Inspection on 29/11/06 for Lorne House

This inspection was carried out on 29th November 2006.

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

Lorne House 20/01/06

Lorne House 05/07/05

Lorne House 07/02/05

Lorne House 12/07/04

Lorne House 09/03/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Lorne House 14 Lorne Street Kidderminster Worcestershire DY10 1SY Lead Inspector Dianne Thompson Unannounced Inspection 29th November and 4 December 2006 10:00 th Lorne House DS0000018509.V318580.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 DS0000018509.V318580.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 DS0000018509.V318580.R01.S.doc Version 5.2 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 Mrs Brigida Saporito Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Lorne House DS0000018509.V318580.R01.S.doc Version 5.2 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. 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 service users 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. The current fee for the service ranges from £330.00 per week. Charges which are additional to the fee include: • • • • • Personal toiletries, clothing and electrical items such as TV and music centre. Activities not covered by the allowance made by the provider or in the funding authority contract Holidays Major extra outings Hairdressing Lorne House DS0000018509.V318580.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection that included an unannounced visit to Lorne House. The main purpose of this inspection was to assess the service provided against key National Minimum Standards. Service user and staff records were examined, and a tour of the building was also carried out. A second visit was made to the home so that time could be spent with the registered manager. Time was spent with the provider, the registered manager, service users and staff on duty. Three service users were at home at the time of the inspection visit. What the service does well: What has improved since the last inspection? Information is now kept in a better way to make sure everything is private. The home checks with other people to find out what they think of the service at Lorne House. Lorne House DS0000018509.V318580.R01.S.doc Version 5.2 Page 6 Out of date information is now being kept in a safe place. 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 DS0000018509.V318580.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 DS0000018509.V318580.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): 1, 2, 3, 4 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home provides detailed information about the services it offers to help service users choose to live at Lorne House and to see if the home can meet their needs. EVIDENCE: The home’s statement of purpose provides up to date information about the home to help prospective service users decide if they wish to live at Lorne House. The registered manager said that copies of the Statement of Purpose and Service User Guide are accessible to all, including visitors to the home. All service users receive copies of relevant information prior to moving into the home, which is offered in preferred formats, such as symbols and pictures, audio or large print. There is a vacancy at the home, and the home’s admissions policy and procedure is being followed for all prospective service users. The home’s assessment process is very detailed and the care records demonstrate that the home receives full information about prospective service users, their background, their needs, their likes and dislikes when they are referred for a Lorne House DS0000018509.V318580.R01.S.doc Version 5.2 Page 9 placement. Information is gathered from a range of sources including other relevant professionals, visits to previous homes or day centres, and discussions with family members. Introductory visits and stays are arranged at the home prior to admission. During the introduction to the home prospective service users are given a copy of the Statement of Purpose and Service User Guide. Lorne House DS0000018509.V318580.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): 6, 7, 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Care plans provide staff with relevant information about users assessed needs. They include risk assessments that show how risks are to be reduced and independence promoted. Service users are helped to make choices and decisions in their daily lives and routines. EVIDENCE: Service user care plans are detailed and informative. The plans show how goals are monitored, how they are arranged and how they can be achieved. Staff have information to make sure that all care is provided in a preferred and consistent way that encourages independence. Files for two service users were examined. Case tracking provides a view of how the home responds to the diversity of needs and how this is being managed and supported. This is particularly evident where health needs and disability requires greater input and support from all staff within the home. Lorne House DS0000018509.V318580.R01.S.doc Version 5.2 Page 11 Relevant information and monitoring is provided in service user files to make sure all staff have the necessary information to provide quality care. The existing care plans provide information for the care and support for each service user. There is evidence that appropriate guidelines and goal planning includes professional and specialist support. The manager has confirmed that following the inspection visit information that was previously held in separate files has now been combined into individual service user files. This will improve and maintain confidentiality and access to information. The registered manager was advised that it is good practice to archive outdated information to avoid confusion and overcrowded files. The manager confirmed that archiving has been completed following the inspection visit. A person centred care plan (PCP) approach is being developed within the home. The manager said that staff training is needed for staff to develop their skills to provide support to service users in completing their PCP’s. Each service user is allocated a key worker to oversee their care. Each key worker builds a closer relationship so they gain more understanding and knowledge of individual needs, goals and wishes. The home completes risk assessments to promote safety and independence for service users. Lorne House DS0000018509.V318580.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): 12, 13, 15, 16, 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users receive help and encouragement to lead active and interesting lives and are supported to access facilities within the wider community. They are also supported to maintain links with their families and to develop friendships. The home offers a well-balanced menu and promotes healthy eating for the welfare of all service users. EVIDENCE: The home provides a range of activities for service users, both in-house and within the local community. All activities are organised to take into account the individual needs and preferences, making sure that everyone has the opportunity to take part. Lorne House DS0000018509.V318580.R01.S.doc Version 5.2 Page 13 At the time of the first visit to the home, the manager, staff and service users were out Christmas shopping. External activities include going for a ride in the car, day trips, shopping, going for a walk, train rides, swimming and lunch out. Some service users go to the Edward Parry Centre for evenings out. The home has planned a theatre trip in January to see the pantomime Snow White. Internal activities include watching a DVD, art, colouring, and bingo. Service users take part in household activities depending on their preferences and abilities. This can include laying the table for meals, vegetable preparation, and cake making. Other regular activities encouraged and supported within the home include cooking, menu planning, shopping, and making sandwiches for lunch. Activity plans are in place for all service users and they are regularly updated. Service users attend local day centres such as the O’Dell centre. They also go to the Tulip Lunch Club and Kidderminster College where they take part in various activities such as cookery, singing, drama and self-advocacy. Regular holidays are planned for all service users. Holidays to Scarborough and Blackpool took place earlier this year. A holiday is planned for next year to Nottingham that will include a trip to see Daniel O’Donnell. Evidence is available to show that regular contact with friends and family is supported. The home provides well-balanced meals, with drinks and snacks available at all times. Food offered is varied, healthy and appropriate to individual needs. Lorne House DS0000018509.V318580.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): 18, 19, 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Personal and healthcare needs are clearly identified in care plans. These plans provide information to promote consistency of care and support for all service users in a way that takes into account their preferences. The home has a clear medication policy and procedure, which is followed to make sure that all medication is administered and stored safely for the protection of service users and staff. EVIDENCE: Service users’ care records and plans provide detailed information about their physical and mental health and the support needed from staff to maintain their good hygiene and health. The care plans sampled contain information about service users preferred personal care routines. The service users at home at the time of the visit were limited in their communication, but they appeared to be comfortable and relaxed in their home environment. Lorne House DS0000018509.V318580.R01.S.doc Version 5.2 Page 15 Records of all physical checks are completed where service users have particular health related issues such as weight. In this way the home is able to closely monitor and respond to changes or obtain appropriate medical input whenever necessary. Service users and the home are well supported by medical services, which include GP’s, community learning disability team, dietician, optician and the continence advisor. Arrangements are in place for preventative health services, such as dental checks and annual health screening. The registered manager said that all personal care is given in private to promote dignity for all service users. The manager is very aware of the specialist services that could be needed to support service users and how to access them. The home has a medication policy and procedure in place. Medicines are suitably and safely stored and there is appropriate storage for controlled drugs, should they be required. Information is available to advise staff about prescribed medication together with any possible side effects. A sample of all staff signatures is now held in the medication file. Staff work in pairs when administering medication to ensure that all medication is given safely. The manager confirmed that the home’s policies and procedures would be followed should any medication error occur. Additionally these would be reported to CSCI. Lorne House DS0000018509.V318580.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): 22, 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users are protected by easy to understand information about how to complain, with appropriate information for staff provided. Staff support service users to express their views and any concerns they may have. EVIDENCE: The home’s complaints procedure is available in widget signs and symbols to make it accessible for service users. The manager confirmed that no complaints have been made to the home. No complaints have been received by CSCI since the previous inspection. The home has relevant policies for service users’ protection. Policies and procedures are available which advise and guide staff in protecting service users. A poster that gives advice about abuse is prominently displayed in the home. Staff were observed interacting with service users in a supportive and respectful way throughout the inspection visit. Lorne House DS0000018509.V318580.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): 24, 30 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Lorne House provides accommodation for service users that meets their needs and offers a safe, spacious and comfortable home. The home is kept clean which ensures that good hygiene and infection control is maintained for the benefit of service users. EVIDENCE: Lorne House is in a three storey terraced house, with an enclosed garden to the rear. Originally two separate houses, they have been combined to form one fully integrated house. Three of the bedrooms are on the ground floor and are easily accessed by people with mobility difficulties. The bedrooms are homely, spacious, and individually decorated and furnished. All bedrooms have en-suite facilities. Notices are evident in all rooms written in signs and symbols appropriate for service users, such as evacuation procedures in the event of a fire. Lorne House DS0000018509.V318580.R01.S.doc Version 5.2 Page 18 There are sufficient toilets and bathroom facilities on all floors, with separate laundry and kitchen facilities. The communal areas of the home are comfortable and well furnished, with adequate space for privacy or individual activities. There are two conservatories, one leading on from the other. There have been new additions to the home since the last inspection visit, namely a new puppy dog and an aquarium with a number of fish. A service user said he ‘likes the puppy’. The puppy seems to have settled in the home with the service users and staff. The premises are clean and tidy. Policies and procedures for infection control are in place and staff are provided with disposable gloves and aprons. Communal bathrooms have paper towels and liquid soap available. All cleaning materials are stored in locked cupboards in the laundry room. Lorne House DS0000018509.V318580.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): 32, 34, 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Suitable staffing levels are being maintained and staff receive relevant training to help them meet service users’ needs. The staff team understand their responsibilities and are committed to their role. They are well supported and work together to provide service users with consistent and good quality care. The home’s recruitment policy and practices make sure that suitable staff are employed and that all necessary checks are made to ensure the safety of all service users. EVIDENCE: The registered manager said that staffing levels have improved since the last inspection following successful recruitment. The home continues to operate a rota for shift cover. The rota was available for inspection. Staff training records at the home demonstrates that planning for future training courses is maintained. Staff complete the mandatory health & safety Lorne House DS0000018509.V318580.R01.S.doc Version 5.2 Page 20 training such as fire safety, first aid, food hygiene, moving and handling, and Cossh. Infection control training is currently being completed as a distancelearning course. The manager confirmed that all prospective staff complete an appropriate application form and that suitable references are obtained including one from their most recent employer. An enhanced CRB/POVA (police) check is undertaken before their appointment is confirmed. All staff are required to work a probationary period at the home. Lorne House DS0000018509.V318580.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): 37, 39, 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home is well managed with an open and positive approach. The registered manager has completed NVQ 4 and is currently completing the Registered Managers Award. This should be beneficial to the service users and the staff team when achieved. The home promotes health and safety that includes risk assessments to keep service users and staff safe and protected. EVIDENCE: The registered manager, Mrs Gina Vaughan has managed the home for many years and has completed training courses relevant to the service provided. Gina was informed last week that she had successfully completed her NVQ level 4. Gina is also an NVQ assessor and has completed an Internal Verifiers Lorne House DS0000018509.V318580.R01.S.doc Version 5.2 Page 22 course. She is working to complete her Registered Managers Award, and hopes to complete this as soon as possible. Additional training has included a Foundation course in Food Management, and Infection Control. A deputy manager who has recently completed NVQ 3 and an Introduction to Management training course supports the registered manager. A Quality Assurance audit has been completed for the service and feedback was discussed with the manager during the inspection visit. The audit report and an action plan for the forthcoming year has been completed and a copy supplied to CSCI since the inspection visit. The report provides views and feedback on the effectiveness of the service and the plan sets out how the home will address areas highlighted for development. This includes the introduction of a Smoking Policy for the home that the manager aims to complete by the end of February 2007. The manager will complete these audits annually as part of the ongoing review of the service. Copies of the report summary together with copies of the home’s complaints procedure are being sent to families and carers. Records show that monthly checks of the fire safety system & equipment, water temperature & storage, fridge, freezers and electrical appliances are completed. Staff are undertaking all mandatory health & safety training topics. Generic risk assessments are in place. Fire drills are being completed. The homes fire risk assessment is up to date. The fire officer has visited the home and all records were checked and found to be up to date. The home was advised to fit an additional fire detector and this has been done. Lorne House DS0000018509.V318580.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 3 3 3 4 3 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 4 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 3 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 3 3 3 X 3 X 3 X X 3 X Lorne House DS0000018509.V318580.R01.S.doc Version 5.2 Page 24 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 Lorne House DS0000018509.V318580.R01.S.doc Version 5.2 Page 25 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: 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 DS0000018509.V318580.R01.S.doc Version 5.2 Page 26 - 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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