Inspection on 15/01/09 for Lynghis Home

This inspection was carried out on 15th January 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lynghis Home 25/07/06

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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: Lynghis Home 40 Beauchamp Road Forest Gate London E7 9PD     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: Lea Alexander     Date: 3 1 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 28 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Lynghis Home 40 Beauchamp Road Forest Gate London E7 9PD 02084716478 02084716478 lynghishome@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Nana Adwoa Edwin care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 4 The Registered Person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD The maximum number of service users who can be accommodated is: 4 Date of last inspection Brief description of the care home The Care home is a four bed roomed terraced house in a residential area of Upton Park. The accommodation comprises of a communal lounge, dining area, kitchen and small staff office. There is a courtyard garden to the rear. The aims to provide care to four adults with mental health issues. The home is nearby local shops and amenities and local bus routes. There is unrestricted parking. The home opened in 2006 and this was the first inspection under National Minimum Standards. Care Homes for Adults (18-65 years) Page 4 of 28 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: One Inspector carried out this inspection over the course of an afternoon. This was their second visit to the home. Since the last inspection the home has revised its registration, and now provides its service to adults with learning disabilities. At the time of this inspection the home had two residents, one of whom was receiving respite care. We looked at a range of records the home is required to maintain, including residents personal files and staff personnel files. We spoke with the Manager and with the care worker on duty. The home completed and returned its Annual Quality Assurance Assessment in the timescales we requested. Care Homes for Adults (18-65 years) Page 5 of 28 Care Homes for Adults (18-65 years) Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: The home must notify the Commission for Social Care Inspection of significant events that affect the well-being of people who use the service. The home must ensure that the staffing rota accurately reflects the situation in the home and that sufficient staff are on duty to ensure uninterrupted work with individuals and completion of administration and organisational tasks. The outcomes of the homes quality assurance excercise must be published and made available to all interested parties. Care Homes for Adults (18-65 years) Page 7 of 28 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 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 9 of 28 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. The home has developed a statement of purpose and service users guide. Admissions to the home are not made until a full needs assessment has been completed by a suitable member of staff. Evidence: The home has developed a statement of purpose and service users guide. These have been udpated to reflect the change to the homes registration. We examined the personal files of both residents. These evidenced that the home assessed each resident prior to their moving in. Care Homes for Adults (18-65 years) Page 10 of 28 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. Residents are supported and encouraged to make their own decisions. The home understands the preferred communication styles of residents. Individual plans are person centred and reviewed regularly. Potential risks are assessed and managed. Evidence: The home has developed individual plans with residents that address their personal, social and healthcare needs. The plans we saw were reviewed every six months, and were found to be person centred with evidence of life story work. Both residents at the home receive support from their families in managing their finances. One resident receives an allowance directly from their parents. For a second resident their family deposits a weekly allowance with the home. This is held in a locked cash box. A record of each financial transaction from these funds is recorded in a log book. Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: The individual plans we examined also reflected residents rights to make decisions about their own lives. The home holds monthly residents meetings. We looked at the minutes of these and noted that house rules and menu planning were discussed at each. We also noted that residents are asked if they have any complaints or feedback about the service. The home had completed a risk assessment for each resident for potential risks identified in the individual plan. Care Homes for Adults (18-65 years) Page 12 of 28 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. The service has a strong committment to residents maintaining and developing their daily living skills. Residents are supported to maintain family relationships. Dignity, respect and autonomy underpin the service being provided. Residents are involved in meaningful daytime activities of their choices according to their abilities and preferences. The menu is varied and nutritious. Evidence: We examined personal files and spoke with the Manager and care worker on duty. This evidenced that residents are supported to engage in a range of community and leisure activities. One resident attends Newham Leisure Centre three times per week for arts and crafts, photography and trampolining. They also attend weekly speech and language therapy Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: sessions and the Gateway Social Club. In addition they are supported to develop their activities of daily living with cookery sessions and shopping. This resident is also encouraged to engage in leisure activities within the home such as colouring books, and number puzzles. They also attend church each Sunday. The Manager told us that a second resident who is at the home for respite care is reluctant to engage in community activites. We were told that the resident will shortly be moving to rehabilitation accommodation and that their activities tend to be inside the home and focus upon developing skills for activities of daily living. The home has developed a daily schedule focusing on different areas of everday living skills such as laundry, shopping, cooking and maintaining the environment. We were told that this resident had been supported to enrol at the local college, but had later changed their mind and withdrawn from their course. Both residents attend the local park. Both of the homes residents are in regular contact with their families. Family members are encouraged to visit the home and residents are supported to visit their parents at their homes. During the course of the inspection we observed the care worker on duty interacting with residents. We also observed residents choosing when to join in an activity and whether to be alone or in company. One resident is able to tell staff which meals they prefer. A second resident can use a pictorial chart to communicate their meal preferences. The Manager told us that they had also spoke to the second residents family to find out more about the meals they prefer. We looked at the homes record of meals provided. This evidenced that a range of nutritious and varied meals had been provided, and that these were reflective of residents cultural backgrounds. Care Homes for Adults (18-65 years) Page 14 of 28 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. Residents are supported to access healthcare services. Support with personal care is responsive to individual needs and preferences. The home has sound medication administration practises. Evidence: One resident requires prompting and reminders to attend to their personal care. The second resident requires practical assistance with their personal care. We spoke with the care worker on duty and examined residents individual plans. This evidenced that the home has identified residents preferences for personal care. We spoke with the care worker on duty, and they were able to describe to us the practical steps they take to promote dignity and respect whilst assisting with personal care. Each residents personal file contains a record of healthcare appointments they have been supported to attend. Recent healthcare appointments included the dentist, GP, optician and community nurse. Copies of correspondence regarding healthcare Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: appointments were found on each residents personal file. We looked at the homes medication policy and procedure. This includes guidance on the storage and administration of medicines. It also includes guidance on the self administration of medicines. At the time of this inspection no residents were self medicating. At the time of this inspection one resident was prescribed medication. This was retained and administered by the care home. Neither resident was prescribed controlled drugs. We looked at the Medication Administration Record (MAR) and available medication for one resident. We found that the available medication corresponded with the MAR sheet. We found that the MAR sheets were correctly completed and in good order. Care Homes for Adults (18-65 years) Page 16 of 28 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 home maintains a record of complaints, and residents and others involved with the service understand how to make a complaint. The home understands local procedures for safeguarding adults and provides staff with adult protection training. Evidence: The home has developed and implemented a complaints policy and procedure that complies with National Minimum Standards. We looked at the homes complaints log. This evidenced that since the last inspection four complaints had been received. For each of these the date, details of the complainant, the nature of the complaint, its investigation, outcome and actions taken had been recorded. The home has developed a safeguarding policy and procedure. This includes definitions of abuse and guidance for staff and managers on their responsibilities. The procedure makes appropriate reference to local multi agency safeguarding protocols. Since the last inspection one adult protection matter had come to the homes attention. They had supported one resident to make a complaint against a third party who was not employed by the home. The matter had been reported to the police and local social services department. At the time of this inspection the investigation was ongoing. We Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: did however note that the home had not notified the Commission for Social Care Inspection of the incident. Discussion with the Manager, the care worker on duty and examination of training records evidenced that all care staff have completed safeguarding training since the last inspection. During our conversation the care worker on duty also demonstrated a sound understanding and awareness of adult protection issues and their responsibilities. Care Homes for Adults (18-65 years) Page 18 of 28 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 home provides a well maintained, suitable environment. Residents have a choice of shared spaces and each has their own bedroom that can be personalised. The home is clean, tidy and smells fresh. Evidence: The home is located in a terraced house on a quiet residential street. Access is via an entrance hallway. A communal lounge with comfortable seating, a TV, stereo and games and activities are located on this level. To the rear of the property there is a dining area with seating. Off the dining room there is a small kitchen. The home has a small garden to the rear with flower beds and a patio. One residents bedroom is located on the ground floor. A further three bedrooms are located on the first floor. One resident showed us their bedroom, which had been personalised with mementos. A shower room and bathroom, both with WC and handbasin are also located on the first floor. We found the home to be comfortable and well maintained. The home was hygenic and free from offensive odours. Care Homes for Adults (18-65 years) Page 19 of 28 Care Homes for Adults (18-65 years) Page 20 of 28 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 members undertake external qualifications and receive regular training provided by the home. The recruitement process ensures the safety of people who use the service. Staff are regularly supervised. However, the home must ensure that the rota accurately reflects the situation in the home and that sufficient staff are rostered on duty at all times. Evidence: At the time of this inspection the home employed 4 permanent care staff. Shifts run from 8 am to 8 pm. One member of care staff is rostered on duty each day, with a second care staff rostered on if needed. One member of care staff works a waking night shift. The Manager is on site each week day. Three of the homes care staff have successfully obtained NVQ level 2, the fourth is currently studying for this award. We examined the homes staffing roster. This did not match the situation we found in the home. The care worker on duty was rostered to finish at 2.15 pm, but in fact stayed on duty after this time. We spoke to the Manager who told us that care worker had been rostered for extra hours that afternoon as there had been a change in Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: residents planned activities. The rota had not been updated to reflect this. We also noted that the rota indicated that for one afternoon each week only the Manager is rostered on duty whilst residents are at home. We looked at the personnel files for two care workers. These evidenced that the home obtains two satisfactory references and an enhanced level Criminal Records Bureau (CRB) check prior to their starting work. Staff receive copies of their employment terms and conditions. We looked at the homes training records. These evidenced that since the last insepction the home has provided training to care staff on breakaway techniques, medication, food hygiene, fire safety, moving and handling, first aid and health and safety. New staff to the home also receive an induction upon appointment. We also looked at the available supervision records for two care staff. These evidenced that staff receive regular supervision, and an annual appraisal. Care Homes for Adults (18-65 years) Page 22 of 28 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 Manager is suitably qualified and experienced. A range of health and safety tests are undertaken regularly and their outcomes recorded. Evidence: The Manager has successfully completed NVQ level 4 and their Registered Managers Award. The home has developed feedback surveys for completion by residents, their relatives, local Social Services Departments and pharmacist. The Manager told us that completed surveys had been received for 2007, and that the outcomes from these had been collated and circulated to purchasing local Social Services Departments. We saw the completed feedback surveys for 2007 and noted that the majority of feedback received was positive. We were told that feedback surveys for 2008 had been circulated in December 2008. The files we sampled were in very good order. The personal files we sampled Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: contained comprehensive recordings. We examined a range of health and safety records the home is required to maintain. These evidenced that fridge and freezer temperatures are checked daily and maintained within acceptable parameters. The home also checks water temperatures on a weekly basis and maintains these at acceptable temperatures. The home also carries out weekly fire alarm tests and records their outcome. These records evidence that the fire alarm system is maintained in good order. The home also carries out monthly fire evacuation drills and records the outcome of these along with the time taken to complete the drill. The home has obtained a Portable Appliance Testing Certificate for electrical appliances around the home. The home displays current registration and insurance certificates. Care Homes for Adults (18-65 years) Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 35 18 The home must develop a 31/12/2006 training and development programme to ensure that support staff have completed mandatory training courses and have the necessary skills to meet service users needs. Care Homes for Adults (18-65 years) Page 25 of 28 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 1 23 37 The home must notify the Commission for Social Care Inspection of significant events that affect the wellbeing of people who use the service. To ensure the safety and well being of people who use the service. 30/04/2009 2 33 18 The home must ensure that 30/04/2009 sufficient staff are on duty to ensure uninterrupted work with individuals and completion of administration and organisational tasks. To ensure the safety and well being of people who use the service. 3 33 18 The home must ensure that the staffing rota accurately reflects the situation in the home. To ensure the safety and well being of people who use the service. 30/04/2009 Care Homes for Adults (18-65 years) Page 26 of 28 4 39 24 The outcomes of the homes 30/12/2009 quality assurance excercise must be published and made available to all interested parties. To ensure service development involves all stakeholders. 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 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: 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 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. 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