Inspection on 28/02/06 for Lowena Hostel

This inspection was carried out on 28th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lowena Hostel 23/01/09

Lowena Hostel 22/01/07

Lowena Hostel 29/06/05

Lowena Hostel 01/12/04

Lowena Hostel 15/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Lowena Hostel Mitchell Hill Truro Cornwall TR1 1JX Lead Inspector Ian Wright Announced Inspection 28th February 2006 13:30 Lowena Hostel DS0000043186.V259964.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 Lowena Hostel DS0000043186.V259964.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. Lowena Hostel DS0000043186.V259964.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lowena Hostel Address Mitchell Hill Truro Cornwall TR1 1JX 01872 270013 01872 241992 jjackson@cornwall.gov.uk 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) Cornwall County Council Ms Julia Jackson Care Home 25 Category(ies) of Learning disability (25) registration, with number of places Lowena Hostel DS0000043186.V259964.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th June 2005 Brief Description of the Service: Lowena is a care home for adults with learning disabilities providing respite care. Over 100 families are currently supported by the service. The home is located within the City of Truro. The home is purpose built, divided into four residential units, linked together by a central entertainments and activities room. One unit accommodates children and is inspected separately. There is a sensory garden and brightly decorated courtyard for service users to enjoy. Each unit has its own kitchen, dining room and lounge. The home is fully wheelchair accessible. Lowena Hostel DS0000043186.V259964.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over five and a half hours. The primary focus was inspecting standards not assessed at the previous inspection, and other relevant ‘key’ standards. The inspector met with the registered manager, and spoke to service users and staff on duty. The inspector examined the medication system, care and service records, and inspected the building. What the service does well: 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. Lowena Hostel DS0000043186.V259964.R01.S.doc Version 5.1 Page 6 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 Lowena Hostel DS0000043186.V259964.R01.S.doc Version 5.1 Page 7 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): 3, 5 The home meets the needs and aspirations of service users. For example there are suitable links with external agencies so service users needs can be met while they stay at Lowena. All service users are issued with an individual statement of terms and conditions of residency so they are aware of their rights and responsibilities. EVIDENCE: The registered manager described suitable links with external professionals such as social workers and district nurses. The registered manager said staff have suitable skills, knowledge and qualities to meet the needs of service users. 61 of staff currently have a National Vocational Qualification in care at least at level two. Senior staff are completing NVQ 4 in care. The registered manager said each service user had a statement of terms and conditions of residency. A copy of these are maintained on service user files. Lowena Hostel DS0000043186.V259964.R01.S.doc Version 5.1 Page 8 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): 6, 7, 9, A suitable care planning system is in place so service users can receive consistent care from staff. Care plans are reviewed to ensure they reflect service users’ changing needs. Staff encourage service users to make decisions about their lives. Service users are encouraged to take responsible risks to encourage personal growth. EVIDENCE: The inspector examined a suitable care planning system. The manager said care plans are reviewed regularly. The manager said service users have review meetings, which are either held, at Lowena or at the day centre where service users’ attend. Some care plans did not have a photograph of the service user, however the registered manager said she would attend to this shortly. The registered manager said staff try and involve service users as much as possible in the day-to-day routine of the home. Service users are encouraged to make decisions during their stay. Residents meetings occur and these are documented. The registered manager said staff look after some monies and valuables for service users. Appropriate records for service user monies kept by staff are maintained. Lowena Hostel DS0000043186.V259964.R01.S.doc Version 5.1 Page 9 Risk assessments for individual service users were inspected. The registered manager said staff encourage service users to take responsible risks to promote their independence. For example some service users are involved in preparing their meals. Lowena Hostel DS0000043186.V259964.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): 12, 15,16 Suitable activities are available for service users during their stay at Lowena. Service users are encouraged to maintain friendships and relationships during their stay, and visitors are welcome. Service users are encouraged to take responsibilities for their lives during their stay. Service users appear to be treated with respect and their rights are acknowledged. EVIDENCE: The registered manager said service users have a range of suitable day activities. These include attending day centres, college and various clubs. When service users stay at Lowena they are able to continue to pursue their usual day activities, as for example, staff arrange transport for them. At weekends activities are arranged for example there is a minibus which enables service users to, for example, go shopping, shopping and to the cinema. The registered manager said service users are encouraged to maintain friendships during their stay. For example service users can telephone their parents, other carers, friends and relatives. Service users can also receive visitors at any time. Lowena Hostel DS0000043186.V259964.R01.S.doc Version 5.1 Page 11 The registered manager said service users are encouraged to take responsibility for helping out in the home during their stay. For example service users are involved in cooking, cleaning and laundry according to their skills. Staff were observed working with service users in a respectful way. Service users who the inspector was able to speak to spoke positively about care received from staff. The registered manager said staff always knock on service users’ bedroom doors before entering. Bedroom doors are lockable, and service users can be provided with a key if they have the ability to use it, and this would not put them at risk. The registered manager said all bedrooms have a lockable drawer where service users can store valuables during their stay. Valuables can also be stored in the safe. Lowena Hostel DS0000043186.V259964.R01.S.doc Version 5.1 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): 20 The registered manager ensures medication is stored and handled appropriately. Training regarding the handling of medication must be improved. EVIDENCE: Medication is stored in the office area of each unit. The registered provider has a suitable policy regarding the handling of medication. Accurate records are kept regarding the storage and handling of medication. The registered manager said many of the Assistant Officer grade of staff have received external training regarding safe handling of medication, and she wishes all staff to receive this. However no certificates to evidence medication training were available for inspection. Lowena Hostel DS0000043186.V259964.R01.S.doc Version 5.1 Page 13 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): 22 The registered provider has a suitable complaints procedure. The registered persons take any complaints seriously, and a suitable process is followed to resolve any concerns. EVIDENCE: A suitable complaints procedure was inspected. Service users and their carers are provided with a copy of the home’s Service User Guide. Within this there is a summary of the complaints procedure. The registered manager said complaints are also recorded in a ‘Complaints book’. The registered manager outlined suitable action regarding complaints, which have been received by the home, for example meeting with complainants with the aim to resolve any concerns. Numbers of complaints recorded are minimal. The Commission for Social Care Inspection has not received any complaints regarding care in this home. Lowena Hostel DS0000043186.V259964.R01.S.doc Version 5.1 Page 14 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, 30 Lowena provides a suitable environment for the service users accommodated. The building was clean and hygienic on the day of inspection, and suitable arrangements are in place to maintain hygiene standards. EVIDENCE: The building was inspected. The building appears to be maintained to a good standard. Furnishings and decorations are suitably maintained, and the home appears comfortable. There appears to be suitable space to meet the needs of service users. The home was clean and there were no unpleasant odours. The registered manager said a cleaner is employed from Monday to Friday. Lowena Hostel DS0000043186.V259964.R01.S.doc Version 5.1 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 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, 33, 35 Satisfactory numbers of staff are employed so service users can be assured they will have enough support. Staff training needs improvement, for example there are some gaps in training required by regulation (e.g. first aid), and to meet the specific needs of some service users (e.g. epilepsy). Training records must be improved so the Commission for Social Care Inspection can evidence the standard is met. The registered persons have a suitable approach to enable staff to obtain a National Vocational Qualification. EVIDENCE: The registered manager said suitable staffing is provided to meet service user needs. There are always four staff on duty on each wing, and one in the training flat during the waking day. Night staffing is suitable (i.e. two waking night staff). Staff rotas are maintained and demonstrate this level of staffing is met. Day to day supervision is satisfactory (i.e. a manager is always on duty). A formal one to one supervision system is in place and this is documented. There is currently a dispute between staff and Cornwall County Council regarding overtime. This has resulted in some staff refusing to carry out more than their contracted hours. If staff refuse to complete more than their contracted hours this right must be respected. The registered provider must under no circumstances staff the home with less than the agreed staffing levels as outlined above. Agency staffing must be used or the service provided must be cut (e.g. providing care in only some of the units). This will ensure care can be delivered within the agreed staffing levels until the dispute is resolved. The Lowena Hostel DS0000043186.V259964.R01.S.doc Version 5.1 Page 16 Commission must be kept informed if the service is adversely affected by the dispute. The registered manager outlined a suitable approach to enable staff to receive a National Vocational Qualification in care. The registered manager said currently over sixty percent of staff have at least an NVQ 2. The registered manager said staff receive a formal induction when they start working at Lowena. The manager said this covers policies and procedures, and practical tasks to assist staff to complete shifts. Staff also receive the opportunity to visit other social services’ establishments. The manager said staff have received specific training to meet individual service users’ special needs e.g. autism, communication etc. The manager said individual training needs are identified through staff supervision and appraisal. The manager said staff have completed the majority of training required by law (e.g. fire prevention, food handling, first aid, and moving and handling.) The registered manager said she has had some difficulty in arranging infection control training, and the inspector suggested the Royal Cornwall Hospital or the Primary Care Trust could be approached. Although a spreadsheet of training received by staff is maintained, no certificates of training attended by individual staff are kept. The Commission for Social Care Inspection needs to be able to inspect individual certificates of training attended by staff as evidence Standard 35 is met. The training spreadsheet also shows a minority of staff have not completed all training required by regulation, and other training necessary for staff to meet the needs of service users (e.g. epilepsy and handling of medication). This training must be completed. Lowena Hostel DS0000043186.V259964.R01.S.doc Version 5.1 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 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): 40, 42, 43 The registered persons have developed suitable records, policies and procedures regarding the running of the home, so service users can be assured the home is managed in their best interests. Suitable health and safety precautions are in place so service users can be assured they are living in a safe environment. EVIDENCE: Suitable policies and procedures were inspected. The registered manager said copies of policies are made available to the staff team. The registered persons maintain suitable financial records and the service appears to be well resourced. The registered persons have a suitable health and safety policy. Suitable records are maintained regarding the testing of health and safety equipment. For example there are appropriate records regarding the testing of fire, gas and electrical appliances. Suitable records are maintained regarding testing to prevent Legionella. Satisfactory health and safety risk assessments are completed. Lowena Hostel DS0000043186.V259964.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 3 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 X 35 2 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 X 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 2 X X X X 3 X 3 3 Lowena Hostel DS0000043186.V259964.R01.S.doc Version 5.1 Page 19 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 YA35 Regulation 18 Requirement The registered persons must provide appropriate training for staff: • As required by law (i.e. manual handling, infection control, food hygiene, first aid, fire safety) • To meet the needs of individual service users (e.g. epilepsy) • All staff who handle medication must receive external training by a suitably qualified person (e.g. pharmacist) • Suitable records of training must be maintained (e.g. certificates of attendance of training courses) The registered provider must inform the Commission for Social Care Inspection of any events which adversely affect the service provided (e.g. if service levels have to be cut due to staff shortages) Staffing levels must be maintained at least at the level agreed with the Commission for Social Care Inspection. DS0000043186.V259964.R01.S.doc Timescale for action 01/09/06 2 YA33 7, 9, 18, 37 01/04/06 3 YA33 7, 9, 18 01/04/06 Lowena Hostel Version 5.1 Page 20 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 Lowena Hostel DS0000043186.V259964.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 Lowena Hostel DS0000043186.V259964.R01.S.doc Version 5.1 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!