Inspection on 10/07/08 for Lynden

This inspection was carried out on 10th July 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lynden 15/06/06

Lynden 11/02/06

Lynden 24/05/05

Lynden 04/11/04

Lynden 03/06/04

Lynden 23/02/04

Lynden 09/10/03

Lynden 28/10/02

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 Lynden 18 Thornton Road Morecambe Lancashire LA4 5PE Lead Inspector Ms Jenny Hughes Unannounced Inspection 10th July 2008 09:00 Lynden DS0000009678.V365092.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 Lynden DS0000009678.V365092.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. Lynden DS0000009678.V365092.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lynden Address 18 Thornton Road Morecambe Lancashire LA4 5PE 01524 420762 01524 401 947 lyndencare@aol.com 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 Kathryn Lesley Regan Mr Robert John Murray Manager post vacant Care Home 11 Category(ies) of Learning disability (11) registration, with number of places Lynden DS0000009678.V365092.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 - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of service users who can be accommodated is: 11 Date of last inspection Brief Description of the Service: The Lynden is registered to provide care for up to 11 adults with a learning disability. The home is a large terraced property in Morecambe, situated close to the promenade. There is a small patio area at the rear, with plants and seating, where people can enjoy the better weather. There are two lounges/dining rooms for the use of the people who live at The Lynden, one of which is a smoking area. There are 9 single bedrooms and 1 flat which has a double bedroom. There is easy parking for cars on the road outside the home, and local shops and the seafront are a short walk away. Information about the service the home provides is available in an easy to read Service User Guide, which tries to cover everything a resident needs to know about daily life in the home. CSCI reports are available in the entrance hall of the home, and from the manager. Fees range from £366 to £502 per week, depending on the care required. Further details are available from the manager. Lynden DS0000009678.V365092.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 3 star. This means that the people who use this service experience excellent quality outcomes. This was an unannounced visit to the home, meaning that the owner, manager or staff did not know that the visit was to take place. This site visit was part of the key inspection of the home - . A key inspection takes place over a period of time, and involves gathering and analysing written information, as well as visiting the home. During the visit we (Commission for Social Care Inspection) spent time speaking to service users, staff, and the manager. Every year the registered person is asked to provide us with written information about the quality of the service they provide, and to make an assessment of the quality of their service. It also asks about the manager’s own ideas for improving the service provided. We use this information, in part, to focus our assessment activity. Surveys were sent and received from service users and their relatives, and staff from the home. During the site visit, staff records and service user care records were viewed, alongside the policies and procedures of the home. We also carried out a tour of the home, looking at both private and communal areas. Everyone was friendly and cooperative during the visit. What the service does well: The home provides good information about the home for prospective service users and their families, which is also available in formats that may be easier to understand if necessary. Lynden DS0000009678.V365092.R01.S.doc Version 5.2 Page 6 Before a service user moves into the home, the manager makes sure it is the best place for them by carrying out a thorough assessment of need, and by the individual regularly visiting the home. Assessments are all based on each individual’s different needs, to make sure the right care and support is given to each person. The service users, and families, were included in deciding what the best care for them was. The information in the care plans produced from the assessments creates a clear mental picture of each person, giving staff good information on how best to look after them. It was clear that service users and their representatives have full involvement with the development and reviews of their care plans, reflecting people’s individual needs and wishes. We saw the staff and the manager going about their work always having time to talk to service users who had questions to ask, and involving all of the service users in what was happening in the home. The staff said that the service users were gently guided to help them make their own decisions, and risk assessments are carried out on service users’ activities. The service users had a group holiday in Blackpool. One service user enjoyed it so much he has planned another visit on his own. The manager is helping to make sure all the arrangements he has made himself are safe and correct. Surveys from service users stated that they liked–“Day trips, holidays, parties” the best. The manager said they try to make sure the service users’ lifestyles in the home are a continuation of what they liked doing before they arrived there. Each service user is offered a key to their own bedroom door ensuring his or her privacy is respected. A relative said “The staff take time to talk to the residents to find out what they really want and why. It is such a relief to me to know that my sister is so happy and well cared for” The home is run as a family home, with a low turnover of staff. This means that both staff and service users know each other well, and so changing needs are easily noted by staff, and passed on by service users who are confident in them. We noted that staff were respectful of people and knocked to enter rooms, or spoke quietly and moved around quietly if they knew someone was asleep or not too well. Lynden DS0000009678.V365092.R01.S.doc Version 5.2 Page 7 The information provided by the manager states that the home has received four complaints, but we noted that as the manager records any service user’s concerns, these four were they. This is very positive action to take, and the manager said that she feels this is important to the service user and shows she takes their worries seriously, and they can be properly discussed and addressed. As one service user said, “They HAVE to listen to me, it’s their job” The manager makes monthly checks of the environment to note any work required. She said over the last two years most rooms have been decorated, and now the last of the carpets are being replaced. We saw that staff record maintenance work, which is signed and dated by the maintenance man when the work is completed. We also noted that regular services to all household appliances and equipment were up to date. Recruitment of staff is structured and always followed, and 75 of the staff hold National Vocational Qualifications (NVQ). A relative said in the survey returned to us, “The care home provides a loving and caring, well organised home for the residents” What has improved since the last inspection? What they could do better: There needs to be a Controlled Drugs cabinet in which to store any Controlled Drugs being used by service users. Daily records should be made for all service users, and not just when there is a change to normal routine, to give a full picture of the care that has been provided. The home is registered to accommodate 11 service users, and all of the rooms should be reasonably decorated ready for use. At this home their is one bedroom that has been decorated, but still needs attention, although the manager said she would not place a resident in that room until it was somewhere she would be happy for one of her own family to stay. Lynden DS0000009678.V365092.R01.S.doc Version 5.2 Page 8 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. Lynden DS0000009678.V365092.R01.S.doc Version 5.2 Page 9 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 Lynden DS0000009678.V365092.R01.S.doc Version 5.2 Page 10 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): Standards 1, 2 and 4 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Information about the home is very good, providing service users and prospective service users and their families with details of the service the home provides, enabling an informed decision about admission to the home. This means that no service user moves into the home before having their needs and aspirations assessed and being assured that these will be met. EVIDENCE: There is detailed information available about the home for all service users, or possible service users, which has been developed over time into a very clear and easy to read description of the services provided, and who provides them. It is available in written and pictorial format, which is used to help the reader understand the content. All of the service users we spoke to knew about this information, that it was in their files, and that they could look at all of the information in their own files whenever they wished. Lynden DS0000009678.V365092.R01.S.doc Version 5.2 Page 11 We selected three service users to case track, where we examined the individual assessments and care of those people from admission to this home, to present day. We saw that individual records were kept for each service user, and the staff discussed the way anyone new would be initially invited to visit the home and meet the service users. We noted that a social work assessment is used to help the owner decide whether the home was the right place for the new person. We saw one service user who was visiting the home on respite, with a view to a permanent long-term stay. She was happily mixing with the other service users in the lounge, and interacting with both staff and service users. “We encourage people to come as many times as they want before they decide to stay or not. We all need to be happy that they get on with the service users already here, and vice versa. And that we can appropriately care for them” stated the manager. We also examined the home’s own assessments of need for these three service users, which the manager had carried out. There was information on the service users’ strengths, needs, personal goals, and choices on how they wanted their support to be provided. “They always ask me what I want to do and check I’m alright”, commented a service user. Lynden DS0000009678.V365092.R01.S.doc Version 5.2 Page 12 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): Standards 6, 7 and 9 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. There is a system in place, carried out together with each individual, which produces detailed and up to date care plans showing how each person should be cared for to achieve the personal goals set. EVIDENCE: We saw that the care planning system is detailed and structured, with each individual’s plan telling staff how to best look after them, giving information which includes areas covering their physical and mental health needs, dietary needs, and a personal profile. The information creates a clear mental picture of each person. Regular reviews and updates of this information takes place. Lynden DS0000009678.V365092.R01.S.doc Version 5.2 Page 13 A booklet titled “Me and My Life” and completed with the service user gives their personal information about their likes and dislikes, outlines any health issues, and details their preferred routines in their lives. Surveys returned from the service users stated that they knew they had a care plan, and they told us about their care plans. “I just tell them if I want something” said a service user “I can talk to anyone”, “I like living here”, said another. The staff said that the service users were gently guided to help them make their own decisions, and risk assessments are carried out on service users’ activities. One service user had decided to book a holiday, and the manager helped him with advice and support. He chatted happily to us about it. Staff also commented that they thought the care planning system was easy to use and follow, and that there was plenty of information about the service users. “I fill in daily records every shift, record information every shift and read the care plan diary every shift”, said one, when asked about keeping up to date with information. We noted that staff did not keep daily records for each service user unless a specific event prompted them, for example an illness that needed to be monitored. The manager explained that they only recorded anything different to normal routines, as otherwise the records were very repetitive. The Care Homes Regulations 2001 do not make a requirement for them, but we discussed the beneficial reasons for having daily records for all service users at all times. These produce a full picture of people’s lives, giving evidence of the constant care provided, and background information for any future incidents. Lynden DS0000009678.V365092.R01.S.doc Version 5.2 Page 14 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): Standards 12, 13, 15, 16 and 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users independence. EVIDENCE: The manager told us that they try to ensure the service user’s lifestyle is continuation of what their preferences were prior to admission. We found evidence in people’s care reviews of activities they enjoyed and took part in, such as cooking, trips out, relative’s visits, puzzles and jigsaws, walks, and arts and crafts. decisions are respected and daily routines promote Lynden DS0000009678.V365092.R01.S.doc Version 5.2 Page 15 One service user loves jigsaws, we chatted to her as she sat completing a difficult jigsaw set up especially on a table in the lounge. Another service user was watching television, and told us how he likes to go out in the car with staff and visit people. One service user had decided to have a lie in, and came downstairs with his washing to put in the wash basket in the laundry area. He then made himself a drink in the kitchen with encouragement and supervision by staff. Service users are enabled and supported in their relationships with other people. The manager said that there is open visiting at the home, and they encourage family, friends, local choir groups, and clergy of varying denominations to visit the home. We noted that the home has acquired more outdoor furniture for the newly built rear patio area, where there are raised garden borders, trellisses and pot plants, to encourage outdoor activities. Service users quietly tucked into their freshly cooked lunch time meal in both the upstairs and downstairs dining areas, with staff offering more if they wanted. They told the staff what they wanted for lunch, from a choice to suit differing tastes and appetites. On this day the main meal was meatballs with mash or chips and vegetables. A record is kept of what has been eaten by all of the service users at every meal. “We always get plenty to eat. I just ask if I want a drink”, said a service user. Fresh fruit was available and on show in a fruit bowl in the kitchen for all the service users when they wanted it. Some of the service users like to help around the home, and are enabled to do so. One service user likes to help put the shopping away, and staff make sure some of the shopping is left out following delivery so that the service user can do this. A grocery delivery arrived during this visit, and the service user was given the choice on whether he wanted to help or not. Lynden DS0000009678.V365092.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19 and 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The staff have a good understanding of the service users’ support needs. The medication at this home is generally well managed, promoting good health. EVIDENCE: We saw that each service user file held a record of ‘Professional Visits’, meaning health professionals such as a GP or district nurse, Dentist, Chiropodist, or Psychiatrist. The manager confirmed that if service users have appointments, staff accompany them. She stated that they always try to ensure people’s physical and emotional needs are met. There is a system where all service users have a risk assessment before it is decided whether it is safe for them to be in charge of their own medication, or whether care staff take control of administering the medication. Lynden DS0000009678.V365092.R01.S.doc Version 5.2 Page 17 Medication records we looked at were clear and up to date. We saw efficient systems for the recording of new medication into the home, and returns to the pharmacist. Staff helping with the administration of medication had attended a medication awareness course, and sample signatures of these were available. Photographs of service users on the medication records ensured correct administration, and Patient Information leaflets about the medication in the home held important information if ever needed. Controlled Drugs are those that are able to be misused, and so need to be stored and recorded separately. We saw that there was a Controlled Drugs Register in use, although the manager was aware the storage of the very minimal Controlled Drugs presently in use was not adequate. She was able to discuss her research into this following her concern after the medication was recently prescribed. She discussed how this was to be addressed, by the acquisition of a standard Controlled Drugs cupboard, which would be bolted to the wall. We discussed how the storage of all the medicines could be improved, and the manager agreed to address this. Service users come and go to their rooms as they wish, some choosing to stay there for a while to watch television or play music, or just spend time on their own. The staff can look after someone who has special needs, for example someone with special dietary needs and who uses a PEG feed. All of the staff have had professional training on how to use the equipment, and the service user is very clear on what can and cannot be eaten, although staff constantly gently guide him, and were seen discussing reasons for the dietary needs with him. Lynden DS0000009678.V365092.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are confident their concerns will be listened to and acted upon. Staff have an understanding of Adult Protection issues, which protect service users from abuse. EVIDENCE: We saw that there is a complaints procedure in place, with a complaints book to record any complaints, which may come to the manager’s attention. All the service users and/or their family receive a copy of the home’s complaints procedure, which is available in pictorial format to enhance people’s understanding, and copies are available in the entrance hall of the home. Service users spoken to said they would tell the staff if they did not like something, ”I can tell Rolanda (the manager), or anyone really. But I like it here, it’s nice”. Staff said that they would note any changes in mood of service users, which would indicate that they were not happy about something, and would try to find out what it was and put it right. Staff spoken to knew about the Safeguarding Adults procedure, and what to do if they had any concerns. Lynden DS0000009678.V365092.R01.S.doc Version 5.2 Page 19 There is a Whistleblowing policy whereby staff are encouraged to report if they suspect abuse may be taking place. Lynden DS0000009678.V365092.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 26 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a homely, comfortable and safe environment, and ongoing maintenance plans mean that this will continue. EVIDENCE: The manager said that the home owners try to maintain the décor and furnishings to a good standard, and we confirmed this during the visit. The two lounges are homely, comfortable and clean, with large televisions in both. One service user often occupies a corner of one lounge with her jigsaws, while the other lounge was a smoking area for service users to use. One service user in the upper lounge said, “I like sitting here. I like this room. I can have a smoke” Lynden DS0000009678.V365092.R01.S.doc Version 5.2 Page 21 Service users’ bedrooms are full of their own belongings. These may be pictures and drawings, football shirts and toys, whatever the whim of the service user. One service user has a goldfish in a small tank to care for. Bedroom doors have locks and service users are able to hold keys, unless a risk assessment dictates otherwise. We saw aids and adaptations in place to aid service user mobility around the home, and the manager confirmed that specialist equipment could be obtained from the central Loan Stores for individuals. One bedroom that was redecorated after the last visit still has some issues with ceiling paper falling off. The room is empty at present. The manager said she would not place a resident in that room until it was somewhere she would be happy for one of her own family to stay. Steps to the front door, and stairs inside the home, mean that service users must have fairly good mobility to stay there. There is a stair-lift to the first floor only, so the manager is very aware that individual assessments are important, as service users need to be mobile enough to manage this, and other rooms are higher with no stair lift. The needs of all of the present service users are met. The outside area at the rear of the home has been developed to make an attractive sheltered patio area with plants set around it. The manager said she planned barbecues in the better weather. Fire and environmental health checks have been carried out. Lynden DS0000009678.V365092.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34, 35 and 36 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home operates a good recruitment policy, which ensures that only people who are suitable for this type of work are offered an appointment. Training is provided and this means that service users are provided with appropriate care and attention EVIDENCE: We selected the files of two recently recruited staff, and saw that recruitment procedures were clear and always followed, with written references, and Criminal Record Bureau disclosures received prior to the applicant starting work. A formal recorded interview was held, which included the applicant being introduced to service users, who are later asked their opinion. Lynden DS0000009678.V365092.R01.S.doc Version 5.2 Page 23 The staffing rotas were checked and they showed that an adequate number of staff are on duty during each shift. The staff said there are enough of them to provide a good quality of care to the service users. All of the staff undergo induction training when starting work at the home, using the Learning Disabilities Award Framework. The manager told us 75 of care staff hold an NVQ qualification, with all of the remaining staff working towards it. She explained that their training matrix identifies which staff need to attend updates to maintain and improve their skills. All staff receive six annual supervisions and annual appraisals. “We have regular meetings and I feel if I am not happy I can talk to my senior or manager,” stated a staff member. “I have two monthly supervisions, appraisals, and there are staff meetings and updates in-between”, commented another. Other specific training is attended as required, for example Dementia Care, or PEG feeding, palliative care, and Challenging Behaviour have been attended. Moving and Handling, First Aid, and Food Hygiene courses have also been attended by staff. Lynden DS0000009678.V365092.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39, and 42. Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Efficient systems and practices in the home promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: The current manager has the Registered Managers Award, and extensive experience working with people with learning disabilities. Throughout this visit she demonstrated a commitment to high standards of care. The information provided to CSCI prior to this visit from the manager was detailed and informative. Lynden DS0000009678.V365092.R01.S.doc Version 5.2 Page 25 The manager stated, “We want this to be the service users’ home, where they can choose to do as they like, as they would in any family home. I think a lot of it is common sense. I tell staff to imagine it’s your relative and care for them in the same way”. The manager discussed the case of a poorly service user, and how she made sure the correct medical tests were done to address the problems. The manager was clearly happy to spend time chatting with service users who wanted to talk. The service users were all relaxed and choosing to do whatever they wanted, clearly telling or signalling the staff about what they did not want to do. This ongoing feedback is dealt with immediately, and recorded for future reference. A relative said, “It gives my brother a comfortable and loving lifestyle that is appropriate to his needs”. Records of service users’ meetings were seen. These are held every four to five months, and cover areas such as: the care given, the environment, menus, and activities. Surveys from the home are given to service users in an easy to understand format. We saw some that had been returned, and they showed that the service users thought the staff were friendly, their room was clean, they were able to make choices and take part in everyday activities, and the staff listened. The staff stated that the service users are encouraged to manage their own finances whenever this is possible. However some people, due to their disability, are unable to understand their finances. The management keep individual, thorough, records of all transactions. The money is securely stored, and two staff witness each entry into the record and check the balance is correct. All files and records are structured and complete. A formal business system is used, enabling the manager to maintain efficient systems with up to date required information. All accidents are recorded on file. Appropriate fire precautions are taken using a fire alarm system, and extinguishers, all of which are checked regularly. All staff are instructed on what to do in case of fire, with regular fire drills. Lynden DS0000009678.V365092.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 4 3 X 4 4 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 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 4 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 4 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 4 X 3 X X 4 X Lynden DS0000009678.V365092.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? NO 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 YA20 Regulation 13(2) Requirement The storage of Controlled Drugs must be within a Controlled Drugs cabinet to comply with legislation. The owner must continue to ensure service users are only placed in rooms that are reasonably decorated. Any room needing maintenance work must remain empty until this has been completed. Timescale for action 31/08/08 2 YA24 23 31/07/08 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 YA6 Good Practice Recommendations Staff should make daily records for all service users to ensure they have a full picture of the care they have provided. Lynden DS0000009678.V365092.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ 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 Lynden DS0000009678.V365092.R01.S.doc Version 5.2 Page 29 - 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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