Inspection on 22/12/08 for Lucerne House

This inspection was carried out on 22nd December 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lucerne House 23/06/08

Lucerne House 05/09/07

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Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

CARE HOME ADULTS 18-65 Lucerne House 12 Mitten Road Bexhill-on-Sea East Sussex TN40 1QL Lead Inspector Andrea Leverett Unannounced Inspection 22nd December 2008 10:30 Lucerne House DS0000069865.V374037.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 DS0000069865.V374037.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 DS0000069865.V374037.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lucerne House Address 12 Mitten Road Bexhill-on-Sea East Sussex TN40 1QL 01424 224181 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) lucernehouse@fsmail.net Care Pro (South East) Ltd Vacant Care Home 8 Category(ies) of Learning disability (0) registration, with number of places Lucerne House DS0000069865.V374037.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning disability (LD). The maximum number of service users to be accommodated is 8. Date of last inspection 23rd June 2008 Brief Description of the Service: Lucerne House is a detached property located in a quiet residential area of Bexhill within easy walking distance of the town centre shops. There is a large garden for use by residents. At the rear of the house, a chalet-type summerhouse. The home is currently registered for eight adults with learning disabilities. Residents private and communal accommodation is provided on three floors and maintained to a high standard. Since the last inspection an extension has been completed to the side of the main house. This has provided three additional bedrooms, an office and a new laundry facility. The home has a mini-bus type vehicle. The current fees charged ranges from approximately £400 to around £850 per week. The current 8 Residents have lived in the home for several years. The latest Inspection report is sent out to any enquirer who expresses an interest in the home. A copy of the report is kept on display in the home with a copy obtainable via the manager. Lucerne House DS0000069865.V374037.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001, uses the term ‘service user’ to describe those living in care home settings. This key inspection was carried out by two Inspectors on 22 December 2008. It included a site visit, a tour of the premises, with the assistance of residents, and meetings with the manager and two members of staff. Informal discussions were had with five residents. A range of documentation was also seen including care plans, staff rotas, staff recruitment records and records related to their quality assurance systems. At the end of the site visit feedback was given to the manager and to the owners. 8 requirements and 2 good practice recommendations have been made as a result of this inspection. What the service does well: What has improved since the last inspection? Lucerne House DS0000069865.V374037.R01.S.doc Version 5.2 Page 6 Since the last key inspection the home has been subject to an adult safe guarding investigation involving poor and inappropriate practices of the manager and several key staff. Many of the issues were substantiated and the manager and staff involved no longer work at the home and have been reported to POVA. The Registered Provider has co operated fully with the investigation and took appropriate steps to safe guard service users. The home now ensures that service user’s mobility allowances are paid into their own individual bank accounts and records are kept to show how this is spent. There has virtually been a total change of staffing since the last inspection, including a new manager and deputy manager. Staffing levels have also been reviewed. There are now three staff on duty whenever there are three or more residents in the house. Systems have been put in place to ensure that service users can influence the day to day running of the home and their views are listened to and acted upon. Since the last inspection an extension has been completed to the side of the main house. This has provided three additional bedrooms, an office and a new laundry facility. The latter has made a big difference, as previously the laundry room was in lean to at the rear of the house. The additional bedrooms have provided the opportunity for two residents who previously shared a bedroom to have their own bedrooms. The homes practices for ensuring that service user’s medication is managed safely have considerably improved since the last inspection. What they could do better: Service user’s contracts need to be more detailed particularly in regard to the costs of facilities and services not covered by the fees. More needs to be done to ensure that activities undertaken by service users are properly risk assessed and documented on their care records. In order to ensure that service users are supported by a staff team that have the skills and knowledge to meet their needs the home must provide all staff with mandatory training in key areas. Lucerne House DS0000069865.V374037.R01.S.doc Version 5.2 Page 7 Although it was clear that staff felt supported by the manager regular formal supervision has not been consistent and a requirement has been made regarding this. Service users live in a homely, comfortable and safe environment but more could be done to ensure that one persons bathroom facilities meet their needs. However more needs to be done to ensure service users monies are managed in a transparent way and in their best interests. 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 DS0000069865.V374037.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 Lucerne House DS0000069865.V374037.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): People who use this service experience adequate quality outcomes in this area. On the whole service users can be confident that the home will meet their needs but the home must ensure that contracts accurately reflect additional charges for activities and services. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a statement of purpose and service user guide that includes most of the information required to ensure that people can make an informed choice when deciding whether to move into the home. Although the home has had no knew admissions for some years the manager stated that prospective service users would be encouraged to visit and test drive the service. Records seen also showed that service users had appropriate care manager assessments in place. An issue identified in previous inspection reports has been in relation to the residents contracts. These have not included all the necessary information, especially information on fees and payment for any extras. Contracts were looked at as part of this inspection and they have improved. They now include how the home manages residents mobility allowances, with these being paid Lucerne House DS0000069865.V374037.R01.S.doc Version 5.2 Page 10 into individual resident accounts. The manager confirmed that residents now pay a set amount per mile when they use the companys transport. They also pay for some activities. This information needs to be included in the contracts and so further work needs to be carried out to ensure the contracts accurately reflect the practices within the care home. Lucerne House DS0000069865.V374037.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): People who use this service experience adequate quality outcomes in this area. Although considerable improvements have been made to support people to make decisions about their lives more needs to be done to ensure that service users assessed and changing needs and personal goals are reflected in their individual plan. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The last inspection report highlighted the need to improve the quality of care plans for residents, as they were not person-centred and lacked detail. A number of care plans were looked at. The home has made a good start towards making the improvements necessary but not all care plans and risk assessments accurately reflect service user’s needs. For example, some risk assessments have now been completed. One service user had a risk assessment in relation to accessing the community. However, this indicated Lucerne House DS0000069865.V374037.R01.S.doc Version 5.2 Page 12 that there is a medium risk, without being explicit about what this meant. Whilst it did include some actions to minimise risk, it did not include road safety training, as said elsewhere in this persons records. In fact, road safety training has not commenced. This service user’s care plan covered all key areas and also included some action points and goals. The latter included assistance in learning how to do washing and ironing. However, some of the documents were not dated, such as the goals, and so it was difficult to know whether they are current and when they need to be reviewed. Although daily notes are kept, these are basic in content and not related to the goals. This made it hard to assess whether the service user was being supported to work on and achieve their goals. Requirements have been made regarding these. There have been some improvements in enabling service user to make choices. For example, one service user explained that he is involved in doing his own laundry and that he helps plan menus. He also said he goes shopping for the food, once service users have chosen what they want. Service users spoken with were positive about living at Lucerne House. One said he has all he needs. Another service user said she was happy to be changing bedrooms and was settling into it very well. She said she had been well supported in moving rooms and sorting things out. Since the last inspection service users have been supported to gain access to appropriate advocacy services where needed and it was clear that this was having a positive impact on service user’s quality of life. A recommendation has been made that the home continue to support these arrangements and include advocates and other professional and none professional representatives when making best interest decisions for service users. Lucerne House DS0000069865.V374037.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): People who use this service experience adequate quality outcomes in this area. On the whole service users are encouraged to undertake a range of activities both inside and outside the home and their rights are respected, but more needs to done to evidence that these are in keeping with their needs wishes. Service users benefit from a healthy diet which is in keeping with their needs and wishes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A key issue at the last key inspection was a lack of activities and service users not being actively involved in making their own decisions about what they wanted to do. At one point of the inspection, four service users were at home Lucerne House DS0000069865.V374037.R01.S.doc Version 5.2 Page 14 and all others out at day services. One service user should have been at a day service, but they had returned to the care home as they felt unwell. Unfortunately, this meant that the other service users could not go swimming, but staff reported that they would try to take service users swimming another occasion. The manager reported that regular service user meetings are held, with these now being weekly. Minutes are kept and these were looked at for the last few meetings. Where suggestions for improvement had been made in a general sense, the manager had, usefully, recorded what action she had taken as a result. The manager reported that these meetings have been used as a means of finding out what service users wanted to do. The minutes supported this. For example, the meeting on 17 December included a number of ideas for activities and events from many of the service users. Ideas included swimming, a curry night, and to go to Drusillas Zoo. One service user described his weekly routines and activities, which illustrated that he is a very busy person. His week includes attending Bexhill College twice, attending cadet training, working in Oxfam and working in a garden centre. He was very enthusiaic about these activities, which he clearly enjoys. On the day of the inspection one member of staff took two service users out. An activity sheet is completed for each resident daily. As stated in a previous section of this report, service users said they are involved in menu planning and shopping. A member of staff stated that the home has recipe books to aid service users in menu planning. Another member of staff also confirmed that service users are involved in choosing the menus and in shopping. However as stated previously not all care plans and goals are sufficiently detailed to evidence that activities undertaken are in keeping with individual needs and although the home has made a good start towards improving these the home must now ensure that all service users care plans are person centred . For example more could be done to ensure that daily living routines and choices are reflected in individual care plans and followed through and evidenced in daily records. Lucerne House DS0000069865.V374037.R01.S.doc Version 5.2 Page 15 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): People who use this service experience good quality outcomes in this area. Service users can be confident that their physical and emotional health needs are met and that they are supported with their personal needs in a way they prefer and require. On the whole service users can be confident that they will be protected by the homes policies and procedures for administering medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Records seen and discussions with the manager showed that the home ensures that health needs are met. Service users have access to GP’s and specialist health services as required. Records evidenced regular appointments with Doctors, dentist, chiropody and specialist learning disability services. However it was noted that all service users were paying for their chiropody service regardless of whether they would qualify for a free NHS service. A requirement has been made that the home Lucerne House DS0000069865.V374037.R01.S.doc Version 5.2 Page 16 ensures that people with health needs that would enable them to have a free NHS chiropody service are supported to do so. The homes medication and administration systems were inspected. Since the last inspection systems for administering, recording and storing medications has improved. The homes medication cabinet has been relocated into the homes new office and is more secure. Mar sheets inspected showed that the home now keeps accurate medication records that are signed for appropriately and a sample list of staff signatures is kept. None of the service users administers their own medications and although this seemed appropriate to the inspector the home must ensure that the need to administer service user’s medication is documented in a medication risk assessment. Although records showed that staff are trained to administer medications a recommendation has been made that a system is put in place to test staff competency at regular intervals and as part of their induction. Lucerne House DS0000069865.V374037.R01.S.doc Version 5.2 Page 17 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): People who use this service experience adequate quality outcomes in this area. On the whole the home now has systems in place to ensure that service user’s views are listened to and acted upon and they are protected from abuse, neglect and self harm. However more needs to be done to ensure service users monies are managed in a transparent way and in their best interests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints policy and procedure in place and discussions with the manager and service users and records seen showed that concerns are listened to and acted upon. Since the last inspection the home has been subject to an adult protection investigation. Many issues identified in the investigation have been substantiated and the manager and key staff involved are no longer working in the home and have been reported to POVA. The registered provider co operated fully with the investigation and took appropriate action to keep service users safe. The investigation also identified that service users mobility monies were being pooled instead of being paid into service users individual accounts. Lucerne House DS0000069865.V374037.R01.S.doc Version 5.2 Page 18 All service users’ bank accounts were seen at this inspection and showed that money owing has been paid back into their accounts and mobility allowances are now being paid directly into their accounts. However it was noted that during this period one service user had spent large amounts of money to cover taxi fares to and from their day service. It was clear that the cost of these fares was not sustainable and when the savings ran out was moved to day services nearer to home. Given that the homes service user contract does not specify the costs of services and facilities not covered in the contract price and that the service user is not capable of making an informed decision in this regard, the registered person is required to review this decision and evidence that this was done in Their best interests. The review must consult professionals charged with supporting the service user to make best interest decisions. Lucerne House DS0000069865.V374037.R01.S.doc Version 5.2 Page 19 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): People who use this service experience good quality outcomes in this area. Service users live in a homely, comfortable and safe environment but more could be done to ensure that one persons bathroom facilities meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection an extension has been completed to the side of the main house. This has provided three additional bedrooms, an office and a new laundry facility. The latter has made a big difference, as previously the laundry room was in lean to at the rear of the house. The additional bedrooms have provided the opportunity for two service users who previously shared a bedroom to have their own bedrooms. All areas of the home are suitably furnished, comfortable and clean. A tour of the premises was carried out, with the assistance of three of the service users Lucerne House DS0000069865.V374037.R01.S.doc Version 5.2 Page 20 and all the new bedrooms were seen. One service user has begun to move into one of the bedrooms. She told the Inspector she would like to have a clock on the wall and a member of staff confirmed that this is planned. All the new bedrooms have en-suite facilities. The Inspector noted that two of the bedrooms had no light shades and the manager said she would sort this out. Service users have personalised their bedrooms and there are pictures of service users throughout the house. There is a conservatory to the rear of the house which is used as a dining area. There is a good sized garden which is used regularly by service users. Discussions with the manager evidenced that one service user was unable to access the en-suite shower which is situated on the ground floor. The en-suite shower room did not meet her mobility needs and consequently they have to use the bathroom on the first floor. A requirement has been made that the home reviews this with a view to modifying the en-suite facilities to meet the service user’s needs. Records seen showed that the home is maintained appropriately. The home keeps fire prevention and equipment maintenance records and gas and electricity supplies are regularly serviced. Lucerne House DS0000069865.V374037.R01.S.doc Version 5.2 Page 21 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): People who use this service experience adequate quality outcomes in this area. Service users are supported by sufficient numbers of staff to meet their needs but more needs to be done to ensure that staff have up to date knowledge and skills. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There has virtually been a total change of staffing since the last inspection, including a new manager and deputy manager. Staffing levels have also been reviewed. There are now three staff on duty whenever there are three or more residents in the house. The manager stated that induction has been provided for all new staff. A training programme has been implemented and a training matrix has also been established. This will enable the manager to monitor the training needs of all staff. The manager confirmed that there is a need for further training. Unfortunately, some training planned for December had not taken place. Lucerne House DS0000069865.V374037.R01.S.doc Version 5.2 Page 22 From discussions with staff, they confirmed that they had received an induction. This included meeting with the manager going through basic information such as fire procedures, key information about each resident and going through care plans. One member of staff stated that they had worked as an extra on shift and shadowed a senior member of staff, in order to find out how care is provided and to get to know the routines. One member of staff, who had work at the care home only a matter of weeks, had already had training on medication and a two day course on learning disabilities. Although there is a programme in place to ensure staff training needs are met, mandatory training such as moving and handling, food hygiene, protection of vulnerable adults and first aid training for some staff is still outstanding. A requirement has been made regarding this. Records also showed that most of the staff had NVQ 2 or above and discussions with the manager evidenced that the home is committed to providing an ongoing programme of NVQ training for staff. Although it was clear that staff felt supported by the manager regular formal supervision has not been consistent and a requirement has been made regarding this. A sample of staff recruitment files were inspected these showed that appropriate checks were undertaken to ensure that service users are protected. Files seen contained CRB and POVA checks, references and application forms. Lucerne House DS0000069865.V374037.R01.S.doc Version 5.2 Page 23 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): People who use this service experience adequate quality outcomes in this area. Although service users have benefited from significant improvements, more needs to be done to ensure that service users receive a good quality of care in keeping with their needs and wishes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last key inspection the home has been subject to an adult safe guarding investigation involving poor and inappropriate practices of the manager and several key staff. Many of the issues were substantiated and the manager and staff involved no longer work at the home and have been reported to POVA. The Registered Provider co operated fully with the investigation and took appropriate steps to safe guard service users. Lucerne House DS0000069865.V374037.R01.S.doc Version 5.2 Page 24 A new manager has been appointed, starting in September 2008. However the homes manager is not yet registered and the need to ensure that the home has a registered manager in place was discussed with the owners on the day of the inspection. Although shortfalls have been identified in this inspection, it is acknowledged that on the whole the home has made significant improvements to the quality of life of the service users since the last inspection and many of these improvements have been made over a relatively short period of time. As stated previously staff felt supported by the manager and feedback from service users was positive. Records also showed that the home is maintained appropriately. An external consultant has been employed to carry out the monthly visits and reports on the service, as part of their quality assurance system. A report for November 2008 was seen. This was comprehensive, identifying good aspects of the service as well as areas for improvement. These visits and reports have not been completed on a monthly basis since the last key inspection and a requirement has been made regarding this. Lucerne House DS0000069865.V374037.R01.S.doc Version 5.2 Page 25 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 2 2 2 3 3 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 2 28 3 29 2 30 3 STAFFING Standard No Score 31 3 32 2 33 3 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 3 2 3 LIFESTYLES Standard No Score 11 2 12 2 13 3 14 2 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 2 2 2 3 3 2 Lucerne House DS0000069865.V374037.R01.S.doc Version 5.2 Page 26 No 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 YA6 Regulation 15 (1) Requirement The registered Person must ensure that service user plans include individual needs and wishes in relation to activities and day to day living and that robust risk assessments are in place to guide practice. The registered person must ensure that the service user contract includes costs of services and facilities not covered in the contract price. The Registered Person is required to review the decision to spend large amounts of one service user’s savings to cover taxi fares and evidence that this decision was taken in their best interests. The review must consult professionals charged with supporting the service user to make best interest decisions. The Registered Person is required to ensure that people with health needs that would enable them to have a free NHS chiropody service are supported to do so. DS0000069865.V374037.R01.S.doc Timescale for action 20/04/09 2 YA5 5(1)b&c 20/04/09 3 YA23 13.6 & 15.1 20/04/09 4 YA19 13.1 20/04/09 Lucerne House Version 5.2 Page 27 5 YA36 18 (2) The Registered Person must ensure all staff receives appropriate consistent supervision. The Registered Person must ensure that service users have a medication risk assessment in place. The Registered Provider must ensure a system is in place to evaluate the quality of the services provided at the care home including monthly regulation 26 visits. 20/04/09 6 YA20 13(2) 20/04/09 7 YA39 24 20/04/09 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 YA20 Good Practice Recommendations Although records showed that staff are trained to administer medications a recommendation has been made that a system is put in place to test staff competency at regular intervals and as part of their induction. A recommendation has been made that the home continue to support advocacy arrangements and include advocates and other professional and none professional representatives when making best interest decisions for service users. 2 YA7 Lucerne House DS0000069865.V374037.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 DS0000069865.V374037.R01.S.doc Version 5.2 Page 29 Lucerne House DS0000069865.V374037.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. 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!