Inspection on 05/01/06 for Lorne House

This inspection was carried out on 5th January 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Lorne House 12/08/08

Lorne House 14/08/07

Lorne House 19/06/06

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 09/07/2008.

CARE HOME ADULTS 18-65 Lorne House 66 Yarm Road Stockton-on-Tees TS18 3PQ Lead Inspector Julia Connor Unannounced Inspection 5th January 2006 9:50 Lorne House DS0000000011.V262347.R01.S.doc Version 5.0 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.V262347.R01.S.doc Version 5.0 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.V262347.R01.S.doc Version 5.0 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 01642 641006 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.V262347.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of persons shall not exceed 14 adults with learning disabilities inc 3 with mental and physical disability 3rd August 2005 Date of last inspection Brief Description of the Service: Lorne House is a 14 bedded home which provides residential care for adults with learning disabilities, including 3 adults who also have physical disabilities. The home has an extension added to the original building, car parking to the front of the home, a conservatory and a very large enclosed private garden to the rear that contains a lawned area, flower beds and garden furniture. There are ample bathrooms, shower rooms and shared living areas, to meet the needs of the people living at the home, which is situated on a busy road that runs into Stockton Town Centre. There are shops and churches nearby. Lorne House DS0000000011.V262347.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection commenced at 9.50 a.m. and concluded at 4.00 p.m. Three Residents’ and three members of staff were spoken to during the inspection. Eight relatives’ returned comment cards. It is of concern that there are requirements from the three previous inspection reports that have not been acted on. What the service does well: What has improved since the last inspection? The Manager has commenced work on the quality assurance system. Some training has taken place; the Inspector evidenced a training programme for 2006. Lorne House DS0000000011.V262347.R01.S.doc Version 5.0 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. Lorne House DS0000000011.V262347.R01.S.doc Version 5.0 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.V262347.R01.S.doc Version 5.0 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): 2 and 5 Residents’ are admitted to the home once their individual needs have been assessed but there was no evidence that they had been involved in their assessment. Written contracts do not contain sufficient information to fully reflect what the Residents’ can expect for their money. EVIDENCE: Three Residents’ care files were audited and all contained assessment documents; however there was no evidence that the Resident had been involved in his/her assessment. At the last two inspections, the Residents’ contracts did not clarify what services were/were not included in the cost of the placement, nor did the contract reflect the full cost of the placement. These issues were still outstanding on this occasion. The Manager informed the Inspector that the Registered Person is currently discussing fees with Stockton Borough Council and the contracts will be finalised once these discussions are completed. Lorne House DS0000000011.V262347.R01.S.doc Version 5.0 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): 7 and 9 Residents are encouraged to make decisions about their lives, which includes taking risks. EVIDENCE: Three Residents’ files were audited and contained an adequate amount of information. However, documentation was not dated; therefore it was difficult to establish whether the information was up to date and reflected the changing needs of the Resident. The Resident or a member of staff had not signed the care documentation. It was evident from talking to the Residents’ that they were encouraged to make their own decisions about their life style, which included taking risks. Lorne House DS0000000011.V262347.R01.S.doc Version 5.0 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): 12, 13, 14, 15, 16 and 17 Residents’ have the opportunity for personal development and take part in age and peer appropriate activities. Residents’ are able to have personal relationships and their rights and responsibilities in their every day lives are acknowledged and respected. Residents’ are offered a healthy diet, which they enjoy. EVIDENCE: Residents’ engage in personal relationships if they so choose. One Resident stated that she had made friends whilst living in the home and still continued to go on outings with a Resident who has moved on to having a flat of their own. Lorne House DS0000000011.V262347.R01.S.doc Version 5.0 Page 11 Discussion with Residents’ confirmed that they had opportunities for personal development. The Residents’ spoke about their time spent at college or the day centre. One Resident stated that she enjoyed going into Stockton to shop and then meet a friend for lunch. It was evident following discussion with Residents’ and staff that the Residents’ rights were respected and they were encouraged to make their own decisions. Residents’ informed the Inspector that the ‘food was good’ and that an alternative meal was available if required. There was evidence on the menu that the Residents’ had been involved in choosing what meals were served. The acting Cook informed the Inspector that the Residents’ baked the cakes and scones that were available. A Resident who spoke to the Inspector confirmed this. The Residents’ are encouraged to make themselves a hot drink as long as they are able to do so. Residents’ are also encouraged to wash up and keep the kitchen clean and tidy. There was a good store of dried and frozen food. Fresh vegetables were evidenced. Fresh fruit is delivered twice a week. Lorne House DS0000000011.V262347.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Residents’ receive personal support in the way they prefer and their physical and emotional needs are met. Medication is dispensed appropriately and Residents’ are protected by the home’s policies and procedures for dealing with medication. EVIDENCE: The Residents’ who spoke to the Inspector were happy with the personal support they received from the staff. One Resident stated that the staff chatted with her when she was upset which was of help to her. There was evidence in the Residents’ notes that staff offered support to the Residents’ at a level that was acceptable to them. There was a policy and procedure for the receipt, recording, storage, handling, administration and disposal of medicines. Two members’ of staff dispense medication; the Team Leader removes the medication from the pack and a support worker checks and then administers the medication to the Resident. No Resident currently self medicates. Lorne House DS0000000011.V262347.R01.S.doc Version 5.0 Page 13 With regards to the recommendation made at the last inspection that an updated BNF be made available. The Manager stated that an updated BNF was purchased unfortunately it has been misplaced. However, there are ‘patient information sheets’ available for the staff to access until the BNF is found or a new one purchased. Lorne House DS0000000011.V262347.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 22 and 23 were not assessed on this occasion. EVIDENCE: Lorne House DS0000000011.V262347.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 27 The Residents’ live in a homely and comfortable environment, which is not well maintained. EVIDENCE: The Manager and Inspector made a tour of the home. Residents’ bedrooms were very personalised and had pictures and personal effects in place. It is of great concern that the large crack running down the wall of the main staircase is still to be repaired. This crack was first reported in the August 2004 inspection report. In the front sitting room there is a large crack running up the skirting board from the floor to a height of approximately one and a half feet. This defect was first reported in the August 2005 inspection report. Lorne House DS0000000011.V262347.R01.S.doc Version 5.0 Page 16 The carpet in the front lounge needs replacing, as there is a patch in front of the TV that is well worn. The basin in the shower needs a deep clean and fresh grouting. The two bathroom/shower rooms identified during the October 2004 inspection have still not been decorated. The dining room and the lounge opposite the dining room require new carpets. The wallpaper border in the dining room is coming away from the wall. The side cushion in the Kingcroft bath needs to be replaced as it is torn and could cause damage to Residents’ skin. The flooring in this bathroom with the Kingcroft bath requires a deep clean and the walls decorating. The carpet in the bedroom near the entrance to the home needs to be replaced. The toilet (opposite the staff cloak room) needs to be decorated and the flooring requires a deep clean. There are a range of doors and doorjambs that are damaged and require attention. On the day of the inspection, the home was clean, tidy and hygienic, with no offensive smells. Lorne House DS0000000011.V262347.R01.S.doc Version 5.0 Page 17 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, 35 and 36 Staff are being trained to NVQ level 2 which will ensure that they shall meet the needs of the Residents’. The home has made improvements in providing staff with the training they need to meet the Residents’ needs. Formal supervision for the staff is not taking place. EVIDENCE: It was recorded in the Pre-Inspection Questionnaire that 40 of staff had been successful in obtaining their NVQ Level 2. The Manager stated that formal supervision had commenced for the Team Leaders however it was still to commence for the support workers. The staff who spoke to the Inspector stated that they received support and supervision but the Inspector was unable to evidence that this supervision had taken place. Training for manual handling and fire has taken place. A training programme for 2006 was evidence. Following discussion with staff it was evident that Resident specific training would be of benefit for example epilepsy and challenging behaviour. Lorne House DS0000000011.V262347.R01.S.doc Version 5.0 Page 18 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 and 42 The Manager is working towards developing an effective quality assurance and quality monitoring system for the home. There are policies and procedures in place to ensure the welfare of the Residents’ and staff are promoted and protected. EVIDENCE: There was evidence that the Manager had commenced an auditing system for the home, which includes staffing, medication and Resident/family questionnaires. However, the Manager must ensure that the questionnaires that the Residents’ and their family members are asked to complete are dated. There were health and safety policies and procedures in place to ensure the welfare of the Residents’ were protected. Lorne House DS0000000011.V262347.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 2 X X 2 Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 2 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X 3 X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 X X 2 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Lorne House Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score X X 2 X X 3 X DS0000000011.V262347.R01.S.doc Version 5.0 Page 20 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard 2 Regulation 24 Requirement The Registered Person must ensure that the Resident and/or their next of kin are involved in assessing, planning and evaluating care. The Registered Person must ensure that the Residents’ contracts include information relating to additional cost; and reflect the actual cost of the placement. THIS IS OUTSTANDING FROM THE OCTOBER 2004 INSPECTION. The practice of the home using residents personal allowances to pay the cost of staff entry when supporting service users on outings must be discontinued. THIS IS OUTSTANDING FROM THE OCTOBER 2004 INSPECTION. The Registered Person must ensure that the crack on the upper hall staircase be repaired and the walls redecorated. THIS IS OUTSTANDING FROM THE AUGUST 2004 INSPECTION. The Registered Person must ensure that the two bathroom/shower rooms DS0000000011.V262347.R01.S.doc Timescale for action 28/02/06 2 5 5 28/02/06 3 14 5 31/03/06 4 24 23 31/03/06 5 24 23 30/04/06 Lorne House Version 5.0 Page 21 6 24 23 7 39 24 identified during the inspection be decorated. THIS IS OUTSTANDING FROM THE OCTOBER 2004 INSPECTION. The Registered Person must ensure that the crack to the wall in the front sitting room be repaired and made good. THIS IS OUTSTANDING FROM THE AUGUST 2005 INSPECTION. The Registered Person must introduce a system to review the quality of care at the home in accordance with Regulation 24 of the Care Homes Regulations 2001. THIS IS OUTSTANDING FROM THE OCTOBER 2004 INSPECTION. 30/04/06 31/03/06 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 2 3 4 Refer to Standard 7 20 32 36 Good Practice Recommendations The Registered Manager should ensure that the Residents’ care documentation is dated. The Registered Manager should ensure that he obtains a current British National Formulary. The Registered Manager should ensure that a minimum of 50 of care staff hold an NVQ level 2 qualifications in care. The Registered Manager should ensure that staff receive supervision 6 times a year. Lorne House DS0000000011.V262347.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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