Inspection on 08/08/05 for Lorne House

This inspection was carried out on 8th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 05/01/06

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 Penni Hughf Unannounced 8 August 2005 09:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lorne House B51-B01 S11 Lorne House V242573 030805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Lorne House Address 66 Yarm Road Stockton-on-Tees TS18 3PQ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01642 617070 01642 641006 Lorne House Residential Home Trust Limited Mr James D Leslie Care home only 14 Category(ies) of LD - Learning Disability - 14 registration, with number of places Lorne House B51-B01 S11 Lorne House V242573 030805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25 & 26 October 2004 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 B51-B01 S11 Lorne House V242573 030805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was undertaken by two inspectors, and took three hours. It was carried out as one of the two annual statutory inspections required by the Care Standards Act 2000. A tour of the premises took place, and staff and care records were inspected. Residents and staff were observed during the inspection throughout the home. Discussions took place with the manager, one of the directors, the clerical assistant, a Team Leader and a member of the care staff. As there were a number of outstanding requirements from the previous inspection, these were the focus of this inspection. What the service does well: What has improved since the last inspection? The home is has improved its’ service user guide to include how to make complaints. The manager and three of the four team leaders have undertaken external training on adult protection and staff have participated in in-house training. Most of the staff have now completed all their mandatory training courses, with those outstanding scheduled for later in the year. The manager, together with the directors, is prioritising the budget to address the many outstanding requirements. Lorne House B51-B01 S11 Lorne House V242573 030805 Stage 4.doc Version 1.40 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 B51-B01 S11 Lorne House V242573 030805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Lorne House B51-B01 S11 Lorne House V242573 030805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 & 5 The home is excellent at providing information about the home in a format that residents can understand. They need to improve the agreements they have with the residents to fully reflect what they can expect for their money. EVIDENCE: The service user guide was in large print and included illustrations and pictures, which enabled residents with severe learning disabilities to access the information. Since the last inspection, the guide had been amended to include how residents could make complaints and to give contact details for the Commission for Social Care Inspection. At the last inspection, 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. However, the manager stated that a new business support company (First Business) had been employed by the home, and they were currently looking at the resident’s contracts, in order to rectify these issues. Lorne House B51-B01 S11 Lorne House V242573 030805 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 The home is good at ensuring that the changing personal goals and needs of residents are identified and met. Residents and their relatives are treated with dignity and respect. EVIDENCE: Staff said that they were in the process of updating care plans and there was evidence on file of reviews having been carried out recently. The care plans were comprehensive and covered areas including health, communication, nutrition and development and activity programmes. These were very detailed, and also included the name of the resident’s key worker. Risk assessments were in evidence. The resident and the key worker had both signed the care plans examined, but they were not dated. Part of the care plan identified that the staff would spend at least half an hour a day on a one to one basis with the resident. It was clear that the plans were working documents, which were filled in twice daily. Lorne House B51-B01 S11 Lorne House V242573 030805 Stage 4.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Standards not assessed on this occasion. EVIDENCE: Lorne House B51-B01 S11 Lorne House V242573 030805 Stage 4.doc Version 1.40 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 standard(s) 20 The home is good at making sure that medication procedures keep the residents safe. EVIDENCE: Medication was securely stored. The home had in place an appropriate system for the recording, receipt, administration and disposal of all medicines received into the home. This included resident’s photographs in the MAR sheets binder, two staff to administer, refusals noted and recorded on the rear of the MAR sheet. However, as the manager pointed out that the dispenser did not always see the distributor administer the medication, it was agreed that the procedure should be altered to show that they were signing for the dispensing of the medication, and the distributor was signing for the administration. The home also kept a British National Formulary, but this was dated September 2003 and it was advised that they obtain an up to date version. Lorne House B51-B01 S11 Lorne House V242573 030805 Stage 4.doc Version 1.40 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 standard(s) The home is good at making sure that residents know how to complain and providing a robust procedure to protect residents from abuse. EVIDENCE: The home’s complaints form, like the Service User Guide, was in a pictorial format, which also included some sign language. This was very user friendly, and had been amended since the last inspection, to include contact details for the Commission for Social Care Inspection. The home had a policy and procedure on the prevention of adult abuse. The manager said that he had completed the Protection of Vulnerable Adults training course, and three of the four Team Leaders had completed the Department of Health’s “No Secrets” training. The fourth Team Leader was scheduled to undertake this training in September 2005. All the rest of the staff had completed the training module incorporated into the “No Secrets” documents. He told the inspectors that the Principal Training Officer from Stockton Social Services had agreed to come to the home, and look at the staff’s work. Staff and the manager when interviewed at the last inspection, demonstrated an appropriate understanding of adult protection procedures Lorne House B51-B01 S11 Lorne House V242573 030805 Stage 4.doc Version 1.40 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 standard(s) 24,25,26,27,28 & 30 The home is good at making sure that the residents live in a home that is comfortable and safe and where their rooms reflect their personalities. Recent investment has improved the environment, although further investment is still required. EVIDENCE: On the day of inspection a tour of the premises was undertaken. The home was well-decorated to an appropriate standard and furniture and fittings were of a suitable quality. The home was spacious and was very domestic in style. All the communal areas were accessible to the residents. There was a large rear garden and patio area, which was enclosed, attractively laid out and well maintained. At the last inspection, it was noted that the wall and ceiling of the staircase had a large crack running down it and this was still outstanding. The manager said that since the last inspection, the roof had been repaired, which had been necessary prior to the crack being repaired. Lampshades missing at the last inspection had now all been replaced. The front sitting room was in need of repair, where there was a large crack running up from the floor to a height of approximately one and a half feet. Lorne House B51-B01 S11 Lorne House V242573 030805 Stage 4.doc Version 1.40 Page 14 The tour of the premises identified that all residents had their own rooms, which were individually decorated to their liking. There was clear evidence of resident’s involvement in choosing their colour schemes and furniture and a number of residents’ rooms were spacious enough to include furniture such as settees and lounge chairs. Residents were encouraged to personalise their rooms, and all the rooms had pictures and personal effects in place. Five of the residents’ bedroom carpets had been replaced and all the carpets throughout the home were of a high quality. The home has sufficient bathrooms and lavatories to meet the National Minimum Standards. These were appropriately decorated but at the last inspection, two required redecoration to make them more homely in appearance. This requirement was still outstanding. It was also noted during this inspection, that there were no towels in a number of the bathrooms/lavatories and this must be addressed. The issues regarding the excessive hot water temperatures within three shower rooms and one bathroom have now been addressed. On the day of the inspection, the home was found to be very clean, tidy and hygienic, with no offensive smells. Lorne House B51-B01 S11 Lorne House V242573 030805 Stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32 &34 The home has made improvements to providing staff with the training they need to meet the resident’s needs. They must make sure that this training provision continues for all the care staff. Improvements have also taken place to the recruitment procedures, but this improvement must be maintained. EVIDENCE: There was a clear structure within the home, with a manager, four team leaders, care staff and ancillary staff comprising a clerical assistant, a handyman/driver, a laundry assistant, a domestic and a cook. A schedule of mandatory training outstanding for the staff at the last inspection, had now been instigated, and was ongoing. Approximately threequarters of the staff had now completed all their mandatory training, with a quarter of the staff having completed most of the courses. The manager must ensure that all the staff complete their full complement of mandatory training courses. Lorne House B51-B01 S11 Lorne House V242573 030805 Stage 4.doc Version 1.40 Page 16 Staff files examined contained the information required by schedule 4 of the Care Homes Regulations 2001, including a copy of the staff members’ contracts. These were out of date in respect of the salary. The manager said that the home had now employed a business support company (first Business) and they were renewing the contracts for both the staff and the residents. Although the manager and staff said that supervision took place, it was not on a regular basis, and should be undertaken for each staff member at least six times a year, as identified in standard 36.4 of the National Minimum Standards for Care Homes for Adults. Lorne House B51-B01 S11 Lorne House V242573 030805 Stage 4.doc Version 1.40 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 The home is showing improvement with the manager demonstrating a clear understanding of the need for staff support to continue to improve staff morale EVIDENCE: The manager held a professional social work qualification and a recognised management qualification. He was well experienced in working with people with a learning disability. At the previous inspection, discussions were held with the responsible person and a recommendation made that the registered manager should be able to remain task focused and manage the day to day running of the home, and not become overly involved in historical issues which are primarily the responsibility of the management board to resolve. This remains the case and further discussion took place at this inspection with the manager regarding this. Lorne House B51-B01 S11 Lorne House V242573 030805 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x x x 2 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 2 3 x 3 Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score 3 2 x x x 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Lorne House Score x x 3 x Standard No 37 38 39 40 41 42 43 Score 3 x x x x x x B51-B01 S11 Lorne House V242573 030805 Stage 4.doc Version 1.40 Page 19 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 5 Regulation 5 Requirement Resident contracts must include information relating to additional cost. Resident contracts must also reflect the actual cost of the placement. This is outstanding from the last 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 last inspection The crack on the upper hall/staircase must be repaired and walls redecorated. This requirement is outstanding from the last two inspections The two bathroom/shower rooms identified during the inspection must be decorated. This requirement is outstanding from the last inspection. The registered provider must ensure that all staff receive training in respect of moving and handling, health and safety, food safety and infection control. This requirement is outstanding from the last inspection. The registered manager must B51-B01 S11 Lorne House V242573 030805 Stage 4.doc Timescale for action 31/12/04 2. 14 5 25/09/05 3. 24 23 30/07/04 4. 27,42 23 31/01/05 5. 35,32 18 31/01/05 6. 39 24 31/01/05 Page 20 Lorne House Version 1.40 7. 8. 9. 24 27,42 23 23 introduce a system to review the quality of care at the home in accordance with Regulation 24 of the Care Homes Regulations 2001. This requirement is outstanding from the last inspection The crack to the weall in the front sitting room must be repaired and the made good. The registered manager must ensure that towels are avaliable in all lavatories. 8/10/05 8/08/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 32 37 Good Practice Recommendations A minimum of 50 of care staff should hold NVQ level 2 qualifications in care or equivalent by 2005 The responsible person should ensure that the registered manager is able to remain task focused and manage the day to day running of the home, and not become overly involved in historical issues which are primarily the responsibility of the management board to resolve. The registered manager should ensure that staff receive supervision 6 times yearly The registered manager should ensure that he obtains a current British National Formulary. 3. 4. 36 20 Lorne House B51-B01 S11 Lorne House V242573 030805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Unit B, 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. Extracts may not be used or reproduced without the express permission of CSCI Lorne House B51-B01 S11 Lorne House V242573 030805 Stage 4.doc Version 1.40 Page 22 - 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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