Inspection on 23/08/06 for Lyndale

This inspection was carried out on 23rd August 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lyndale 21/11/05

Lyndale 13/05/05

Lyndale 26/11/04

Lyndale 23/06/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Lyndale Lyndale 24 Southbank Close Hereford Herefordshire HR1 2TQ Lead Inspector Unannounced Inspection Report 23rd August 2006 (& additional visit 24th 1.30pm Lyndale DS0000055244.V307879.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 Lyndale DS0000055244.V307879.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. Lyndale DS0000055244.V307879.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lyndale Address Lyndale 24 Southbank Close Hereford Herefordshire HR1 2TQ 01432 378118 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) Lyndale (Hereford] Limited Mrs Julie Lyn Mogg Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Lyndale DS0000055244.V307879.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service users may have a physical disability or a mental health disorder in addition to their learning disability. The registered manager must undertake training to achieve a qualification in management and care at NVQ Level 4 by 31/03/06. The registered manager must undertake training in fire safety and in relation to general health & safety matters (including risk assessments) to a management level by 31/03/06. 21st November 2005 Date of last inspection Brief Description of the Service: Lyndale is registered to provide accommodation with personal care for up to eight adults (men and women) who are aged between eighteen and sixty-five. At the time of this inspection there were seven men living in the home. Service users must require care due to learning disabilities and they may also have an associated physical disability or a mental health disorder, which could include conditions such as epilepsy. Service users may also use behaviours that can challenge a care service, and so they often have complex needs. The home is a large detached Victorian house in a quiet residential cul-de-sac. It has some parking spaces at the front and a large, secure garden to the rear. There is also a small enclosed courtyard area which can be accessed from the kitchen and has patio tables and chairs. Lyndale is a short walking distance from Hereford city centre and so the shops and facilities can be reached easily. Service users have single bedrooms and all but one are on the first floor. Two bedrooms have an en-suite toilet and shower facilities. There is also a selfcontained flat on the ground floor for one person with its own kitchen/sitting area, bathroom and bedroom. There are two lounges and a separate dining room on the ground floor and bathrooms/toilets on both floors for everyone to use. There is also a separate laundry room, office and team leader’s room. The current fee for the service is a minimum of £1575 a week. This level can be increased depending on individual service users need for staff supervision in the home and/or when out in the community. Additional charges are made for such as personal clothes and toiletries, newspapers, taxis, dry cleaning and for the cost of accomodation and spending money when staff accompany service users on holiday. Lyndale DS0000055244.V307879.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. These two inspection visits are part of a key inspection of the home. The main aim of the inspection is to assess if the service provided by Lyndale meets with key National Minimum Standards. The first visit was made unannounced on a Wednesday afternoon and took four and a half hours. The second visit was arranged at the first visit and was made the following afternoon. During these three and a half hours some of the time was taken discussing management issues and the findings of this inspection with the manager. Time in the home was also spent in the sitting rooms with service users to observe their activities and how they get on with each other and staff. Two service users were also asked in private about their life at Lyndale, as due to their learning disabilities it is difficult to communicate with other service users. Survey forms had been sent to the home for all the service users before the inspection asking for their views of Lyndale. Six were completed (three by the service users’ relatives) and a comment card was also returned which was sent to their GP surgery. The feedback received is referred to in this report. Several staff were spoken with individually. They were asked about how they got their job, their training and support, the care that service users receive, how the home is run and their experience of working there. Some relevant records kept by the home were also checked and parts of the house looked at. Other evidence used in this report was obtained from all contacts between the home, provider and the Commission since the last inspection. They include notifications about events in the home that had affected service users and the reports made by the provider following their monthly visits to check if the home is being run properly. The manager had also completed a questionnaire before the inspection, which gave other helpful information about the service. What the service does well: Lyndale offers a very comfortable and safe home to service users. The home is in a good place near to Hereford’s shops and other facilities and so service users can walk to them easily. The home was found to be clean, tidy, bright and fresh and service users who want to have made their bedrooms nice and personal. The house is well furnished and decorated and kept in a good state. There is a very friendly and relaxed atmosphere in the home and service users said they like living there. Their families also commented very positively about the home, saying they are kept well informed and are always made welcome. One parent said that their son “has never been so happy anywhere”. Each service user has a written plan of their care showing all their needs and goals in their life and how they should be met. Staff know and understand service users’ needs and make sure they are cared for well and are helped to Lyndale DS0000055244.V307879.R01.S.doc Version 5.2 Page 6 be in good health. The plans also show staff how to support service users to stay as safe as possible and what to do to help them when they are upset. Service users all have particular staff who give them some individual attention. These staff try to find out more about them and their likes and dislikes, which makes the support they receive more personal. Service users are encouraged to lead active and interesting lives by taking part in a variety of activities and going out and mixing in the community. They are also helped to develop their social and life skills and to be as independent as they can and want to be. Staff complete all training necessary to keep service users and the home safe, including training about the special needs of people with learning disabilities. This helps staff to know, understand and have the skills to meet service users’ care needs and to protect them better. The home is well run and the manager and staff team work together to make sure service users receive good care. 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. Lyndale DS0000055244.V307879.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 Lyndale DS0000055244.V307879.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including these visits to this service. Thorough assessment and admission procedures are in place to make sure that prospective service users needs would be appropriately met by the home. EVIDENCE: There had not been any service users admitted to the home for some time, however there is a vacancy currently. A referral had recently been made in respect of a prospective service user and so it was discussed with the manager how their needs would be assessed and the admission dealt with. The provider had been given initial information about this person’s care needs from their funding authorities care manager and the home will be obtaining a copy of their community care assessment. Consideration was already being given to the level of staff support and some special adaptations this person may need. The prospective service user’s family had been to look around Lyndale and introductory visits would be arranged for the service user. The manager and staff also intend to visit them at their current residence to carry out their own needs assessment and give them information about the home. Following this if they all feel the home could suitably meet their needs a trial stay of at least three months will be arranged. At the end of this period a review will be held involving the service user (if possible), their family, care manager and the home, before a decision is made about the continuation of the placement. Lyndale DS0000055244.V307879.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including these visits to this service. Service users are involved in drawing up plans of their care so staff know their needs, goals and wishes and how to meet them. Possible risks to their safety are also assessed so that any risks to themselves and others are minimised. Service users are enabled by staff to make choices and decisions in their daily lives and routines. They are also encouraged to develop their life skills and their independence is promoted, to the extent they are able to. EVIDENCE: A sample of two service users’ care records was looked at in detail, as their care was “case tracked”. This also involved discussing their needs and lifestyle with one of these service users and with the manager and staff interviewed. Views of the home and their care were also sought from their families, social workers and/or community nurse. Although only their relatives responded the feedback received confirmed they are satisfied with the home and are kept informed and involved in the care being provided. One service user talked about the progress he is making towards moving onto to a more independent Lyndale DS0000055244.V307879.R01.S.doc Version 5.2 Page 10 living setting. Also that he could get up, engage in activities and that staff would support him to go out if and when he wished. Care files contain information about service users’ background, their current lifestyle and a photograph. Staff make daily reports on each person, including their mood, health, behaviour, activities and any other significant events in their lives. Each service user also has a detailed care plan, covering relevant aspects of their needs. This information all provides a comprehensive picture of all their current and changing needs, how these are being met and progress made towards meeting individual goals. Plans have appropriately been drawn up with service users’ involvement to the extent they are able and are “person centred” so service users’ wishes, goals, likes and dislikes and strengths are known. One service user discussed his plan and how he had participated in his recent care review. It was confirmed that staff are fully aware of and work with service users as their plans specify. Plans are accessible and all staff are expected to sign a checklist when they have read them. Some staff had recently attended a training session taken by the local Social Services person centred planning co-ordinator and the home intends to introduce a new format for plans, which is entirely person centred. Particular staff are allocated to each of the service users as their keyworker. They spend time with these service users to get to know them well and take a lead role in such as sorting out their clothes and toiletries, supporting them to attend health care appointments, activities and maintaining family contact. Keyworkers are also involved in reviewing their allocated service users’ care needs and plans. Service users spoken with understand their keyworkers’ role and value their input. Keyworkers are clear about their role and responsibility and feel they know the service users well and make sure that their needs and wishes are recognised and appropriate support is given to meet them. Plans are reviewed regularly, with the involvement of relevant other people, and include any short and long term goals. It is good that other professionals (a community nurse and Psychologist) had taken sessions at the home with staff to discuss two service users’ particular needs in order to help the staff team understand and manage them better. Risk assessments are carried out in relation to behaviours that may be harmful to service users and other people, including such as road safety, bathing and moving & handling. When necessary an individual physical intervention policy is in place, although these are only ever used as a last resort. Staff are clear about techniques to use, such as diffusion, to help to minimise any incidence of aggression and service users have individual management plans whenever any intervention may be necessary to protect them or others. Lyndale DS0000055244.V307879.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including these visits to this service. Service users are enabled by staff to lead full, active and interesting lives and to mix in the wider community, to the extent they are able and wish. Their individuality, daily and life choices are respected and contact with their families is supported and maintained. Service users’ healthy eating is promoted through the provision of wholesome and varied meals, which they can choose and enjoy. EVIDENCE: Service users have an individual weekly activities sheet drawn up showing their interests and any activities they like, with a plan to ensure they are supported to pursue them. Their daily records log what they have actually taken part in and where they have been and even if they have been given the opportunity to do so and refused. Activities include going out for walks to the shops, cafes and pubs in Hereford, swimming and to a hydro/snoezelen sensory centre. Lyndale DS0000055244.V307879.R01.S.doc Version 5.2 Page 12 One service user is currently on a literacy course at college and another is to enrol on a life skills course in September. Further opportunities have recently been sought, such as doing a Gateway Award and going to a Club for people with learning disabilities, which could help them to develop peer friendships outside Lyndale. Tutors from a local college also take music and craft sessions at the home weekly and service users have their own televisions, music centres and take magazines etc to occupy their time whilst at home. Staff aim to support all the service users to go out every day, including those who are unable to be involved in college or day services due to the nature of their learning disability and/or their behaviours. Outings and holidays are arranged by keyworkers who ensure that service users interests and wishes are taken into account. Trips are planned to Blackpool and Ludlow and one service user is going to Disneyland Paris and others to the Cotswolds. The home has a people carrier and one service user has their own car for transport. Service users confirmed, and it was seen, that they are able to make choices in their daily lives and routines, such as where to go, when to get up and go to bed. Those capable and wishing to are encouraged to be independent and are involved in household tasks, such as keeping their bedrooms clean and tidy, doing their laundry etc. Two service users are clear that living at Lyndale is a step towards them moving onto to a more independent living setting, and it was good that are staff actively helping them to work towards this. House meetings are also held regularly so that service users are involved in what goes on in the home and can make choices about such as outings and menus. Staff and service users discussed how the home actively supports them to maintain links with their families, providing transport for visits etc. Relatives confirmed they are kept informed and involved in their family members’ care and made welcome in the home. Two service users had made friends from outside the home and staff enable them to meet up. Service users said the food is nice and they make some choices in what they eat, although staff try to promote healthy eating options meaning they can’t always have what they would prefer. Staff produce a four-week menu plan that includes service users’ suggestions and indicates a variety of wholesome meals is provided. Mealtimes were seen to be flexible, according to service users’ activities during the daytime. This evening’s main meal of roast beef, cauliflower, broccoli and all the trimmings looked and smelled very appetising. Lyndale DS0000055244.V307879.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 & 21 Quality in this outcome area is good. This judgement has been made using available evidence, including these visits to this service. Service users are supported to meet their personal care and emotional needs. Staff also ensure that service users’ health is monitored, their good health promoted and that health care issues are managed appropriately, including illness and death. Service users’ safety is promoted by their medicines being dealt with safely. EVIDENCE: Service users’ care records and plans provide relevant information about their medical history and /or condition and all their personal and health care needs. Records are kept which show that staff closely monitor service users physical, mental, and emotional health and involve appropriate health care professionals when any problems are identified. Records are also kept of relevant health related matters, such as weight and body charts indicating any injuries. Keyworkers ensure service users attend regular health care check ups, such as dentist and optician. The benefit of service users each having an annual health action plan was discussed with the manager, and she agreed to follow this up. Lyndale DS0000055244.V307879.R01.S.doc Version 5.2 Page 14 Service users are all registered with one GP practice because none of them are from this area. This surgery was sent a comment card by the Commission asking for their views of the home. They confirm staff always communicate appropriately, understand service users’ needs and follow the advice they give. The Commission had been kept well informed when a service user had been cared at the home recently throughout their terminal illness. Whilst this is not the type of care often needed by service users in care homes for physically able younger adults it is a credit to the staff team how they handled the situation. It was ensured the service user could be cared for at the home, as they wanted to be. Appropriate support was obtained for them by the home, including Macmillan nurses who visited regularly and gave staff instruction on palliative care and continued to offer support after the service user had passed away. The practice nurses were also involved and provided aids, such as a pressure mattress and slide sheets, and made sure staff knew how to use them. One nurse had subsequently praised staff in writing for the good care they had given and the service user’s family had also sent a letter to the home thanking them for all their hard work through a difficult period. Medicines prescribed for service users are stored securely in the home and only designated staff who have done the necessary safe handling of medicines training appropriately administer and deal with them. Service users manage their own medication if they are able to and one person had signed a written agreement confirming this and also signs their own administration records. All the relevant records relating to medicines were being maintained properly and a useful weekly audit system had recently been set up. Although there were some initial problems in how this was being used by staff, the team leader responsible for medication will ensure they are all clear about this. The home provides satisfactory medication policies and procedures (including guidelines for all medicines that can be given as and when required) and keeps patient information leaflets and a copy of a recent medication reference book. Lyndale DS0000055244.V307879.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including these visits to this service. Service users’ views are sought and listened to and the home operates an effective complaints procedure to deal with their and other people’s concerns. Appropriate steps are taken by the home for service users’ protection. EVIDENCE: The home provides a complaints procedure that is in a format that people with learning disabilities are more likely to understand. However some details need updating and the manager agreed to revise the document. There is also an appropriate record kept of any concerns raised (and compliments) and the manager was reminded this must include information about action taken and the outcome of two recent issues, although this was referred to in care files. Service users who are able to express their views said they know who to speak to if they have any concerns, that most carers listen to them and they would feel confident to report concerns to the home’s manager and deputy manager. Staff interviewed understand and reiterated their role to advocate for service users who are less able to communicate their wishes and views directly. The Commission had not received any complaints about the home since the last inspection and was notified about an allegation made by a service user, which the home had appropriately referred under multi-agency procedures for the Protection of vulnerable Adults. The manager and staff clearly understand their responsibility in ensuring the protection of service users. The staff team have now received training from the local Adult protection co-ordinator and confirm they understand relevant procedures, including whistle blowing. Lyndale DS0000055244.V307879.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including these visits to this service. Service users benefit from accommodation that suitably meets their needs and offers them a comfortable, safe and secure home. The house is kept clean and good hygiene and infection control promote service users’ health and welfare. EVIDENCE: Lyndale is in a convenient location for accessing the facilities and services of Hereford city. The home is in a quiet cul-de sac within a residential area and offers service users a secure, homely and comfortable home. All areas seen were clean and tidy and the impression of the environment is bright and fresh. It is evident a good standard of repair, décor and furnishings is maintained. Work is ongoing to improve the premises and to enhance its facilities. The laundry is currently being moved to a larger, more suitable space in the cellar. This will also mean the office can be moved to a more accessible place on the ground floor and another bedroom be extended to include en-suite facilities in due course. The home employs a maintenance person to undertake minor repairs and upgrading, such as decorating. Lyndale DS0000055244.V307879.R01.S.doc Version 5.2 Page 17 The bedrooms seen are well personalised and service users are able to choose their own décor etc. These rooms are also furnished and equipped to meet any special needs, such as one fitted with an air conditioning unit. Those able to manage them have keys and choose to lock their own bedrooms. The home provides policies & procedures in respect of infection control. Disposable gloves and aprons are provided for staff and suitable arrangements are in place for the disposable of clinical waste. Lyndale DS0000055244.V307879.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including these visits to this service. Staffing levels are appropriate to meet service users’ needs and staff receive relevant training to help them care for service users better and keep them safe Service users would be better protected from risks of unsuitable staff providing their care if the home operated more thorough recruitment procedures. EVIDENCE: Information obtained from staff, service users and staffing rotas show suitable staffing levels are being maintained to meet service users’ care and social needs. This includes for those service users with a specified staffing ratio needed to support them in the home and/or out in the community. Staff are deployed flexibly and team leaders each shift allocate staff members to service users for their daily activities and to provide the support specified in their plan. Staff were seen to interact well with service users and have an open and caring rapport with them, offering guidance when needed in a relaxed and respectful way. They clearly understand that their role is to encourage and facilitate service users to develop their life skills, to lead as full and active a life and to integrate into the wider community as much as is possible and they are able. Lyndale DS0000055244.V307879.R01.S.doc Version 5.2 Page 19 Staff interviewed described their recruitment process, which had included them completing an application form, having an interview and necessary checks taken up before they started work at the home. Following this they completed an induction and probationary period before their employment was confirmed. Their induction had also included “shadow” shifts at the home and a day spent with the deputy manager going through the home’s policies and procedures. Whilst this reflected appropriate recruitment procedures, a sample of staff records were checked and it was found that the home’s application form does not request a full employment history and request for any gaps in employment to be explained, as is now required. In addition one person’s references were from a friend and a work colleague, which is not necessarily a creditable source. Whilst there may be particular situations where obtaining a reference from previous employers is difficult effort should always be made to obtain references from their most recent employer or from such as a college tutor or other person who has had a more professional relationship with the applicant. All staff had undertaken, or are currently completing, the LDAF induction & foundation training programme, which is accredited especially for staff working in care with people who have learning disabilities. The provider has also revised their homes’ own induction programme, which is very comprehensive. Staff are expected by the home to move onto NVQ training following induction and although only three staff have achieved this qualification to date , another five were about to complete it and more had recently started the training. This should continue so that at least 50 of care staff are qualified. All staff complete the required health & safety training and they have training opportunities in other topics relevant to care and the special needs of service users, including abuse & protection and positive interventions for managing challenging behaviour. Some staff had received training on epilepsy and autism, although the manager is to arrange for more to do so. A training session had also been planned on effective communication with a Speech Therapist, which should be very useful. Staff receive individual supervision and their training and work related needs are discussed with them and training arranged to increase their skills and knowledge. The home is to set up personal development plans for each of the staff as the standards specify. Lyndale DS0000055244.V307879.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including these visits to this service. The home is well run by a competent and experienced manager, which ensures that service users receive a good service. This will be further confirmed when the manager completes and achieves a management and care qualification. There are processes in place to ensure the quality of the service is monitored and continues to develop, for the benefit of service users. Appropriate steps are taken to ensure that the home is kept safe so that service users and staff are protected. EVIDENCE: The manager had now completed a comprehensive health & safety course and most of the work required for an NVQ 4 qualification in management and care . Confirmation that both have been achieved is now awaited and then the conditions of registration in relation to this training can be removed from the Lyndale DS0000055244.V307879.R01.S.doc Version 5.2 Page 21 home’s certificate of registration. In any event the manager (Mrs Mogg) has many years experience in care and other relevant qualifications. The evidence obtained in this key inspection shows there is an open and positive management approach, and that the home provides a good service. Staff are very positive about the support they received the manager and feel that tasks are allocated and the home managed well. Communication in the home is open and they are given all the information they need to do their job properly and about service users, through shift handovers, daily report and a communication book. Staff meetings are held regularly and staff feel able to raise issues and make suggestions and know they will be dealt with constructively. The manager and deputy manager feel they and the home are well supported by the provider and said they are always available and responsive to issues they raise. The manager receives regular individual supervision and attends monthly meetings with other managers of care homes that are also registered to the provide and finds this peer support very helpful. The required monthly visits are made to the home by a representative of the provider when they also undertake a quality audit of all aspects of the service, with an action plan to address any shortfalls identified. It was discussed that an annual development plan should be drawn up, based on the views of service users and other stakeholders. This will also provide very helpful information for the Commission as part of the inspection process. Staff undertake all the mandatory health & safety training i.e first aid, moving & handling, fire safety, food hygiene and infection control. It was confirmed in the pre-inspection questionnaire that the home contracts with relevant engineers to annually service such as the gas and central heating systems. Other ways that health & safety is maintained in the home includes: • Portable Appliance Tests are carried out annually. • COSHH risk assessments. • Water temperatures are checked weekly. • Accident records are being maintained. • Nofications are made appropriately to the Commission. The fire log was checked and showed that fire audits and weekly tests of the alarm system were recorded as having been carried out. Fire drills are being arranged regularly, although the names of staff participating in each drill should be recorded to ensure that all staff do so at least once a year There were no hazards observed in the environment during these inspection visits, and overall the home it is apparent the home pays due attention to ensuring the safety and welfare of service users and staff. Lyndale DS0000055244.V307879.R01.S.doc Version 5.2 Page 22 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 X 32 2 33 X 34 1 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 2 X 3 X X 3 X Lyndale DS0000055244.V307879.R01.S.doc Version 5.2 Page 23 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 YA34 Regulation 19 Requirement Staff employed at the home must submit a full employment history, (with any gaps explored and a satisfactory explanation given) before their appointment is confirmed. References must be from a creditable source including their most recent employer. The manager must complete a general health a general health & safety training course (including risk assessment) to a management level. This is a condition of the home’s registration and previous timescales had been set. Whilst only confirmation is needed for sucessfull completion of this training course the timescale is again extended. The manager must achieve an NVQ level 4 qualification in management and care. This is a condition of the home’s registration. Progress has been made but there have been issues with the training body. Hence the timescale is extended Lyndale DS0000055244.V307879.R01.S.doc Version 5.2 Page 24 Timescale for action 30/09/06 2 YA37 9 31/12/06 3 YA37 9 31/12/06 again. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider to consider carrying out. No. 1 Refer to Standard YA32 Good Practice Recommendations The programme of NVQ training for care staff should continue to ensure that at least 50 achieve this qualification. Lyndale DS0000055244.V307879.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Lyndale DS0000055244.V307879.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. 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. 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