Inspection on 06/07/05 for Lyndhurst & Albany

This inspection was carried out on 6th July 2005.

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 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 20/01/09

Lyndhurst & Albany 22/02/07

Lyndhurst & Albany 17/01/06

Lyndhurst & Albany 01/03/05

Lyndhurst & Albany 22/09/04

Lyndhurst & Albany 09/03/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Lyndhurst & Albany Maitland Terrace Newbiggin by the Sea Northumberland NE64 6UR Lead Inspector Janine Smith Announced 6 July 2005 10:00 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 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 Stationary 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. Lyndhurst & Albany B53-B03 S668 Lyndhurst & Albany V226427 060705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Lyndhurst & Albany Address Maitland Terrace Newbiggin by the Sea Northumberland NE64 6UR 01670 812714 01670 812714 N/A Community Integrated Care Telephone number Fax number Email 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 M Mason CRH 7 Category(ies) of LD Learning Disability registration, with number of places Lyndhurst & Albany B53-B03 S668 Lyndhurst & Albany V226427 060705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: There is one condition of registration which states that two persons are over the age of 65 years. This condition continues to be met. Date of last inspection 22/9/04 Brief Description of the Service: Lyndhurst and Albany provides residential care for up to seven adults with a learning disability. Nursing care is not provided. The building provides ground floor accommodation throughout in 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. The two parts of the home are linked by a central corridor and an office, which is also used as a bedroom for staff who sleep on the premises. The home has been designed with the needs of people who have physical disabilities in mind, particularly wheelchair users. There are 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-bythe-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. Lyndhurst & Albany B53-B03 S668 Lyndhurst & Albany V226427 060705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was given prior notice of this inspection, which took place over seven hours. A partial tour of the premises took place and a sample of care records were inspected as well as other records. The Manager, two of the staff and five residents were spoken to. Prior to the inspection comment cards were made available in the home for residents and relatives to complete and forward to the Commission. Six comment cards were received from residents who were help by their Care Manager to complete these. Two were received from professional visitors to the home. This was a very positive inspection and there was good evidence that the home is well run and that residents were satisfied and happy living here. What the service does well: What has improved since the last inspection? Lyndhurst & Albany B53-B03 S668 Lyndhurst & Albany V226427 060705 Stage 4.doc Version 1.30 Page 6 The menus have been reviewed to ensure that they provide a varied and nutritious diet for residents. Nutritional assessments are being introduced to ensure that any problems are quickly identified and acted upon if any resident has any problems with their diet. Each member of staff now meets with a senior member of staff on a regular basis to review how their work is going. The kitchen units and flooring have been replaced which has provided a very nice eating area for the residents. What they could do better: The residents are not being weighed regularly enough. It is important that this is done as part of the monitoring of residents’ wellbeing. Medications were being stored and handled well, however, it was noted that there was one gap on a record so it was not clear whether a medication had been taken or not. The Company vets applicants for jobs in the home well, but it was noted that a declaration regarding any criminal record had not been signed. The applications for jobs should be looked at more carefully to ensure that they are fully completed. An up to date record could not be found to show that the gas appliances had been serviced within the last twelve months by a competent person. This needs to be provided. The Home’s copy of the Certificate of Insurance had expired. An up to date copy must be obtained so that interested parties know that the home has this insurance. Both parts of the home’s Certificate of Registration, issued by the Commission, must be displayed so that interested parties can confirm what the home is registered for. Lyndhurst & Albany B53-B03 S668 Lyndhurst & Albany V226427 060705 Stage 4.doc Version 1.30 Page 7 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. Lyndhurst & Albany B53-B03 S668 Lyndhurst & Albany V226427 060705 Stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Lyndhurst & Albany B53-B03 S668 Lyndhurst & Albany V226427 060705 Stage 4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Most of the residents have lived in the home for some years and there have been no new admissions. EVIDENCE: Lyndhurst & Albany B53-B03 S668 Lyndhurst & Albany V226427 060705 Stage 4.doc Version 1.30 Page 10 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 standard(s) 6, 7 and 9. There is a clear care planning system in place, which ensures that the staff team are well informed as to how they should assist and care for the residents living in the home. Residents’ rights to make decisions about their day-to-day lives are respected by the staff team, which ensures that their lives in the home are fulfilling and satisfying. Risk assessments are carried out which helps to ensure the protection and safety of residents. EVIDENCE: Two care plans were inspected. They contained a great deal of detailed information about the personal, social and health care needs of the residents concerned. There was evidence that monthly reviews of the care plans are carried out. Members of staff on duty were well informed about the individual needs of the residents. Not all of the residents use verbal communication, however staff could describe how they offer choices to them and carefully observe their body language or other means of communication, which helps the staff to know what they like and dislike. The staff were observed to do this throughout the day. They were Lyndhurst & Albany B53-B03 S668 Lyndhurst & Albany V226427 060705 Stage 4.doc Version 1.30 Page 11 seen to consult residents and respect their choices regarding food and how they spent their time. During discussion with individual members of staff, they provided further examples of how they assist and respect residents rights to make decisions about their day to day lives. Risk assessments have been carried out and are aimed at ensuring residents’ safety and wellbeing both inside and outside the home. Lyndhurst & Albany B53-B03 S668 Lyndhurst & Albany V226427 060705 Stage 4.doc Version 1.30 Page 12 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 standard(s) 11, 12, 13, 14, 15, 16 and 17. The support provided by the staff team means that residents can enjoy educational, work, leisure and social activities in the community which gives them a fulfilling lifestyle. The staff help residents maintain contact with their relatives. The meals in this home are good and residents are given choice about what they eat. EVIDENCE: Discussion with staff and examination of records showed that residents use a variety of facilities in the community, such as, restaurants, pubs, cafes, bowls. One of the residents said she enjoys going to the local shop every day to get the milk. A music therapist and an aromatherapist visit the home weekly and residents’ wishes about participating in these activities are respected. Some residents attend day services, college or have jobs. It was confirmed with staff that arrangements are made for holidays for residents. Lyndhurst & Albany B53-B03 S668 Lyndhurst & Albany V226427 060705 Stage 4.doc Version 1.30 Page 13 The atmosphere in the home was cheerful and three of the residents enjoyed a game of skittles which staff helped them with. Other residents preferred to spend time alone. A baking session takes place weekly which residents participate in. It was confirmed that residents’ visitors are welcomed to the home. Staff also spend time with residents helping them to write to relatives to keep them up to date with their news. This is good practice. A new menu plan is in place for both Lyndhurst and Albany and a copy has been sent to a dietician for comments. Staff confirmed they usually prepare home-made meals. Home made soup was sampled and was very tasty. The home was filled with enticing smells as the evening meals were prepared. Observations made and discussion with staff confirmed that residents are offered choices at mealtimes and if they do not want the meal on the menu, another of their choice is made. Food is prepared appropriately and eating aids used where needed. Six residents completing comment cards with the help of their Local Authority Care Manager, said they liked the food. Nutritional assessments are currently being introduced. Residents have not been weighed for some time and the Manager is currently exploring ways to do this. Lyndhurst & Albany B53-B03 S668 Lyndhurst & Albany V226427 060705 Stage 4.doc Version 1.30 Page 14 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 standard(s) 18, 19 and 20. The health and personal care needs of residents are well met, other than more thorough monitoring of their weight. The systems for the storage, handling and administration were generally good apart from one oversight. EVIDENCE: Inspection of the care records and discussion with the Manager and staff showed that residents are provided with the support they need to meet their personal and health care needs except for regular monitoring of their weight. Six residents completed comment cards with the help of their Local Authority Care Manager and said they liked living here, were well cared for and treated well by the staff and their privacy was respected. A random sample of medication records and the system for storage and handling medication was looked at and found to be appropriate, other than one unexplained gap in a medication record. Lyndhurst & Albany B53-B03 S668 Lyndhurst & Albany V226427 060705 Stage 4.doc Version 1.30 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 standard(s) 22 and 23. The home has a satisfactory complaints system and staff have been trained in adult protection which helps to protect residents from abuse. EVIDENCE: A complaints procedure is in place. No complaints had been received since the last inspection. The Manager described how she endeavours to create a culture within the home to encourage residents to make clear their feelings and wishes. Some residents have difficulties communicating verbally, but discussions with staff showed that they were well informed about how residents communicate non-verbally and knew what to do if they felt any resident was unhappy about anything. An adult protection policy and whistle blowing procedure is in place. Some of the staff have received training in adult protection issues and the rest are to receive this in July this year. Evidence of this training was seen within staff records. A member of staff spoken to during the inspection had received this training, showed an understanding of the issues and was very clear about the action she would take if she had any concerns. Lyndhurst & Albany B53-B03 S668 Lyndhurst & Albany V226427 060705 Stage 4.doc Version 1.30 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 standard(s) 24, 25, 26, 27, 28, 29 and 30. The home is designed to meet the needs of people with learning and physical disabilities and fits in well with other houses in the neighbourhood providing residents with an attractive and homely place to live. It is a well maintained and clean home providing a safe place for people to live. EVIDENCE: Three bedrooms were seen which were a suitable size, attractive and reflected the interests of their occupants. The shared kitchens, dining rooms and lounges were pleasant areas to use and relax in. New kitchen units and flooring have been fitted. Further redecoration and refurbishment is planned for the future. There are an appropriate number of bathrooms and toilets. The home is equipped with hoisting equipment and a tracking system for lifting people. Dining chairs have been adapted for use by people living in the home. A belt is being used to ensure the safety of one resident when sitting in a dining chair. It was recommended that an Occupational Therapist assess the suitability of the belt to ensure it is completely safe. Lyndhurst & Albany B53-B03 S668 Lyndhurst & Albany V226427 060705 Stage 4.doc Version 1.30 Page 17 The home was very clean and no unpleasant smells were noted. Protective clothing is available to staff and suitable laundry facilities are in place. Outside, there is a garden around three sides of the building, which providing plenty of space for residents to use. A new decking area has been installed in the Albany garden, which provides a nice sitting area for residents. Lyndhurst & Albany B53-B03 S668 Lyndhurst & Albany V226427 060705 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35 and 36. The number of staff and type of staff on duty throughout the day and night is sufficient to meet the needs of residents. Staff morale is high resulting in an enthusiastic workforce that works positively with residents to improve their whole quality of life. The procedures for the recruitment of staff are robust which helps to ensure that residents are protected. Training is provided to the staff team, which ensures that they have the skills necessary to support the residents living in the home. EVIDENCE: Examination of staff rotas and discussion with members of the staff team provided evidence that there are an adequate number of care staff. There are a minimum of three support staff on duty between 8 am to 10 pm. Through the night there is one waking night carer and a second carer sleeps in on the premises in case further assistance is needed. On many days there are more than three staff on duty to support residents going out for day care or social activities. The support staff carry out food preparation, laundry and cleaning tasks. Staff turnover has been low which provides for greater consistency of care. Lyndhurst & Albany B53-B03 S668 Lyndhurst & Albany V226427 060705 Stage 4.doc Version 1.30 Page 19 The records of two recently recruited members of staff were examined. Vetting procedures were fine apart from in one case, where the statutory declaration had not been signed by the applicant. It was confirmed through discussion with the Manager and staff and examination of records that induction training to Learning Disability Award Framework (LDAF) Standards is carried out. The Manager confirmed that ten of the care staff team have now achieved a National Vocational Qualification at Level 2 or above. Certificates are awaited for those who have recently achieved this qualification. Other certificates were seen on staff files. Members of the staff team have also received training since the last inspection in other relevant areas, such as, challenging behaviour, prevention of falls, podiatry, protection of vulnerable adults and safe administration of medication. The staff on duty were observed to be kind and respectful when supporting residents and to have a good relationship with the residents living in the home. Staff spoken to during the inspection said they enjoyed their work and were keen to develop their skills further. They were skilled and knowledgeable about the needs of the residents they were supporting. Comment cards were received from two professional visitors to the home who were satisfied with the care provided. Additional comments were made as follows:“Establishment is more like a family than residential care. Well run. Well maintained. Works to care standard.” Excellent person centred approach to care. Great staff who are committed to their work.” Lyndhurst & Albany B53-B03 S668 Lyndhurst & Albany V226427 060705 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39 and 42. The Manager provides clear leadership, which ensures that the home is well run and the staff team are fully aware of their roles and responsibilities. The home regularly reviews aspects of its performance through a programme of self-review and consultations, which include seeking the views of residents, relatives and staff. There is a thorough approach to health and safety, which ensures the home provides a safe environment for residents, however, some documentation was out of date. EVIDENCE: There was evidence that the home is run well by the Registered Manager, Mrs Maureen Mason. She has obtained the Registered Manager’s Award qualification. Lyndhurst & Albany B53-B03 S668 Lyndhurst & Albany V226427 060705 Stage 4.doc Version 1.30 Page 21 The positive comments of residents, members of staff and other interested parties, give confidence that the Manager provides good leadership throughout the home and has an ‘open door’ policy which encourages good communication. Meetings are held with staff and residents. The home has a quality assurance programme in place, which includes seeking the views of residents, relatives and other interested parties, to provide feedback on the quality of care provided. Discussions with the Manager and examination of records provided evidence that the staff were being supported in their roles through regular supervision meetings. A thorough approach is adopted towards health and safety. There is a system in place to ensure that the staff are given training in moving and handling skills, fire safety, first aid, infection control and good hygiene. Risk assessments are carried out in respect of particular areas of health and safety. Evidence of maintenance and servicing contracts were seen in respect of equipment and systems in the home to ensure that they are maintained safely except for the gas appliances. No health and safety concerns were identified during this inspection other than advice given regarding the adapted dining chair. The Manager was reminded that both parts of the Home’s Certificate of Registration must be displayed. The Certificate of Employer’s Liability Insurance displayed in the home was out of date. Lyndhurst & Albany B53-B03 S668 Lyndhurst & Albany V226427 060705 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 2 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Lyndhurst & Albany Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x 2 2 B53-B03 S668 Lyndhurst & Albany V226427 060705 Stage 4.doc Version 1.30 Page 23 Yes. Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 17 Regulation 16, 17 Requirement Nutritional assessments must be carried out for each individual. This requirement was made at the last inspection and is being acted upon within the timescale. Ensure that residents are weighed at least monthly. Ensure that the medication administration record is completed at all times. Ensure that statutory declarations of offences are signed by shortlisted applicants for posts. Provide evidence that the gas appliances are serviced by a competent CORGI registered engineer every 12 months. A current Certificate of Liability Insurance must be in place. Both parts of the Homes Certificate of Registration must be displayed. Timescale for action 30/7/05 2. 3. 4. 17 20 34 12 13(2) 19 30/9/05 31/7/05 31/7/05 5. 42 23(2)(b) 30/9/05 6. 43 25(2)(e) 30/9/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Lyndhurst & Albany B53-B03 S668 Lyndhurst & Albany V226427 060705 Stage 4.doc Version 1.30 Page 24 No. 1. Refer to Standard 29.6 Good Practice Recommendations The advice of an Occupational Therapist should be sought concerning the use of a belt with a dining chair for one resident. Lyndhurst & Albany B53-B03 S668 Lyndhurst & Albany V226427 060705 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Northumbria House Manor Walks Cramlington, Northumberland NE23 6UR 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. 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