualified contractors carry out work on a regular schedule, and the home keeps the records, invoices and certificates they provide as evidence. But its own maintenance log was not completed fully, on the day of the inspection. Lorne House DS0000000011.V371358.R01.S.doc Version 5.2 Page 23 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 2 3 x 4 x 5 3 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 4 26 x 27 x 28 3 29 x 30 4 STAFFING Standard No Score 31 x 32 3 33 2 34 3 35 2 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 2 3 3 x 3 x 2 x 2 3 x Lorne House DS0000000011.V371358.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 14 Requirement Timescale for action 01/04/09 2. YA18 12 3. YA36 18 The home must introduce its own assessment processes for new service users to build on the information provided by care managers in the Single Assessment. The home must carry out its own assessment before the person is admitted or during the introductory and trial period. This must clearly identify the needs of the service user and how they will be met by the service and include any staff training, equipment or additional care hours required. The home must involve 01/04/09 established service users in a person centred planning and review process that includes their health action plans and addresses their health, personal and social care needs in a coordinated, holistic way. All members of staff must have 01/12/08 recorded one to one supervision meetings on at least 6 occasions per year. This requirement is outstanding from the last inspection. Lorne House DS0000000011.V371358.R01.S.doc Version 5.2 Page 25 3. YA41 17 sch 4 The home must improve the way 01/12/09 that it records and organises information about the care needs of individuals and ensures that important information is communicated to all staff and available to the particular individuals concerned. This requirement is outstanding from the last inspection. 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 YA1 Good Practice Recommendations The home should provide information in alternative forms, for people who can not or do not read English fluently, for example in simpler language with pictures, on audio tape. It should also let people know that the information can be provided, on request in other languages and Braille. The registered person should ensure there are sufficient members of staff on duty to enable service users to participate in social and recreational activities in their local community and to support people’s individual interests. All staff should also have training on equality and diversity issues. So that they can help make sure that they recognise the ways that people are different and treat everyone fairly. 2. YA33 3. YA35 Lorne House DS0000000011.V371358.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Lorne House DS0000000011.V371358.R01.S.doc Version 5.2 Page 27 - 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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