Inspection on 16/04/07 for Lynton

This inspection was carried out on 16th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lynton 30/09/09

Lynton 19/04/09

Lynton 22/04/08

Lynton 06/11/06

Lynton 03/11/05

Lynton 25/05/05

Lynton 20/09/04

Lynton 29/04/04

Lynton 22/07/03

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Lynton London Road Ashington West Sussex RH20 3JS Lead Inspector Mr E McLeod Unannounced Inspection 26th April 2007 08:30 Lynton DS0000014618.V331963.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 Lynton DS0000014618.V331963.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. Lynton DS0000014618.V331963.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lynton Address London Road Ashington West Sussex RH20 3JS 01903 893406 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) jallies@btinternet.com www.caremanagementgroup.com Care Management Group Limited Post Vacant Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Lynton DS0000014618.V331963.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Up to 3 male and / or female Service Users in the category of learning disability may be admitted. Only persons between the ages of 18 - 65 years may be admitted / accommodated. Date of last inspection Brief Description of the Service: Lynton is a care home that is registered to provide care for three adults with learning disabilities between the ages of 18-65. The Registered Provider is Care Management Group Ltd and the Registered Manager’s post is currently vacant. The current scale of monthly charges ranges from £1,080 to 1,532.08 per week. Lynton is a detached property, with accommodation provided on two floors. In addition there is a pleasant garden area that can be easily accessed by the residents. The home is located in a residential area of Ashington, a small village approximately 20 minutes from both Worthing and Horsham town centres. There is a bus service from the village that connects with mainline trains. There are local shops and a pub in the village and residents can access nearby leisure facilities, colleges and work placements. Lynton DS0000014618.V331963.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was arranged to update assessments and follow up requirements made at the previous inspection. All key standards from the National Minimum Standards for care homes for adults (aged 18-65) were assessed during the visit. In preparation for this visit, a pre-inspection questionnaire and survey forms were sent, and information gathered from these sources was included in planning for the inspection visit and also in the writing of this report. A plan for the inspection visit was recorded, and this was the inspection plan used during the visit. The unannounced visit was carried out by one inspector, began at 08.30 a.m and was completed at 12.15 p.m. on the 26th April 2007. We talked with one resident present during the visit, and observed interaction between staff and a resident. Written feedback on the service was received from all three residents prior to the visit. We interviewed the manager of a service local to Lynton who is presently providing some management support for the service, and who represented the company at the inspection visit and the feedback provided at the end of the inspection visit. Two care staff were interviewed, and two sets of staff recruitment and training records were sampled. Two sets of care plans and care records were sampled. Policies and procedures relevant to the standards assessed were also sampled. A partial tour of the premises was made, and observations of how staff were providing care and support for people were made. What the service does well: The service provides a homely, comfortable living environment for people. People using the service have an active lifestyle which meets their social and educational needs. People are supported to make their own decisions and develop their independence skills. Lynton DS0000014618.V331963.R01.S.doc Version 5.2 Page 6 Care staff are skilled and dedicated, and relate well to people using the service. What has improved since the last inspection? What they could do better: Two of the seven requirements made at the previous inspection were assessed as not met. One new requirement has been made. Further improvements to the service provided are dependent on an appropriately experienced, competent and qualified person being appointed to manage the service. Records of concerns and complaints need to provide better evidence of the investigation of the complaint undertaken and the subsequent response made to the complainant. The safety of people using the service will be supplemented by a more transparent recording of the process of the complaint. The safety of people accommodated will be supplemented by a food hygiene system being put in place which complies with recent food safety legislation. Lynton DS0000014618.V331963.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Lynton DS0000014618.V331963.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 Lynton DS0000014618.V331963.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People entering the home have had their needs fully assessed, and can therefore expect that those needs can be met by the service. EVIDENCE: No new people have been admitted into the home since the previous inspection. However, care records sampled indicated that people are receiving a full assessment of their needs before they are admitted to the home. Lynton DS0000014618.V331963.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service know their assessed and changing needs are reflected in their individual plan, to which they have contributed. People make decisions about their lives with assistance as needed, and therefore benefit from an increase in their independent living skills. People are supported to take responsible risks as part of an independent lifestyle, which improves their quality of life. EVIDENCE: Two sets of care records were sampled, which indicated that care plans are in place which have been agreed with the person, and which are being regularly reviewed. Lynton DS0000014618.V331963.R01.S.doc Version 5.2 Page 11 A key worker is allocated for each person, and staff advised us that key workers meet once or twice a week with the person and records are made of the plans and activities agreed. Staff interviewed provided good examples of how people are supported to make personal choices and decisions. People are being supported to manage their own finances. Plans and schedules seen indicated that people are being supported to take risks as part of an independent lifestyle, and that risk assessments are being updated. No indication that people accommodated were being discriminated against because of their disability, religion, gender or race were evident during the visit or in the care records and procedures sampled. Lynton DS0000014618.V331963.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the service have opportunities to further their education and training, do jobs, and take part in activities they enjoy. People are taking part in the local community and making use of facilities in the community. Staff are supporting people to maintain contact with family and friends, which helps them maintain their social network. Routines and care support are flexible enough to ensure that retain their independence and have their choices supported. Balanced and nutritious meals are provided which people enjoy. Lynton DS0000014618.V331963.R01.S.doc Version 5.2 Page 13 EVIDENCE: People accommodated have opportunities to continue their education and training and take up jobs. One person interviewed attends college four days a week, and works at a supermarket. Discussion with people using the service and staff indicated that the favourite communal activities are going to the pub, playing pool, going bowling and to the cinema. Favourite outings were said to be Brighton pier and the Littlehampton amusements arcade. People’s individual interests are also being supported. For example, one person enjoys walks and going to country parks, and another enjoys doing gardening and visiting garden centres. Records seen indicate that these activities are arranged for them. Staff said relations with the local community had improved, and the home was taking part in a local carnival. Holidays are planned at residents’ meetings. One person wants to go to a holiday camp this year, and two others are planning to go abroad and have been looking at brochures. The provider assists in the funding arrangements for holidays. People are being supported to maintain contact with family and friends, and this was confirmed through discussion with a person living at the service. Care plans seen and interaction between people and staff observed indicated that there is some flexibility in care routines provided, and dignity, privacy and choice for people is supported. People find staff supportive, approachable, and responsive. Residents have an active lifestyle, and staff said there was always something to do. Individual activities plans seen indicated that a range of activities are being provided or facilitated. People using the service have a choice of menu, special diets are provided for, and there are facilities for people to make drinks and snacks. Menus seen indicated that balanced and varied meals are being provided. Lynton DS0000014618.V331963.R01.S.doc Version 5.2 Page 14 People like the meals provided, and told us this in written surveys we received from them. Lynton DS0000014618.V331963.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s privacy, dignity and independence are being supported by flexible personal support. People have access to the healthcare services they are in need of. People are protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: We observed that staff attending to personal care did this with patience and understanding, and took into account how the person wished their care to be provided and when. Where specialist needs are identified in the care plan, it was noted that specialist community team involvement was being arranged as appropriate, and care records clearly displayed the team and specialist worker allocated. Lynton DS0000014618.V331963.R01.S.doc Version 5.2 Page 16 Care records seen indicated that people are able to access the health care support they are in need of, and on the day of the inspection staff were observed seeking medical advice and support for a person accommodated. We discussed the frequency of health checks and reviews of medication with staff. Since the previous inspection staff believed that less ‘to be taken as required’ medication was being kept, and that the pharmacy now does more regular collections of out of date medicines. Prominently displayed on the medicine cabinet is guidance for staff on identifying when medicines are out of date. Staff said that medication is regularly reviewed by the GP and/or psychiatrist, and indicated to us when each person had most recently had their medication reviewed. A pharmacy visit carried out on 24.1.07 indicated that medication policies and procedures are satisfactory. Medication administration records were sampled, and were in good order. There are suitable arrangements in place for the lockable storage of medicines. Staff administering medicines receive training in this. Lynton DS0000014618.V331963.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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Complaints are not being adequately recorded. The handling of complaints needs to ensure that people feel their views are listened to and acted upon. People are being protected from abuse, neglect, and self harm. EVIDENCE: The record of complaints was sampled. Complaints records were not always identifying the complainant, what investigation was carried out, what response was given to the complainant, and what appropriate action had been taken. We noted from records of residents’ meetings that complaints were sometimes being voiced and dealt with through the residents’ meetings. These complaints were not being recorded in the record of complaints. Prior to the inspection visit written feedback was received from three people using the service. They indicated they felt listened to, were being helped to think about their future, were being protected from harm, and were not being bullied. Lynton DS0000014618.V331963.R01.S.doc Version 5.2 Page 18 None of the residents have an advocate working on their behalf, although staff advised that an advocacy service had been contacted at the request of one person. The provider advised CSCI that no people handle their own financial affairs, that financial records are held, and that people receive their full personal allowance to dispose of as they wish. A recent incident which involved two people living at the service and had led to a referral to the local social services authority was discussed with staff. Appropriate action was taken concerning the incident, including an increase in staffing levels and the involvement of specialist community services. Behaviour management plans were also put in place. Staff training in safeguarding adults and in dealing with aggression is being provided. Lynton DS0000014618.V331963.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have their individual and collective accommodation needs met in a comfortable and homely way. The home is clean and hygienic. EVIDENCE: Improvements to the premises since the previous inspection include a new bath, a new shower, and the decoration and furnishing of a bedroom and some communal areas. Improvements to the premises including painting and decoration have improved the appearance of the home. Lynton DS0000014618.V331963.R01.S.doc Version 5.2 Page 20 The main communal areas are the dining room and sitting room, which are homely, comfortable, and decorated to a good standard. The dining room flooring has recently been replaced, and staff advised that the sitting room carpet is to be replaced. The garden is accessible and is being maintained well. The kitchen was found to be neat and tidy, suitably equipped and clean. There are lockable cupboards for cleaning materials. There is a bathroom with w.c. and a shower room with w.c. which were in a good state of repair and adequately equipped. Two bedrooms were visited, which had been personalised by the person accommodated, and which were decorated and furnished to a good standard. The staff office includes overnight accommodation for staff. Thee is a fax machine and telephones but no computer facility for staff. Lynton DS0000014618.V331963.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A requirement was made at the previous inspection concerning staffing levels. Care staffing levels have now been improved, with a corresponding decrease in the use of agency staff. This will provide a more consistent level of care for people using the service. The staff team have the competencies and qualities to meet the needs of people accommodated. People are supported and protected by the home’s recruitment policy and practices. Staff are receiving training and supervision which will support them in meeting the needs of people receiving the service. EVIDENCE: Lynton DS0000014618.V331963.R01.S.doc Version 5.2 Page 22 The staff vacancies at present are for a full time manager and a part time carer. The appointment a new senior carer recently has helped reduce the need for agency staff. Staff said now that there was more staff cover staff were now able to attend training courses, and to ensure care planning and recording are improved. Training schedules indicated there was a good take up of training by staff in the home. Staff said there were always 2 members of staff on duty, which helped provide the levels of one to one support required. On the day of the inspection visit, there were sufficient staff on duty to ensure personal care needs were being met, and outings and escorts were being provided for the people accommodated. One of the care staff employed has the national vocational qualification (NVQ) in care at level 2, and two care staff are presently undertaking NVQ training. Two sets of recruitment and training records were sampled, which indicated that required checks and references are being obtained before new staff have unsupervised access to people accommodated. Staff supervision records sampled indicated that appropriate levels of staff supervision are now taking place. Lynton DS0000014618.V331963.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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home’s capacity for further improvement will be limited unless a registered manager who is suitably qualified, competent and experienced is appointed. People using the service feel that their views are being taken into account in how the home is run. The health, safety and welfare of people accommodated will be improved by a food safety system being put in place which complies with recent food hygiene legislation. EVIDENCE: Lynton DS0000014618.V331963.R01.S.doc Version 5.2 Page 24 Ms Marina Noone, who manages a care service local to Lynton for the provider, attended the inspection and the inspection feedback on behalf of the provider. Ms Noone said that since the previous inspection a manager had been appointed, but had subsequently decided not to take up the post. Ms Noone said that some new applications for the post have now been received. We sampled the records of recent residents’ meetings, which provide a snapshot of how the service is performing and responds to requests and concerns. The provider has set up arrangements for the independent auditing of each service, which will include the views of residents, their friends and relatives, and other stakeholders in the community. No audit has taken place so far this year at Lynton. The provider has advised us of the most recent health and safety services, checks and inspections which have taken place at Lynton. Monthly checks on health and safety issues on the premises are carried out, and records of these seen were satisfactory. Hot water temperature checks seen indicated lower than recommended temperatures being recorded. Hand testing of hot water outlets including in bathrooms and bedrooms indicated water temperatures to be near recommended levels. Ms Noone agreed that the provider would further investigate this anomaly to ensure that people using the service have safe hot water at all times. While a copy of the Safer Food system which records food hygiene checks was in the home, this system is not yet being used in the home. The provider must ensure that a food safety system which complies with recent food hygiene legislation is put in place. Lynton DS0000014618.V331963.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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 1 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 1 X 3 X X 2 X Lynton DS0000014618.V331963.R01.S.doc Version 5.2 Page 26 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 YA37 Regulation 8 (1) Requirement The registered provider shall appoint an individual to manage the care home where (a) there is no registered manager in respect of the care home. (Previous timescale of 31/03/07 not met). The registered person shall ensure that any complaint made under the complaints procedure is fully investigated. (Previous timescale of 31/12/06 not met). The registered provider shall ensure that a system for food hygiene that complies with recent food safety legislation is put in place for the health and safety of people accommodated. Timescale for action 30/06/07 2. YA22 22 (3) 30/07/07 3. YA42 13.3 29/06/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Lynton DS0000014618.V331963.R01.S.doc Version 5.2 Page 27 No. Refer to Standard Good Practice Recommendations Lynton DS0000014618.V331963.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Lynton DS0000014618.V331963.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!