Inspection on 23/05/07 for Lucerne House (21-23)

This inspection was carried out on 23rd May 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Lucerne House (21-23) 13/10/09

Lucerne House (21-23) 22/04/08

Lucerne House (21-23) 08/05/06

Lucerne House (21-23) 10/02/06

Lucerne House (21-23) 01/11/05

Lucerne House (21-23) 10/03/05

Lucerne House (21-23) 28/07/04

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Edenvale

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Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Lucerne House (21-23) 21-23 Lucerne Road Thornton Heath Croydon Surrey CR7 7BB Lead Inspector James Pitts Key Unannounced Inspection 23rd May 2007 10:24a Lucerne House (21-23) DS0000025808.V336590.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 Lucerne House (21-23) DS0000025808.V336590.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. Lucerne House (21-23) DS0000025808.V336590.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lucerne House (21-23) Address 21-23 Lucerne Road Thornton Heath Croydon Surrey CR7 7BB 0208 239 9547 0208 239 1151 NO EMAIL 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) Mrs Naomi Wallen Mr Wayne Wallen Mrs Naomi Wallen Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Lucerne House (21-23) DS0000025808.V336590.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th May 2006 Brief Description of the Service: 21 and 23 Lucerne Road were two terraced houses, which have been joined by means of walkways on the ground and first floors. Having applied two years ago to run the two establishments as one home, the Registered Providers are registered as a single home accommodating up to a maximum of six adults with learning disabilities. At the time of inspection the home had one vacancy as a service user moved out earlier this year. The home is close to the town centre and accessible public transport. Lucerne House (21-23) DS0000025808.V336590.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Since the previous key standards inspection in May 2006, two further random inspection visits took place in September 2006 and January 2007. The reason for these visits was to ascertain whether the home was making improvement, which had been very slow to achieve. As a result of this inspection it was seen that further improvements have been made, which can clearly be seen to be as a result of the increased awareness of the proprietor. This new knowledge has been obtained as a direct result of undertaking the NVQ level 4 qualification. It is important for those reading this report to have an understanding of the current situation in which the home is operating. Some time ago a service user moved from the home, by their own choice, which left a vacancy that has not been filled. Another service user is soon due to leave to move into more independent accommodation, which will leave 4 people living here. The proprietor explained during this inspection that as no new referrals are being received, and two of the service users fees are being re negotiated, that there is increasing financial pressure on the service. Two local authorities currently fund two service user placements each at the home. In the case of one of these authorities the proprietor has asked, and received, a re-assessment of the service users needs with a view to seeking an increase in their placement fee. No decision has yet been received from the authority in question and if the request is refused the proprietor has stated that they will have no choice but to consider whether the home can continue to operate as it is currently. The proprietor undertook to write to that authority in order to obtain an early decision and to keep the local Commission office informed of that decision and the implications for the home. This inspection took place on a Wednesday although all of the service users were out at that time. However, service users have been seen at other inspections that have occurred over the last twelve months. It should be noted that no negative or critical opinions have been expressed about how the home is run by service users, relatives or other professionals who have contact with this service. The proprietor, Mrs Wallen, was present at the time of this visit. What the service does well: The home continues to be good at ensuring that service users are supported appropriately in all aspects of their day-to-day living. This includes providing the necessary support to service users that will enable them to be a part of the wider community and to have aspirations, expectations and goals. The people who work here continue to encourage service users to maintain family relationships and friendships. The home is comfortable and a new larger lounge has been created at the rear of the house. Lucerne House (21-23) DS0000025808.V336590.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Lucerne House (21-23) DS0000025808.V336590.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lucerne House (21-23) DS0000025808.V336590.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Standard 2 has been assessed as being met at previous key standards inspections. EVIDENCE: As no new service users have come to live at the home for quite some time this standard could not be assessed at this visit. This standard will not be assessed again until such time as any new service users come to live at the home. It should be noted that the home has previously been seen to properly consider admissions. Lucerne House (21-23) DS0000025808.V336590.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 6, 7, 8 & 9 were assessed at this inspection. The service users can still feel confident that staff generally know what they need. The home has a keyworker system to further support this work. The service users can be assured that the people who support them will try their best to make sure that each person who lives at the home is allowed to live the sort of life that they choose. EVIDENCE: Three of the four service user care plans were examined at this inspection (the fifth service user is moving to another project very soon so their care plan was not seen). Each service user has an individual care plan that is drawn up by the manager. These plans are broad in their context but do cover the necessary areas that need to be considered. As none of the care plans have been updated since March 2006, it is now necessary for this to occur. Lucerne House (21-23) DS0000025808.V336590.R01.S.doc Version 5.2 Page 10 A keyworker system is in operation at the home. As no other staff are currently employed apart from the proprietors family, Mrs Wallen manages keywork. The home has previously been required to ensure that consultation with service users must be in greater evidence and show that the home is taking their views and preferences into account. Further improvement had previously been seen to occur, albeit slowly. As there is some reluctance on the part of particular people to attend meetings the manager has individual monthly discussions with each service user to ask how they are and what, if anything, they would like to change. This would seem to be an appropriate solution in these circumstances. The homes has previously been required to ensure that risk assessments must be more detailed and outline the nature of any perceived risk, and must be updated at regular intervals. Since the previous random inspection visit general risk areas have been included, and although these could still be more detailed, it is evident that general common risks, as well as any risk related to individual support needs are being considered. It was recommended at the previous random inspection visit that an access to files policy should be established. It was also explained to the home’s proprietors that the aim of this policy should be to enable service users to have reasonable access to information that is held about them by the home, and to restrict access to particular third parties without the express consent of the service user. Since then the home has obtained a policy and procedure manual for care homes that is compiled by a private consultancy firm. This manual covers the necessary policy in relation to access to files. Lucerne House (21-23) DS0000025808.V336590.R01.S.doc Version 5.2 Page 11 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 12, 13, 15, 16 & 17 were assessed at this inspection. The service users can feel confident that the opportunity for each to develop and maintain personal and family relations is also offered and actively supported by the staff team. EVIDENCE: The people who come to live here stay for a very long time, although sometimes people might move somewhere else if they want or need to. The service users are supported by the staff to be as independent as possible and to make as many choices as they can. All of the service users go to day centres or independently out to activities of their choice. Additionally all Lucerne House (21-23) DS0000025808.V336590.R01.S.doc Version 5.2 Page 12 participate in shopping for the home if they choose to and all make use of other things in the community such as the cinema, the pub and other places of interest. The staff help the service users to be a full part of the local community. The home is very close to bus stops and a train station. All of the service users are physically able to use public transport. The staff are very pro active with supporting each service user to keep in contact with their families and friends where they wish. Family and Friends are made very welcome when they visit the home. There are not many rules at this home. The most important one is that no one is allowed to smoke in the house. All of the people who live here are allowed to use the entire house, except other people’s bedrooms. Each of the people who live at this home is allowed to make choices about what they want to eat. The staff are good at making sure that healthy food is on offer. Lucerne House (21-23) DS0000025808.V336590.R01.S.doc Version 5.2 Page 13 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 18, 19 & 20 were assessed at this inspection. Service users can continue to feel confident that they will get the right support to take care of their personal and healthcare needs. Anyone who needs to take medicine regularly to help them stay well will get the proper support from staff to make sure that this happens EVIDENCE: The carers are able to show that they are very aware of what each service user needs and they are sensitive about how they should meet those needs. None of the service users needs technical aids or equipment to help them to be independent. All of the people who live at the home usually go to see a local GP if they are not feeling well. The service users can see any local GP but most see the same one that the staff know very well and get along with. The staff are still very good at writing down anything that happens if anyone becomes unwell. If any Lucerne House (21-23) DS0000025808.V336590.R01.S.doc Version 5.2 Page 14 of the service users have an illness or something else is wrong with them then the staff do know what this is and how to help them to get the treatment that they need. Some of the service users need to take medicine every day and the carers are very good at making sure that this happens so that they can stay well. The carers are also good at making sure that no one can get hold of any medicine that they should not have and so they keep medicines locked away. Medicines are handled properly to help to keep everyone safe. Lucerne House (21-23) DS0000025808.V336590.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 22 & 23 were assessed at this inspection. The service users can continue to feel confident that the staff team at the home know what to do if there are complaints or concerns about abuse. The home has clear guidance for staff about the procedures to be followed in either of these circumstances. EVIDENCE: The service users are given clear information about how to complain and what happens when they make a complaint. No complaints have been made to either the home or to the Commission since the previous key standards inspection visit. Lucerne House (21-23) DS0000025808.V336590.R01.S.doc Version 5.2 Page 16 The staff continue to be good at making sure that all of the service users are protected from abuse (this means that the staff at the home do everything that they can to stop any of the service users from being hurt by someone else). There is also clear written information for staff about what to do if they think that a service user is being hurt or abused by another person. The staff know what they then have to do to keep people safe. The home has a whistle blowing policy, and also one dealing with bullying or harassment, which also refers to service users. There is evidence that staff have read these policies. There have been no reported concerns about any of the service users having been harmed. Lucerne House (21-23) DS0000025808.V336590.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 24 & 30 were assessed at this inspection. The service users can continue to feel confident that they are living in a well maintained and clean home. EVIDENCE: The home has undergone some extensive refurbishment work since the key standards inspection in May 2006. This work has been designed to create additional living space and to expand the number of places for service users. An application to increase the number of people that can be accommodated was being considered. However, in light of the comments that are made elsewhere in this report an application is not going ahead at present until the long term future of the home is decided upon. Lucerne House (21-23) DS0000025808.V336590.R01.S.doc Version 5.2 Page 18 The house continues to be kept very clean and is free of any unpleasant odours. Lucerne House (21-23) DS0000025808.V336590.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 31, 32, 34, 35 & 36 were assessed at this inspection. Service users can feel more confident that there is improvement to the awareness of the manager about the necessity to properly follow diligent procedures when recruiting staff. EVIDENCE: The home has previously been informed that a full copy of the General Social Care council code of practice must be obtained and be issued to all staff at the home. It was previously acknowledge that the manager did have a code of conduct that was obtained from another source; however, the GSCC code still needed to be obtained. Since the previous random inspection the GSCC code has been obtained. Lucerne House (21-23) DS0000025808.V336590.R01.S.doc Version 5.2 Page 20 Aside from the proprietor, who is also the manager, no other staff are employed at this time, other than the proprietors husband who had previously been registered as a proprietor and manager of a home. The home has previously been informed that updated CRB checks must be obtained for all newly recruited staff prior to their commencing work at the home, even if the person (s) concerned have had previous satisfactory checks completed by their former employer. The member of staff who was appointed prior to the previous random inspection visit had not had a CRB check carried out prior to commencing their work at the home. This check has now been obtained although this person has since stopped working at the home. The home is reminded that if any future staff are employed and permitted to commence work at the home without the necessary and satisfactory pre employment checks having been obtained then the Commission is legally entitled to commence immediate enforcement action without further consultation. It is, however, noted that the manager was able to demonstrate during conversation at this inspection that she has a much improved awareness of the importance of properly recruiting staff. The partner of the proprietor who works at the home is qualified at NVQ level 3. The standard of supervision for staff that was seen to need improvement at previous inspections could not be assessed at this time as no other staff apart from relatives of the proprietor are currently employed at the home. The home is reminded that proper supervision must be in place should any new staff be employed in the future. Lucerne House (21-23) DS0000025808.V336590.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Standards 37, 39 & 42 were assessed at this inspection. The service users can feel more confident that they are living in a home that has an increased awareness of the need for diligent management. A quality assurance audit does, however, need to be undertaken to further support these improvements. EVIDENCE: Mrs Wallen, who is the proprietor / manager, has been undertaking the NVQ level 4 qualification over the last year and is expecting to complete this in October 2007. This has undoubtedly helped to raise her awareness of the need Lucerne House (21-23) DS0000025808.V336590.R01.S.doc Version 5.2 Page 22 to professionally manage the home, which is evident by the further improvements that have been made. The Registered Providers have previously been informed that they must develop quality assurance tools, which are designed to obtain the views of service users and their families, as well as professionals who they have contact with in the day to day running of the home. The proprietors were also advised you that they might wish to consider purchasing a quality assurance system from a specialist company rather than attempt to develop their own from scratch. Since the previous random inspection some further development has occurred, however, this must now be completed and a quality audit of the service must be implemented. The following health and safety checks have been carried out within the last year: Fire Alarm System: 22/01/07 Gas Safety Check: 15/05/ 07 Portable electrical appliances: 16/10/06 The home is usually good at making sure that the people who live and work here are kept safe from fire and other hazards. However, the hot water temperature checks should be written down rather than using ditto marks to show that it is within the safe temperature. The manager was advised of this at this inspection but this will not result in a requirement at this time. Lucerne House (21-23) DS0000025808.V336590.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 x 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 2 3 X 3 x Lucerne House (21-23) DS0000025808.V336590.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 YA6 Regulation 15 (2) (b) Requirement (This requirement remains out standing from the previous key standards inspection in May 2006) Timescale for action 23/07/07 2. YA39 24(3) 23/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Lucerne House (21-23) DS0000025808.V336590.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Lucerne House (21-23) DS0000025808.V336590.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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