Inspection on 10/07/07 for Lowfield House Care Home

This inspection was carried out on 10th July 2007.

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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lowfield House Care Home 14/12/09

Lowfield House Care Home 03/06/09

Lowfield House Care Home 14/06/06

Lowfield House Care Home 19/01/06

Lowfield House Care Home 01/07/05

Lowfield House Care Home 04/01/05

Lowfield House Care Home 12/07/04

Lowfield House Care Home 13/11/03

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Lowfield House Care Home Cornwall Street Kirton-in-lindsey Gainsborough Lincolnshire DN21 4EH Lead Inspector Ms Wilma Crawford Unannounced Inspection 10th July 2007 09:30 Lowfield House Care Home DS0000002793.V346206.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 Lowfield House Care Home DS0000002793.V346206.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. Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lowfield House Care Home Address Cornwall Street Kirton-in-lindsey Gainsborough Lincolnshire DN21 4EH 01652 648835 F/P 01652 648835 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) info@prime-life.co.ukwww.prime-life.co.uk Prime Life Limited Mr Brian Charles Ward Care Home 21 Category(ies) of Learning disability (21), Physical disability (21) registration, with number of places Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD Physical Disability - Code PD The maximum number of service users who can be accommodated is: 21 14th June 2006 2. Date of last inspection Brief Description of the Service: Prime Life Limited owns Lowfield House. The home is registered to provide care for 20 adults aged 18-65 who have a learning disability and additional physical and nursing needs. The home is situated in a residential area of Kirton-inLindsey and is close to local shops and amenities. It has a large private garden and a sensory garden. The home has 18 single bedrooms and one double bedroom; all bedrooms have a wash hand basin. There is a range of communal rooms and facilities including a large conservatory and a spa bath. The home employs nursing and care staff. A qualified nurse is on duty at all times. Information about the home and its service can be found in the statement of purpose and service user guide, both these documents are available from the acting manager of the home. A copy of the latest inspection report for the home is available in the reception area. Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection report is based on information received by the Commission for Social Care Inspection (CSCI) since the last key inspection of the home on 23rd May 2006. including information gathered during a site visit to the home The site visit was unannounced and took place over eight hours including preparation time. Four people living in the home, and three staff were spoken with during the visit. The manager was available throughout the visit. The main method of inspection used was called case tracking which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. The premises were looked at and the records of three residents and two staff were inspected. An Annual Quality Assurance Assessment (AQAA) document asking for information about the home was sent out before this visit and information from this was included as part of the inspection process of this service. Twenty-two surveys were sent out to people living in the home and staff, six of these were completed and returned. The comments from these and from discussions during the site visit are also included in the report. The range of fees charged is £407 — £615 per week. These fees are based on a standard fee and an additional package of hours based on the individuals needs. Additional charges are made for hairdressing £5(cut and blow dry) private chiropody treatment £7, reflexology£20 and aromatherapy £12. What the service does well: The needs assessment process at the home is robust and thorough, enabling people who access the service to be confident that their needs can be met. Residents said they felt well cared for and that the staff were kind. The home provides a detailed plan of care for each individual and this is regularly updated. Residents are involved in the care planning process and are regularly consulted. People living in the home are given the opportunity to make decisions about their lives and the day to day running of the home. They said that the manager and staff ask them what they think about things, through individual discussion, surveys and service users meetings. The home’s administration, handling and storage of medicines is well managed. The home is well organised and managed, with trained staff that are well supported and have a good knowledge of residents’ needs. Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The staffing levels in the home need to be reviewed to ensure that there are adequate numbers of staff available at all times to meet individual needs. Although the staff team plan for and work flexibly to support people living in the home with external evening activities, most of them finish their shift at 8 Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 7 pm, which does not allow for impromptu external activities to take place. The manager has identified this need and is currently looking to appoint staff to provide additional cover between 5p.m. and midnight, which would allow more planned and spontaneous evening activities to take place outside of the home. 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. Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 8 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 Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 9 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, & 5 People who use this service experience good quality outcomes in this area. A full needs assessment is carried out and people are given enough information about the home and its facilities before admission, for them to be confident that their needs can be met by the service. The judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a Statement of Purpose and Service Users Guide, copies of these are provided by the home to all prospective service users and a copy of these is also displayed in the entrance hall. Each individual has a statement of terms and conditions with the home, which are signed by the individual or their representative. Prospective service users are visited by the manager or the deputy manager and a full assessment is completed. A decision is then made as to whether the individual’s needs can be met and the person is invited to visit the home with their family for a meal or an overnight stay. This gives the individual the opportunity to see what they think about the home, before committing to a decision. Each person living in the home has their own individual care plan which includes a needs assessment from both the home and the funding authority. Care plans are drawn up with input from the individual and their relatives. Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 10 Comments from relatives and people living in the home commented that ‘the staff are wonderful’. Information included in the Annual Quality Assurance Assessment document indicates that there are people living in the home with specialist communication needs. Since the last site visit, the home has worked at improving their Makaton skills, to support these individuals. Policies and procedures are now available in Makaton format and the Speech and Language therapist is supporting the staff to develop their skills. The manager has looked into obtaining advocacy services from external agencies, details of these are displayed in the entrance hall. He also involves the local care management and nursing teams for support with any aspects of advocacy services required. Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 11 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): 6,7,8 and 9 People who use this service experience good quality outcomes in this area. People using the service are able to make decisions and everyday choices as part of an independent lifestyle. The judgement has been made using available evidence including a visit to this service. EVIDENCE: Verbal feedback from people living in the home and relatives is that they are involved in the review and development of care plans and that they have the opportunity to discuss any changes or wishes that they have in relation to their care. Individual care plans are in place and covers health, personal and social care needs. Risk management strategies are in place for all areas of need and cover aspects of daily living as well as specific behaviours. Examination of a sample of 3 care plans showed that they are kept under constant review and updated as needs change. An annual review is also held with each individual and their representatives. Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 12 Discussion with staff indicated that they respect the peoples right to make decisions and have worked hard to develop communication skills, in order that they can support individuals in their decision making, when they are not able to communicate verbally, but rely on alternative methods of communication. Staff were able to give good examples of how they could support choices offering people the choice of a bath or a shower, showing several sets of clothing, so they can select their preference, showing pictorial menus so people can point to what they would like to eat. The manager has involved relatives more in supporting staff in how the specific needs of people in the home can be met in their preferred manner. Service users are also regularly consulted via service users meetings, which are recorded. Recent refurbishment work has been completed and both people living in the home and their relatives were consulted about décor and soft furnishings during this process. Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 13 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): 12,13,14,15,16,and 17 People who use this service experience good quality outcomes in this area. People using the service have opportunities to access a variety of leisure activities, are supported to maintain relationships and have their nutritional needs met. The judgement has been made using available evidence including a visit to this service. EVIDENCE: Many of the people living in the home previously attended a local day service, which has recently closed. The home has developed a structured activities plan having spent time with the people living in the home and seeking their views as to what type of activities they would like to access. Details of this, was recorded in the service users meetings notes. As well as providing activities some of the people living in the home wanted to maintain friendships with the people they had met at day services. The manager has looked into this and is arranging to be part of a music group in Brigg to give people the opportunity to meet up regularly. Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 14 People living in the home have the opportunity to engage in a range of activities both in the home and in the local community. The garden of the home has been fully adapted with specialist equipment to allow people a range of experiences for example swings that can be accessed using a wheelchair. In house activities include card making, craft, music, baking and cookery, manicures, painting, gardening, dominoes, bingo and music and movement. The home also has a fully equipped snozelean available for individuals use. An aromatherapist, hairdresser and reflexologist also visit the home on a monthly basis. The home has a vehicle allowing outings to take place on a daily basis. A variety of visits are planned on a weekly basis and include day trips to The Deep, or Whelton farm. Other visits are also planned to garden centres, local shopping centres, swimming, and picnics. The people living in the home also have the opportunity to go on holiday and holidays have been taken in Marbella, Centre Parcs, Scotland and a trip is being organised to Disneyland in Paris. Staff have also supported people with home visits, when their relatives are not able to visit themselves. The manager is also looking into educational activities being provided. Six people were out on a bus trip during the site visit and garden and music activities were also taking place. Discussion with people living in the home indicated that they enjoy going out into the community and have their own interests and hobbies which are supported and encouraged by the home. Examination if individual files also shows that regular activities are accessed. and this information is recorded. People spoken with said that they were very happy about the way that staff looked after them, they said that they felt safe and that their privacy, dignity and choices were respected. Observations of the interactions between staff and people living in the home showed that there is a good relationship between the two groups of people based on trust and friendship. The amount of contact between people living in the home and their relatives depends on the wishes of the individual and these are recorded in individual care plans. Relatives are welcomed into the home and have a kitchen facility they can use for refreshments. A full and varied menu is available in the home. This has been planned by the chef in consultation with the dietician and the people living in the home. The chef regularly holds theme nights, giving people the opportunity to sample a variety of dishes and allowing everyone the opportunity to contribute to the Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 15 planning of the menu. Individuals likes and dislikes are recorded in individual care plans and a copy of these is also maintained by the chef. A cooked breakfast is available on a daily basis and there is a choice of main meal provided. Staff and service users explained that as well as the choices on the menu, additional alternatives are always available. Individuals have their weights taken on a monthly basis and nutritional assessments are also completed to ensure that people’s dietary needs are being met. Staff being observed supporting people with eating and drinking were seen to be doing so in a patient and dignified manner. Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 16 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 People who use this service experience good quality outcomes in this area. Residents receive appropriate health care and personal support. The judgement has been made using available evidence including a visit to this service. EVIDENCE: . The staff rota is worked to offer a mix of both female and male workers, giving people a choice of who they prefer to have their care needs supported by. The information in care plans showed that everyone living in the home has their own preferred routine and discussion with staff demonstrated that they had a good understanding of the wishes and choices made by each individual and were able to describe their care needs and how staff were quick to offer help when it was needed, they also respected their wishes to be as independent as possible. Each individual care plan documents the visits and input each person has received from outside professional for example GP’s, chiropodist, epilepsy liaison nurse, psychologist, dentist, and optician. Staff and service users confirmed that they support individuals with all appointments. An assessment of consent for examination or treatment has also been completed with external Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 17 professionals for each individual and an agreed action plan developed to support with this. The medication policy, states that people coming into the home can self – medicate if they wish to after a risk assessment has been completed and agreed. No one currently chooses to administer their own medicines. The medication system and records were found to be accurate up to date and well managed. Staff have received regular ongoing training from the pharmacist supplying the home. Medication is only administered by a qualified nurse. Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 18 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 People who use this service experience good quality outcomes in this area. People using the service feel able to air their concerns without any fear of repercussions. The staff vetting procedure is sufficiently robust to ensure the safety of the service users. The judgement has been made using available evidence including a visit to this service. EVIDENCE: A copy of the complaints procedure is displayed in the entrance hall of the home, this is available in both written and pictorial formats. People living in the home spoken with were able to describe how they could use the complaints process and were confident that they could talk to any of the staff if they had any problems. Some people living in the home are unaware of the complaints procedure and the manager has information of local advocacy agencies displayed in the home to help individuals with the complaints process. One complaint has been received by the home during the last twelve months,. At the last site visit the inspector recommended that separate complaints forms be developed so that they can be filled in by the complainant or staff and filed away by the manager once an issue has been investigated. Action has now been taken by the manager to address this and was available for examination. Staff spoken with showed that they had a good understanding of their role in dealing with Safeguarding Adults issues. A recruitment procedure is in place and the manager is very clear about the calibre of staff that he wishes to recruit. Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 19 The manager oversees the recruitment process. An application form, two written references, a Criminal Records Bureau check and a Protection of Vulnerable Adults check are undertaken prior to a person starting employment. The risk of harm to people is minimised due to the stringent procedures in place. Two staff files were examined and these were found to be up to date Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 20 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 People who use this service experience good quality outcomes in this area. The residents have been provided with a homely environment that is clean and has been decorated to a good standard, with both private and communal space being suitable for their needs. The judgement has been made using available evidence including a visit to this service. EVIDENCE: Considerable redecoration and refurbishment of the home has been completed during the last twelve months. This has included redecoration of all areas, fitting of new carpets, purchase of new furniture, purchase of new beds, replacement window units, bathrooms have had new cupboards fitted and have been retiled, all of which has greatly improved the environment for people living in the home and made the surroundings more comfortable and homely. During the refurbishment regular consultation processes took place with people living in the home and their relatives to ensure that they had a say in how they would like the home redecorated and what type of furnishings they preferred. During a tour of the building a carpet in a bedroom was seen to be showing signs of stretching and needs to be replaced or refitted, before it becomes a Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 21 trip hazard Similarly the doors to the en-suite to a bedroom and the door to the medication room have holes to the main panel and need to be repaired. Bedrooms are personalised and decorated to suit individual tastes. Each bedroom has a suitable lock that can be used for privacy. Some individuals had cable television installed in their rooms. Many individuals had personal belongings and furnishings in their rooms, making them feel homely and reflect the personalities of the occupants The home was found to be clean tidy and odour free. Domestic staff are employed to carry out cleaning duties and laundry tasks. Policies and procedures are available for the control of infection. Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 22 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): 32,33, 34 and 35 People who use this service experience good quality outcomes in this area. People living in the home are supported by staff who are supervised and undertake training. The staff vetting procedure is sufficiently robust to ensure the safety of the residents. The judgement has been made using available evidence including a visit to this service. EVIDENCE: The current staffing levels consist of the manager, a nurse and six care staff, a chef, cleaner and laundry assistant until 4p.m.in the evening. A nurse , five care staff are available in the evening and a nurse and two care staff during the night. Individual packages of care are provided by the home for individuals where a need has been identified. The staff provide support with activities during the evening, but the evening shift usually finishes at 8 p.m. This can make it difficult for impromptu or planned late activities e.g. to the theatre to take place The manager and staff said that activities are usually planned in advance and staff are always willing to support these, however, the manager has 111 hours/week shortfall, which he is proposing to use for a twilight shift from 5p.m. to midnight to support evening activities further. During discussion with staff there were mixed views as to whether the staffing levels were adequate or not, with some of the team feeling that they were and others feeling that additional staffing was required Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 23 to further support individuals with additional staffing needs. The manager was aware of this and was due to meet with placing authorities to review the staffing levels for individuals requiring additional support. 62 of the staff team have achieved a National Vocational Qualification (NVQ) level two or above. The remaining staff, are working towards this award. This means that the staff are well trained and have the necessary skills to support the people living in the home. Newly appointed staff complete an organisational induction and the Learning Disability Award Framework. Information from the AQAA and staff training files shows that the home provides a rolling programme of staff training that covers mandatory subjects and an NVQ programme for learning disabilities. At the last site visit it was recommended that a wider range of specialist training be developed and implemented, to improve staff knowledge of the client group and illnesses related to their conditions. The organisation has recently appointed a new training manager and this is now being worked towards. However, the manager has taken action himself to ensure that additional training required by the staff team has been sought and made available to staff, e.g. Makaton, Epilepsy, and POVA. Non Physical Intervention is still currently being awaited. The manager has recognised that his team would benefit from accessing this training. He has also provided necessary training to the nurses in the home, where training has been requested in specific areas: Mental Health, Peg feeding and cleaning, Epilepsy , Diabetes, Cardiac Care, and Safe Handling of Medicines. Staff supervision files showed that staff receive regular ongoing supervision with a line manager. Staff also have annual appraisal sessions. Staff spoken with said that they felt well supported in their role and valued by the manager and the organisation. Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 24 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 &43 People who use this service experience good quality outcomes in this area. People using the service benefit from a safe and well managed place to live. The judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection the (Acting Manager) has attended a fit person’s interview and is now the Registered Manager. He has extensive experience of working with people with Learning Disabilities and has achieved The Registered Managers award and NVQ leve4 in Care. Discussion with the staff team included comments ‘The home hasn’t looked back since he came’, ‘I couldn’t say enough good things about him’, ‘He has built our confidence and raised staff morale’, ‘He has worked wonders in the home, he has picked it up from the floor and worked miracles.’ All the staff felt supported by the manager and found him approachable. Staff were also positive about the change in work practices, philosophy and staffing and felt that it was beneficial to the people living in the home, offering them an Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 25 improved service. They also felt supported by the nurses and able to go to them with any suggestions or problems. Information from staff team minutes and discussion with staff indicate that they can attend meetings each month and were able to express their views Prime Life Limited completes an annual audit as part of the Quality assurance system. A development plan is created from the results of this, which is discussed with the staff team at staff meetings. Quality assurance surveys are also completed periodically with people living in the home, relatives, visitors and professionals and the results of these collated and action plans developed from these if required. Progress from these surveys is also discussed at Service users meetings. A sample of maintenance records checked from information submitted on the AQAA was found to be in place and up to date. Maintenance certificates for moving and handling equipment and training certificates for staff training updates were also in place. Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 26 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 X 5 3 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 x 3 X 3 X X 3 3 Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 27 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. 18. Standard YA33 Regulation 18 Requirement The registered person must ensure that the home provides a staff team, in sufficient numbers to support service users assessed needs at all times, particularly during the evening to allow for impromptu or planned late activities e.g. to the theatre to take place. Ongoing 14/06/07 Timescale for action 30/09/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA35 Good Practice Recommendations A wider range of specialist training should be developed and implemented, to improve staff knowledge of the client group and illnesses related to their conditions. Specialist training in supporting people who exhibit challenging behaviours should be provided to further develop staff skills in supporting and managing individual service users needs. DS0000002793.V346206.R01.S.doc Version 5.2 Page 28 2. YA35 Lowfield House Care Home 3. YA26 The manager should ensure that the carpet in room number 7 is replaced or refitted, before it becomes a trip hazard. The manager should ensure that the doors to the en-suite in room 4a and the door to the medication room are repaired/replaced. 4. YA26 Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Lowfield House Care Home DS0000002793.V346206.R01.S.doc Version 5.2 Page 30 - 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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