Inspection on 20/01/09 for Lyndhurst & Albany

This inspection was carried out on 20th January 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Lyndhurst & Albany 22/02/07

Lyndhurst & Albany 17/01/06

Lyndhurst & Albany 06/07/05

Lyndhurst & Albany 01/03/05

Lyndhurst & Albany 22/09/04

Lyndhurst & Albany 09/03/04

Similar services:

22 Sandown Road

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Dilston College Of Further Education

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Park View (15)

Craigmore House

1 Lanark Close

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

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Lyndhurst & Albany Maitland Terrace Newbiggin By The Sea Northumberland NE64 6UR     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Janine Smith     Date: 2 0 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Lyndhurst & Albany Maitland Terrace Newbiggin By The Sea Northumberland NE64 6UR 01670-812714 01670812714 Maitland@c-I-c.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Community Integrated Care Name of registered manager (if applicable) Mrs M Mason Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 7 The registered person may provide the following category 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 category: Learning disability Code LD, maximum number of places: 7 Date of last inspection Brief description of the care home Lyndhurst & Albany provides a home and care for up to 7 adults with a learning disability. Nursing care is not provided. The house is a bungalow style. It has two distinct parts, both having a lounge, separate kitchen/dining area, bathroom and shower room and bedrooms. One part is known as Lyndhurst; the other as Albany. Three residents live in Lyndhurst and four in Albany. Each resident has a single bedroom. A central corridor and an office, which is also used as a bedroom for staff who sleep on the premises, link the two parts of the home. The home has been designed with the needs of people who have physical disabilities, in mind. There are Care Homes for Adults (18-65 years) Page 4 of 27 care home 7 Over 65 0 7 Brief description of the care home aids and adaptations in place, including assisted baths and a hoist tracking system. The house has a large garden to the rear and sides of the building and ample car parking space at the front. It is located close to the centre of Newbiggin-by-the-Sea, which has shopping and leisure facilities. The home is close to bus routes. It is run by Community Integrated Care, a national registered charity, which also runs several other services in the North East of England. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: Before the visit we looked at the following. Information we have received since the last visit on 22nd February 2007. How the service dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service, staff and other professionals. An unannounced visit was made on 20th January 2009 by Mrs Janine Smith, Regulatory Inspector, and Miss Victoria Bowman, Expert-by-Experience. An expert-byexperience is a person who, because of their shared experience of using services, and/or ways of communicating, visits a service with an inspector to help them get a Care Homes for Adults (18-65 years) Page 6 of 27 picture of what it is like to live in or use the service. During the visit we talked with people who use the service, staff and the manager. We looked at information about the people who use the service and how well their needs are met. We looked at records which must be kept. We checked that staff had the knowledge, skills and training to meet the needs of the people they care for. We looked around parts of the building to make sure it was clean and comfortable. We checked what improvements had been made since the last visit. We told the manager what we found. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? No statutory requirements were made at the last inspection. Staff have had training in personal care planning. Changes have been made to the garden, including creating a snozelum facility, where service users can go to relax. Raised planting areas have also been made for growing vegetables. An awning has been fitted between the two bungalows. Care Homes for Adults (18-65 years) Page 8 of 27 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may use the service and their representatives have the information needed to choose a home that will meet their needs. Evidence: There have been no new admissions since the last key inspection. The manager stated in documentation provided before the inspection that a comprehensive assessment would be carried out before any new admission take place. Any potential new resident would be offered opportunities to visit the home and have a short stay to help them decide if it was the right place for them. Six of the current service users said in a survey that they were asked if they wanted to move to this home and that they received enough information about it. A care manager stated that the service always ensures accurate information is gathered and the right service is planned and provided. Assessment information and contracts were seen to be in place on two of the records looked at. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are involved in decisions about their lives, and play an active role in planning the care and support they receive. Evidence: Two service users care records were looked at, which showed that a detailed plan of care had been drawn up which reflected the wishes of the individual service users. Six service users confirmed by survey that they always make decisions about what they want to do each day and can do what they want. Staff were seen to offer choices to service users during the inspection, for instance at mealtimes. They are also encouraged to go on shopping trips and make decisions about what is purchased. Service users can choose when to go to bed and get up, although some residents need to be worken up so that they can attend day centres and colleges. All six service users said the carers listen to and act on what they say. A care manager was spoken to, who said that the home always provides support to the individuals living here to live the life they choose. This approach was also reflected in the surveys received from staff Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: working in the home. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to make choices about their life style and are supported to develop their life skills. Evidence: A local authority care manager said that the home adapted to the changing needs of service users and responded to them as individuals. Each service user has an individualised plan setting out what they want to achieve or spend their time. On the day of inspection four service users went out as part of their normal routine, for example, to go to work placements, or resource/day centres. Two staff stated in a survey that the service users are supported to integrate with the local community. Staff provide individualised support to service users, for instance, to carry out gardening tasks at home, to go to the local shops to buy items needed for the home, to carry out domestic tasks within the home. A new greenhouse had been obtained, Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: which a resident was using. The home have also developed a snozelum room, which is housed in the garden. The staff said that they use an activity sheet to help service users make choices about what they want to do. The sheet included activities, such as foot spas, singing using a karoke machine, going for a walk, a meal, or to the theatre or having a chat with staff. Service users also go on a holiday each year of their choice. Some had gone to Blackpool last year, another went to London and another to Euro Disney. Photographs of one service users last holiday were seen. The staff also support service users to keep in touch with friends and family. One resident was looking forward to a visit from a relative. Six service users said in a survey that they do what they want during the day, evening and at weekends. Service users are given choices at mealtimes. At lunchtime on the day of inspection, service users were offered a choice of sandwich fillings or anything else they wanted. The food was enjoyable. The bulk of shopping is obtained via the internet, but service users go on shopping trips with staff and they can choose what food goes into the trolley. A four week menu plan is followed. The staff prepare the meals, but service users can help out in the kitchen if they wish to. Service users can also help themselves to food and drink from the kitchen with staff support. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: A local authority care manager said that staff always provide the support people need regarding their health and medication and that their privacy and dignity is always respected. The two care plans looked at showed that comprehensive plans were in place to meet service users individual personal and health care needs. There was also evidence that they had routine health care checkups and saw doctors, community nurses and other health professionals when necessary. Advice was obtained on how to support service users with challenging behaviours, which was clearly recorded in the care records. The care manager said that the staff were able to adapt to the changing needs of service users and provide the support they needed. This was demonstrated as one resident had spent some time in hospital The staff drew up an intensive programme of Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: support for her, which enabled her to return home and regain some mobility and independence. The care manager also said that staff consulted dieticians and speech therapists when necessary. Two surveys were received from staff, who both said that they have received training to understand and meet the individual needs of service users and they have the right support, experience and knowledge to do this. The arrangements for medication were discussed with a carer and a sample of records looked at. The carer could clearly describe the system used and what safeguards are in place to ensure that medication is handled safely. She could clearly describe the triggers, which staff would expect to see, before administering as required medication to a service user. Written guidance was in place for this. The medication administration records were up to date and clearly recorded, apart from one instruction written by the pharmacist which did not make clear one medication was only to be given when required. The carer confirmed she had received training about medication and a training certificate was seen on the staff record looked at. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live here are able to express any concerns and have access to a robust, effective complaints procedure. They are protected from abuse. Evidence: Copies of the homes complaints procedure were held in the service users care file. A care manager stated in a survey that the service has always responded appropriately to any concerns. Six service users stated in a survey that they know who to speak to if they are unhappy. Three know how to make a complaint. The care manager states the other three could do this with support from families or care manager. The manager stated in documentation provided before the site visit, that staff listen and had been trained in appropriate intervention techniques if any service user displays challenging behaviour. Evidence of this was seen on a staff record looked at, as well as confirmation that training about protecting vulnerable adults had also been provided. A member of staff confirmed they had received this training and could describe what the Whistle Blowing Policy and procedure were about. Appropriate procedures in place to handle service users monies, which are audited regularly. Clear records were kept of service users money and how it was used. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables service users to live in a safe, well-maintained and comfortable environment. Evidence: The home comprises of two bungalows, which have been joined together internally. Service users can move freely around the two homes. The home was nicely decorated and spacious. Each service user has their own bedroom, which were filled with their personal belongings. A new sensory room has been created in the garden, which was padded out with soft furnishings and was full of fibre optic lights. The staff said that they played relaxing music for service users who spend time in it. The staff also explained how they were going to support service users to grow their own vegetables, using the new greenhouse and vegetable plots, which have been installed. The home is well equipped, with sophisticated tracking hoists, which allow service users with mobility difficulties to use all parts of the bathrooms. Specialist equipment is also obtained when necesssary to help individual service users. Six service users said in a survey that the home is always fresh and clean. Care Homes for Adults (18-65 years) Page 19 of 27 Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support the people living in the home. Evidence: The rota showed that 3 or 4 staff are on duty between 8 am to 3 pm and three staff on duty from 3 pm to 10 pm. Through the night there is one waking carer and one sleeps on the premises to assist if required. This was also confirmed by discussion with staff and by staff survey. Staff spoken to said that the staffing levels were fine and gave them time to work with individual service users. The manager said that staff were given a range of training to equip them with the skills needed. A member of staff said that they had received a wide range of relevant training, including obtaining a National Vocational Qualification at level 2, and that the manager always supports staff to obtain additional training. The member of staff had also recently received training about the Mental Capacity Act, which is new legislation which helps protect people with learning disabilities, amongst others. Two members of staff, who completed surveys, said they received training relevant to their role, which keeps them up to date and able to understand and meet the Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: individual needs of service users. Both said they always or usually had the right support and experience and knowledge to meet the different needs of service users. Staff spoken to during the inspection and those who completed surveys said their manager supports them and meets with them regularly to discuss their work. A care manager stated in a survey that the manager and staff have the right skills and experience to support the individual needs of people living in the home. Six service users who completed a survey said that the staff always treat them well and always listen to them. Staff were seen to have good relationships with the service users and demonstrated a good knowledge of their needs. The record of a new member of staff was looked at, which showed that appropriate vetting checks had been carried out before they were employed and that they were receiving induction training. The carer concerned confirmed that they were receiving training and good support from the manager and staff team to help them understand their role and provide the support service users need. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect. There are effective quality assurance systems in place, which helps to ensure the home continues to be well run for the benefit of service users. Evidence: The registered manager, Mrs Maureen Mason, has managed the home well for some years. The views of staff and a care manager spoken to provide good evidence that she continues to run the home effectively for the benefit of the people who live here. The organisation running the homes has a quality assurance system, which includes a number of different audit processes to test how well the service is meeting its aims. Minutes of staff meetings showed that this are used to good effect to discuss policies and procedures and reinforce the homes objectives. Meetings are held with service users, which gives them opportunities to affect how the home is run and what service is provided to them. There was evidence that staff changes, how to spend funds raised, and improvements to the garden had been discussed with them. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: There is a training programme in place to ensure that the staff team are given training in moving and handling skills, fire safety, first aid, food hygiene and infection control. Evidence of the training was seen on the staff file looked at and confirmed by the staff spoken to. A sample of servicing/maintenance documentation was seen for the equipment used in the home. Records also showed the checks carried out on the fire safety systems. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 16 Place the activity board in a communal area, rather than the office, so service users have easier access to it. More pictures and symbols could be used on the activity board and menu. This will allow the residents to choose what they would like more easily. Ensure that the pharmacist has given clear instructions on the pre-printed medication administration records about any medication that is taken when required. This will help ensure that service users receive the correct medication. 2 20 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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!