Inspection on 29/03/07 for Lynfield

This inspection was carried out on 29th March 2007.

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

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Lynfield 22 Norwich Road Ditchingham Norfolk NR35 2JL Lead Inspector Silas Siliprandi Key Unannounced 29th March 2007 09:30 Lynfield DS0000067879.V335630.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 Lynfield DS0000067879.V335630.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. Lynfield DS0000067879.V335630.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lynfield Address 22 Norwich Road Ditchingham Norfolk NR35 2JL 01986 897196 01986 895748 joe@kingsleycarehomes.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) Kingsley Care Homes Ltd Mr Joseph Patrick Waring Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Lynfield DS0000067879.V335630.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection No previous inspection. Brief Description of the Service: Lynfield provides residential care for nine adults with learning difficulties. The home is sited in the northern outskirts of Bungay, but within easy reach of the town and its amenities. Bedroom accommodation is all in single rooms with communal lounges and dining area. Accesses has been worked on by providing ramps in key areas There is a sizeable garden behind the house, with paved as well as lawned areas. Lynfield DS0000067879.V335630.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Lynfield is a new home that is working hard to build on the good foundation it laid during the process of registration. The home has not rushed to fill its beds, but has taken time to implement and develop a properly professional basis of assessment and consultation that gives people genuine choice and support. Even in the case of an emergency admission there was plain evidence of how the manager had worked hard to avoid rush or hurry and to build in a very considerable proportion of the normal admission procedure. The policies and procedures of the home lay out a very strong commitment to individual consultation and choice. The opening stages of actual practice are already firmly following these expectations. The staff group is not yet complete, but a very commendable amount of work has been done in a very short space of time to ensure that they bring the right kind of attitude to the job, and that they are well supported by training and instruction in their roles. Those staff interviewed were all very positive and enthusiastic about developments so far. The building itself ought to be able to meet quite a range of demands, it has plenty of space inside, people living at the home do have space, both in their private rooms and in the communal areas. There is also a large garden with both paved and lawned areas that provides a sensible amount of safe outdoor space. The home is sited in an area where here is actually opportunity to access outside services such as education, and a range of social activities. People living at the home and their relatives/representatives are extremely positive in what they have to say. The rating of “adequate” under the separate “outcomes groups” needs to be properly understood. “Adequate” already means that most standards have been met or nearly met. For a home to reach this stage in such a short time is highly commendable. It also has to be remembered that at such an early stage of development and so few people living at the home at present the home just cannot yet present the in-depth evidence required for a rating of “good” or “excellent”. This is further commented on in the individual judgements throughout the report. What the service does well: Lynfield DS0000067879.V335630.R01.S.doc Version 5.2 Page 6 The most impressive thing developed and implemented so far is the truly robust and thoughtful process of assessing abilities and needs. This has included constructing agreed plans for care springing from these assessments. It proved easy to see what people wanted, needed and preferred. Staff had very clear help and guidance in delivering the care that individuals needed in the way in which they wanted it done. The home has also worked very hard [and it has to be remembered that this is all done from scratch in a new and unknown neighbourhood] to research and access activities and contacts outside the home. The home has already set up a strong rapport with service users’ relatives/representatives who express positive views about the welcome they receive in the home. They also say that they feel involved and supported in their own continuing caring roles. “It [Lynfield] has exceeded all our expectations”. Staff training has also set an impressive pace since the home opened. Staff said that they felt properly supported and clear in their roles. Service users’ relatives and representatives were equally pleased with the staff, saying things like, “ Without exception the staff have all the skills needed and their dedication to the residents is beyond compare”. What has improved since the last inspection? What they could do better: It is probably time to think about how to keep a focus on the small number of ‘key’ items in each individual care plan. This needs to be done in such a way as not to loose the rest of what has been garnered. To a great extent this is simply a reflection of how well the home has done. All professional person centred assessment and care planning systems reach the stage where they risk drowning in their own information. This is usually the point where they also risk loosing sight of the key direction an individual’s progress is taking them in. Lynfield DS0000067879.V335630.R01.S.doc Version 5.2 Page 7 The managers diligent work has just brought them to this point rather earlier that is usually the case. The communal areas of the home still look rather “plain”. The Commission however shares the Manager’s view that this is likely to take care of itself as more people move into the home and their views on the furnishing, layout and decoration of those areas begins to take account of what people actually want and prefer in practice. 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. Lynfield DS0000067879.V335630.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lynfield DS0000067879.V335630.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 – 5 were all considered as this was the first inspection of the home. Quality in this outcome area is adequate. People who may use the service and their representatives do have the information needed to choose a home that will meet their needs. They have their needs assessed and a contract that clearly tells them about the service they will receive. As a new service the home has not yet had the necessary time to develop the entire process, nor yet the time to develop their intended range of formats to assist in providing a wide range of accessibility to service users. The provision is already solidly “adequate” and well on the way to being “good”. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been minor developments of both the Statement of Purpose [SOP] and the Service User Guide [SUG]. They are both plain understandable documents that give a useful range of information. Lynfield DS0000067879.V335630.R01.S.doc Version 5.2 Page 10 The section explaining what needs the home can and cannot meet is also clear. The SUG is also available in “Widgets”, which is a standardised picture format aimed at making the information more widely accessible to some service users. Neither the SOP or SUG are available in other formats [such as video] as yet. The manager reported an intention to develop and expand versions of the SUG in a photographic format to ensure wider accessibility. The assessments sampled were detailed, solid and comprehensive. Social and emotional issues were as well looked after as issues around basic care and health needs. The “Interventions” sections of the assessments lay a good foundation for deciding how well the home can meet individual assessed need. [Which then develop into more detailed care plans] The home has already begun to explore additional educational resources to assist in meeting identified and potential need. There is an admissions policy to guide decision making and individual understanding of the scope of care available in the home. The policy of promoting visits and stays prior to admission has been closely observed. This is also true of an emergency admission where although attenuated, visits were scheduled into a tight timetable. There has not [as yet] been any significant consultation with users about potential admissions, but this is simply because there has not been a group to consult with in detail. The underlying intention is explicit and clear in policies and explanations given by the manager. The contracts for each service user proved clear and detailed and were issued in a timely fashion. The overall evidence was limited by small number of people living at the home so far and by the very early stage of development. Lynfield DS0000067879.V335630.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7,8 and 9 were inspected. Standard 10 was not inspected. Quality in this outcome area is adequate. Individuals are involved in decisions about their lives and do play an active role in planning the care and support they need. It proved too early for the home to present the full range of evidence about how deeply service users views are taken actively into account in the general running and developing policies of the home. The provision is already solidly “adequate” and well on the way to being “good”. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are very solid and comprehensive individual plans. Lynfield DS0000067879.V335630.R01.S.doc Version 5.2 Page 12 These plans detail how individuals will be supported in doing what they prefer to do. The plans are specific and personal. The plans offer clear guidance and support to staff in their caring roles to the individual. The plans also open doors to potential new interests and activities. The plans keep track of activities and programmes. The plans facilitate professional updating. The plans are not sufficient in number to see how they will eventually function across a wider number of people. The plans are becoming very full of information, not yet to the point where the information is getting difficult to retrieve, but approaching that point. There was a very clear policy to guide staff in understanding the importance of respecting and promoting choice. Staff were able to describe what “choices” comprised of, and also were able to explain the importance of choice in daily life. People living in the home were positive about their choices being respected. It proved too early to see how people were having their say in the general running of the home, but the potential and intention were apparent from policies and what the manager and staff had to say. The risk management and respect for risk issues were difficult to tease out at this early stage. In general terms the care plans, risk assessments and policies all pointed firmly towards a proper and professional intention. This intention was supported by what staff and the manager had to say. The overall evidence was limited by small number of people living at the home so far and by the very early stage of development. Lynfield DS0000067879.V335630.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,15,16 and 17 were considered in some detail. Standards 11 and 14 were also looked at briefly. Quality in this outcome area is adequate. People who use Lynfield are supported to make choices about their lifestyles and in developing their life skills. Their broad social, emotional, cultural and recreational activities are being tailored to meet their individual preferences and aspirations. The provision is already solidly “adequate” and well on the way to being “good”. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The two assessments and care plans sampled showed clear supporting intentions in their layout. Lynfield DS0000067879.V335630.R01.S.doc Version 5.2 Page 14 There were appropriate prompts to assist in recording individual preferences and choices in both the assessment documents and the care plans. Appropriate care responses were laid out and planned for in this documentation. The risk assessment process covers ground relevant o the individuals sampled. Research into how an individual could be better supported in their educational aspirations was clearly laid out as an appropriate and realistic response [for example]. Staff were well directed to the importance of these issues in policy documents. Staff interviewed] gave sound explanations of their supportive and exploratory roles in supporting individual lifestyle choices. The manager gave a detailed breakdown of progress so far, described adjustments already made and pointed out proposed future plans and actions directly related to individual needs and wishes. The same range of sources supported the idea that the home was already taking big steps to assist people who lived there to become integrated into the community. The same evidence applied to the solid start well under weigh with promoting and supporting family and other social links, including a wide range of actual and potential activities outside the home. All of the policies and records support a clear intention of promoting choice and independence and this intention is reflected in individual plans for care. At this stage nobody had been appointed with the specific role [and detailed underpinning knowledge] to assist in ensuring appropriate diets. There was evidence from assessment that there was already some specific need in this area, but at present this was supported by outside advice. Service user and service user representatives interviewed during the visit backed up their previous written comments with equally positive views about lifestyle choices. The overall evidence was limited by the small number of people living at the home so far and by the very early stage of development. Lynfield DS0000067879.V335630.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19 and 20 were looked at in detail, standard 21 was also looked at briefly. Quality in this outcome area is adequate. People living at Lynfield receive personal and healthcare support soundly based on assessment and their own personal needs and preferences. Their dignity and privacy are properly safeguarded and promoted. The provision is already solidly “adequate” and well on the way to being “good”. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The assessments sampled [along with the care plans and care actions springing from the assessments] have prompts to assess healthcare needs and to investigate personal individual preferences. The care plans go on to detail care responses based on what was found and recorded in the assessments. Policies and procedures are clear in their instruction and support to staff about the important concept of flexible and individual care. Lynfield DS0000067879.V335630.R01.S.doc Version 5.2 Page 16 Staff interviewed were equally capable of describing the concepts and their importance. They were able to describe scenarios where their own practice had reflected individual needs or preferences. Service user and their relatives/representatives backed up their positive written views of the practice of the home in discussions during the visit. The medicine records were simple and straightforward and the underlying system ought to be sufficiently robust to safely support expansion as more people move into the home. The medicines were safely stored. The manager explained that the intention was to have all care staff [probably excepting relief staff] trained in the administration of medicines. Records showed this process well in hand. One service user does look after part of their medication within an agreed and assessed framework. The manger said that staff needed now to become more familiar with the effects of prescribed medication. A new folder of instruction and information had been prepared for this purpose. There was only a very brief discussion of how Lynfield and its staff would deal with dying and death, and this topic needs to be explored at a later time. The overall evidence was limited by the small number of people living at the home so far and by the very early stage of development. Lynfield DS0000067879.V335630.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 were both inspected. Quality in this outcome area is adequate. People using the service at Lynfield can express their concerns and can use a sound complaints procedure? People are also protected from abuse and have their rights protected. The provision is already solidly “adequate” and well on the way to being “good”. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service user’s guide has a pictorial [Widgets] supplement that now also covers the issue of raising concerns or complaints. There is no alternative medium – such as video- to broaden accessibility further as yet. The manager said that there is early research in train for access to advocacy services. Records show staff being involved in an ongoing programme of Adult Protection training. Policies and procedures were found to contain clear reference to appropriate measures and understandings protective of individuals. Service users and their relatives/representatives were all able to say who they would talk to in the home if they had any worries. They said that they felt that people could be trusted if they had anything of this kind to say. Lynfield DS0000067879.V335630.R01.S.doc Version 5.2 Page 18 The overall evidence was limited by the small number of people living at the home so far and by the very early stage of development. Lynfield DS0000067879.V335630.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Although all of standards 24 to 30 were considered briefly the main focus concentrated on standards 24 and 30. Quality in this outcome area is adequate. The physical layout and design of the home enables the people living there to live in a safe, well-maintained and comfortable environment. The environment encourages their independence. The present overall provision is likely to be equally satisfactory for people moving into the home, and there is scope for fine-tuning within the overall provision to assist in such development. The present rather “plain” schemes and furnishings in the communal areas are likely to develop in the way described by the manager. The provision is already solidly “adequate” and well on the way to being “good”. This judgement has been made using available evidence including a visit to this service. Lynfield DS0000067879.V335630.R01.S.doc Version 5.2 Page 20 EVIDENCE: The number of service users actually accommodated at the time of the visit [two only] made it difficult to evaluate in the more specific way planned for. The building and its services did make a good match to the assessed abilities and needs of the people living there. There were no difficulties or mismatches yet identified in the building and facilities. The size and layout of the rear garden adds to the probability of a good “across the board” match in the potentials that it offers. The bedroom shown by one of the service users was obviously individual and personalised. The person concerned described their accommodation with equally evident satisfaction. The communal areas were in good decorative and repair order, but staff and management alike described them as being rather functional [as opposed to being truly “homely” or “domestic”. The tour confirmed this evaluation. The manager explained that it had proved difficult to move ahead on altering this fact without more people living in the home to respond to. While it might have been possible to take more input from those people already at the home this would have shut down opportunities for participation and input from later arrivals. The manager said that it was expected that the present rather “plain” appearance would move on to reflect greater diversity and choice as more people moved into the home and had their say about how the communal areas should be laid out, decorated and furnished. The home was clean and hygienic in all of the communal areas and in the one bedroom seen during the visit. The overall evidence was limited by the small number of people living at the home so far and by the very early stage of development. Lynfield DS0000067879.V335630.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31 to 36 were all considered as part of this first inspection of a new home. Quality in this outcome area is adequate. Staff are present in the home in sufficient numbers to support the people living in the home. The staff also have a good level of basic training that is continuously improving. Staff are properly aware of the vital role they have to play in supporting and protecting vulnerable people. The provision is already solidly “adequate” and well on the way to being “good”. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Sampled job descriptions were comprehensive and appropriate to the purpose of the home. Job descriptions clearly stated the intention for the home’s practice to support the White Paper “Valuing People”. The job descriptions also supported other good practice imperatives such as respecting choices and involving service users. Lynfield DS0000067879.V335630.R01.S.doc Version 5.2 Page 22 Staff interviewed were able to give clear and sensitive explanations of their roles and why it was important to behave in specific ways while performing their jobs. Staff interviewed were all emphatic about the way in which they felt that they had been supported by the management of the home in understanding their roles. They were equally positive about their views of the training they had received, and continued to receive. The manager said that it was now important to move onto some more specialist training in respect of learning difficulties. The staffing complement is presently sufficient in numbers to meet the needs of the people living at the home. Sampled records [tracking from the homes policies and procedures through to confirmation of employment and issue of contracts] followed the expectations of regulation and good practice. Proper safety protocols were in place and observed. Records showed a very solid level of appropriate training, including training on abuse awareness and “key worker” training. Professional training and development plans for staff were already in place and active. Professional staff supervision and appraisal processes were already in place and active. People living at the home and their relatives/representatives were all very positive about the approachability and willingness of staff. It was also felt that there were no staff shortages. Or shortages of staff time to give appropriate care and attention. Lynfield DS0000067879.V335630.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37 to 43 were all looked at, but the main focus remained on standards 37, 39 and 42. Quality in this outcome area is adequate. The management of the home is based on openness and respect. The manager is competent, experienced and qualified for the role. The quality assurance system is at an early [but very sound] stage and is under active development. The provision is already solidly “adequate” and well on the way to being “good”. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Lynfield DS0000067879.V335630.R01.S.doc Version 5.2 Page 24 The manager’s job description tallied with expectations laid out in the National Minimum Standards and with the purposes of the home. The views of the service users, of their relatives/representatives and of the staff all agreed in saying that the home was thoughtfully run by somebody they could trust in and talk to. The Quality Assurance process has a sound foundation, but as the manager said, as yet little additional evidence had accumulated about its long-term effectiveness. Also the sample sizes are [up to this point] too small to give a reliable overall rating. The policies had been extensively and thoughtfully overhauled and fundamentally improved, chiefly in respect of adjusting their focus more on people with learning difficulties. The manager said that this was all quite new, and further review would take place after a reasonable period of further trial. Evidence gathered throughout the visit had shown good detailed records meticulously maintained and kept up-to-date. The registered manager is the person designated as the person responsible for all health and safety issues [as detailed in job description]. Lynfield DS0000067879.V335630.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 2 29 2 30 3 STAFFING Standard No Score 31 3 32 2 33 2 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 2 2 X LIFESTYLES Standard No Score 11 2 12 2 13 2 14 2 15 3 16 2 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 2 2 3 3 3 X Lynfield DS0000067879.V335630.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No previous 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. Standard Regulation Requirement Timescale for action 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 To consider how best to keep an up-to-date ‘abstract’ of key issues in the care plan so the stay readily in view. This will help everybody to keep working consistently on “change” issues. To also consider how to ensure [at the same time] that the impressive weight of information so far gathered remains accessible for consideration. As discussed there may well be methods of achieving both these ends in a way that also performs a significant part of the Quality Assurance process. To consider how best to put somebody trained and/or qualified into a staffing position where they can give reliably founded help and advice about diet and nutrition. This will help ensure that everybody gets the maximum opportunity to choose and receive a healthy diet, and also that people with specific dietary needs receive the best possible care and support. To consider how best to provide alternative routes to DS0000067879.V335630.R01.S.doc Version 5.2 Page 27 2 YA17 3 Lynfield YA22 4 YA22 5 YA32 accessing the process by which complaints and concerns may be raised in the home. This is actually a broad recommendation about widening the accessibility of all of the documents people need to understand to maintain control of their lives in the home. “Wigets” may help some people who cannot access printed text, but it isn’t a universally taught or comprehensible system for everybody. Complaints and concerns may be a good place to start with when it comes to experimenting with various means of including more people so that they can take better and fuller control of their own lives? To consider the role of advocacy services as a means of supporting some service users in accessing the process by which concerns and complaints may be raised in the home. This is actually a broad recommendation to seek to provide advocacy services within the home. Concerns and complaints again seems a good starting point at which to introduce the general concept of advocacy as a support [and independent protection] to vulnerable people living at Lynfield. To consider the best and most expeditious means of brining forward specific staff training in the area of learning difficulties. Preferably training with an accredited outcome for staff taking part. This will help staff understand people living at the home better in respect of specific needs, conditions and syndromes as well as in the general concepts of promoting their general independence and autonomy. The training ought also to increase the self-esteem and confidence of staff. Lynfield DS0000067879.V335630.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Lynfield DS0000067879.V335630.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. 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!