CARE HOME ADULTS 18-65
Lorne House 14 Lorne Street Kidderminster Worcestershire DY10 1SY Lead Inspector
Dianne Thompson Unannounced Inspection 20th January 2006 10:00 Lorne House DS0000018509.V281826.R01.S.doc Version 5.1 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 DS0000018509.V281826.R01.S.doc Version 5.1 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 DS0000018509.V281826.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Lorne House Address 14 Lorne Street Kidderminster Worcestershire DY10 1SY 01562 630522 01562 631074 lornehouse@hotmail.com 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) Mr Gerardo Saporito Mrs Brigida Saporito Mrs Gina Margaret Vaughan Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Lorne House DS0000018509.V281826.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. The service is primarily for people with learning disabilities who are under 65 years of age but may accommodate three persons over this age. The Home may also accommodate one named person with an additional mental disorder. The home may also accommodate a maximum of three people with an additional physical disability. 5th July 2005 Date of last inspection Brief Description of the Service: Lorne House is a care home that provides personal care and accommodation for 9 adults with learning disabilities. Support is provided in a homely setting, enabling residents to lead as ordinary lives as possible. The home is located in a quiet residential area that is accessible to the centre of Kidderminster. Kidderminster rail station is a few minutes walk away. The premises consist of two adjoining terraced houses, which have been combined and adapted for their present purpose. All the homes bedrooms are single and have an en suite bath or shower facility. A garden at the rear is mainly used for growing vegetables and fruit. The house opens onto a terrace, which is a pleasant facility in good weather. The business is family owned. The owners live next door and are involved in the day to day running of the home on a full time basis. The owners are referred to in this report as the providers. Lorne House DS0000018509.V281826.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place on a weekday morning. Lorne House provides accommodation for 9 people in a residential area of Kidderminster. Time spent planning for the inspection included reading previous inspection reports, and reviewing the history of the home. The focus of this inspection was to meet with service users and staff, to follow up on requirements and recommendations made following the previous inspection and to assess key standards that were not covered during the previous inspection. The inspector was assisted by the staff on duty and met with service users who were at home. A partial tour of the home was conducted and a range of documents, policies and procedures were checked. What the service does well:
Lorne House is a care home that provides personal care and accommodation for 9 adults with learning disabilities. Support is provided in a homely setting, enabling residents to lead as ordinary lives as possible. Medication is well managed and staff are trained so that residents receive medication safely as prescribed and in keeping with the home’s policies and procedures for dealing with medicines. Resident’s are supported and benefit from a committed and effective staff team. Regular staff training and supervision is provided to ensure that staff develop their skills and knowledge in order to provide appropriate care and support for the residents. . There is a clear management structure within the home, which ensures that appropriate and consistent care is provided in keeping with the philosophy of the home. Health and safety matters are addressed to reduce the risks to people in the home. Lorne House DS0000018509.V281826.R01.S.doc Version 5.1 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. Lorne House DS0000018509.V281826.R01.S.doc Version 5.1 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 DS0000018509.V281826.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not assessed during this inspection. Lorne House DS0000018509.V281826.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not assessed during this inspection, but will be fully assessed during the next inspection. Lorne House DS0000018509.V281826.R01.S.doc Version 5.1 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 the following standard(s): EVIDENCE: These standards were not assessed during this inspection. Lorne House DS0000018509.V281826.R01.S.doc Version 5.1 Page 11 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20, 21 Medication is well managed and staff are trained so that residents receive medication safely as prescribed and in keeping with the home’s policies and procedures for dealing with medicines. EVIDENCE: All medicines are suitably stored in a locked cabinet. The content of the Medication cabinet was seen. All medicines are well organised and clearly labelled and dated. The medication administration record sheets now highlight any allergies as recommended at the previous inspection. The home has introduced additional forms to monitor changes in health or any concerns that may arise. Records show that regular blood tests are organised with the GP practice, where warfarin is prescribed. Lorne House DS0000018509.V281826.R01.S.doc Version 5.1 Page 12 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Policies and procedures are available in the home, which advise and guide staff in protecting the residents. EVIDENCE: The home has developed an Adults Protection Policy and Procedure to advise and provide guidelines for staff in protecting residents. This policy also includes guidelines on whistle blowing. Staff are encouraged to report any issues of concern, and resident protection is promoted through regular staff meetings and supervision. Discussion with the registered manager considered that the addition of flowcharts to the guidelines is good practice and would support staff in the appropriate action to take should an incident occur, e.g. an incident of abuse, or even an unexpected death in the home. Training in adult protection and abuse awareness was undertaken on 18th January 2006. LDAF and NVQ training for staff include elements on protection from abuse. Lorne House DS0000018509.V281826.R01.S.doc Version 5.1 Page 13 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not fully assessed during this inspection. However, requirements and recommendations from the previous inspection were assessed. A heater has now been installed in the outer conservatory to ensure the room is suitably heated. The heater operates on a timer to provide adequate and constant heat during cold weather. The wall of one of the resident’s bedroom has been repainted where the radiator had been removed. All requirements from the previous inspection have now been met. Lorne House DS0000018509.V281826.R01.S.doc Version 5.1 Page 14 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 Lorne House is well managed, and resident’s benefit from a committed and effective staff team. Regular staff training and supervision is provided to ensure that staff develop their skills and knowledge in order to provide appropriate care and support for the residents. EVIDENCE: Discussion with the registered manager and supervision records demonstrate that regular staff supervision and learning development sessions are provided for all staff. Courses are arranged for all staff on a regular basis. Recent training courses include first aid and adult protection/abuse awareness. Autism awareness is planned for 23rd March 2006. The staff training record provides evidence of all training that has been completed and includes planned future training. Staff are supported by the home to complete their NVQ II; one member of staff is due to start with NVQ II on completion of the LDAF induction course. There have been some difficulties in continuing assessor support from the local college due to a lack of assessors. The home has sought to address this
Lorne House DS0000018509.V281826.R01.S.doc Version 5.1 Page 15 difficulty with the college, attempting to re-establish support for staff with their NVQ training. Further development within the staff structure at the home has included the appointment of a deputy manager to assist the home manager in the running of the home. The deputy has completed NVQ III and is commencing an Introduction to Management Course. The manager is continuing with the Registered Managers Award (RMA) training, and work completed towards the award was seen. It is evident that learning from the RMA is proving to be beneficial to the home manager and to the home, e.g. the development of systems and procedures such as Food Safety and Food Analysis, and a Quality Assurance system, which are more keeping with the National Minimum Standards. Staff recruitment within the home remains difficult, although recent interviews have been successful with the appointment of two part time staff. References and CRB checks are being applied for. Lorne House DS0000018509.V281826.R01.S.doc Version 5.1 Page 16 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 40, 41, 42, 43 The home is well managed and structures support the delivery of good care. There is a clear management structure within the home, which ensures that appropriate and consistent care is provided in keeping with the philosophy of the home. Health and safety matters are addressed to reduce the risks to people in the home. EVIDENCE: The home manager, registered providers and staff work to provide quality care and service for all residents living in the home. This is evident in the efforts that are being made to improve standards of recording and in the development of the homes policies and procedures. Residents are encouraged and supported to be involved in the development of the home, and evidence was seen where all residents have taken part in a quality assurance review of the service and standards of care within the home. Lorne House DS0000018509.V281826.R01.S.doc Version 5.1 Page 17 This quality review is in progress and at the time of the inspection the outcome of the review had not been completed. At the previous inspection the fitting of a handrail to the top of the stairs had been identified as a requirement to ensure safety for residents and staff. The handrail has been fitted to a very high standard. The area on the top stair landing has been altered to prevent the unsafe storage of items. The alterations have been completed in a very effective and considered use of the space. This space now provides an ensuite facility for the resident in the adjoining bedroom, and has been completed to a high standard. This meets all requirements from the previous inspection. Lorne House DS0000018509.V281826.R01.S.doc Version 5.1 Page 18 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 X 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 X 23 3 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 3 X X 3 3 3 3 3 Lorne House DS0000018509.V281826.R01.S.doc Version 5.1 Page 19 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. 1. Refer to Standard YA23 Good Practice Recommendations It is good practice to include flowcharts in guidelines to support staff taking appropriate action should an incident occur, e.g. an incident of abuse, or even an unexpected death in the home. Lorne House DS0000018509.V281826.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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