Inspection on 17/10/05 for Lynwood House

This inspection was carried out on 17th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Lynwood House 23/02/10

Lynwood House 24/11/08

Lynwood House 10/05/07

Lynwood House 25/04/06

Lynwood House 23/05/05

Lynwood House 03/02/05

Lynwood House 27/07/04

Lynwood House 06/02/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Lynwood House Lynwood Close Midsomer Norton BANES BA3 2UA Lead Inspector Mark Dunford Announced 17 October 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lynwood House D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Lynwood House Address Lynwood Close Midsomer Norton BANES BA3 2UA 01761 412026 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Voyage Ltd Mrs Angela Czerny Care Home Only 14 Category(ies) of LD Learning disability registration, with number of places Lynwood House D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Lynwood House is registered to provide care and support for up to 14 people in total who have a learning disability. Additional conditions of registration enable the home to offer as part of the overall total number of people accommodated accommodation to people who, in addition to their learning disability, have associated needs including autistic spectrum disorder, and in designated rooms up to four people who, in addition to their learning disability, have a physical disability and are wheelchair users. The home can accommodate people aged 18 years and over. Up to 10 people may be accommodated in the main house and up to 4 people may be accommodated in the annexe. Date of last inspection 23 May 2005 Unannounced Brief Description of the Service: Voyage Limited, who are part of the Paragon Healthcare Group, operate Lynwood House. Lynwood House is a spacious detached property situated in a quiet residential cul de sac in Midsomer Norton. A neighbouring property also forms part of the registration and is known as Lynwood Annexe. The service is near to local shops and facilities in the town of Midsomer Norton. Bath city centre is nine miles away. The house and the annexe are set within their own grounds backing onto school playing fields. Lynwood House’s statement of purpose describes its philosophy of care as based upon ‘Gentle Teaching’ and good parenting techniques. The home’s ethos is transitional care in the sense of young adults moving from specialised educational settings or from parental homes to a setting where their needs can be met on as long-term a basis as their healthcare conditions allow. An initial additional condition of registration enabled the service to accommodate people aged between 16 and 18 years on admission, subject to meeting relevant supplementary National Minimum Standards: this condition has been removed following this inspection via written agreement between the registered provider and the Commission as there is no longer anyone aged between 16 and 18 accommodated and as the registered provider has stated they will no longer seek to admit anyone aged 16 or 17 on admission. Lynwood House D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place over one day. The Inspector gained information for this report from discussion with the home manager and some of the staff on duty; looking at records and other documentation; talking with those residents who can use verbal communication; observing staff interaction with the residents; and observing part of a music therapy session. Information was also gained from comment cards completed by parents and other people who work with the residents. Occupancy on the day of inspection was 11, comprising 8 in the main house and 3 in the annexe. 2 referrals for new admissions were being considered. What the service does well: A number of residents have degenerative illnesses, which both limit their dayto day abilities and opportunities and also severely reduce their lifespan. In very many ways, the service does a very good job of maximising their quality of life and this is recognised by those who advocate for each resident, be they parents, social care professionals or health professionals. A wide range of professional expertise is actively used in order to support and maintain residents’ health and well-being. The expertise of families is also acknowledged and there is an openness to this vital partnership. There is a strong core of committed staff who have worked at the home since its opening and who are very focussed on their responsibilities. Staff are well supported by a manager who is dedicated and able. Staff were responsive to the needs of the residents. Residents were seen to be relaxed and happy in the company of staff. Staff continue to support residents to participate in their local community and to develop their potential through the use of a range of community facilities and through experiencing events and places of interest. The sensory room is a particular strength. Lynwood House offers clean, pleasant and homely accommodation with essentially good quality furniture, fixtures and fittings. Despite the amount of equipment necessary to meet health needs in many of the bedrooms and bathrooms, these rooms have been personalised to an impressive degree. Lynwood House D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 Page 6 Pre-admission assessment procedures are thorough and are well applied, as are staff recruitment, selection and disciplinary procedures. Issues relating to the protection and well being of residents have been appropriately reported to the Local Authority and the Commission. What has improved since the last inspection? What they could do better: The home needs to continue to reinforce the importance to staff of objective and full recording of day to day care and support and to monitor that this level of recording happens. The linkage of monthly summaries by residents’ key workers to the relevant care plan could be improved further to show how residents’ needs are being monitored and plans amended where necessary. The home also needs to ensure that monthly checks of the emergency lighting system are kept up to date to ensure that the safety of residents and staff is fully promoted. An alternative means to the passenger lift of transferring between the ground and first floors is needed. Internal redecoration of communal areas in the main house should be kept on a rolling programme in anticipation of the inevitably high levels of wear and tear. Lynwood House D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 Page 7 Residents could be involved in ideas for making the back garden of the main house more visually interesting and developing its use. The organisation will need to inform CSCI how they intend to reach the national target for the percentage of care staff achieving NVQ awards. 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. Lynwood House D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Lynwood House D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 There is a thorough and tailored process of assessment and visiting which enables the home and each prospective resident and their families to make an informed decision about the placement. EVIDENCE: The Statement of Purpose for the home was updated in September 2005, principally to reflect changes in staffing. Together with the Service User Guide, it provides clear information about the service for families and placing authorities. Constructing versions of these documents which are accessible to all the residents at Lynwood House is extremely problematic. All residents have been placed by Local Authorities and have a care manager overseeing their placement in the home. One admission had taken place since the last inspection. A senior manager from Voyage Ltd was responsible for all the necessary discussions about this placement with the various stakeholders involved in their care, carried out assessments and negotiated contracts with the relevant placing authority. The home manager and other members of the staff team were able to visit and spend time with this person within their previous home environment prior to Lynwood House D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 Page 10 their admission. Visits by the person and their representatives to Lynwood House also occurred before a decision to make the placement on a trial basis was made. A transitional plan was subsequently agreed and this process is enabling the home to further assess whether it is best placed to meet this person’s needs. Decisions about the type and number of visits, which may be part of any admission process, are made on an individual basis. Two referrals are under consideration by the home but referrals do not necessarily lead to placement. Lynwood House D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 9, 10 Care plans are detailed and informative and are being regularly reviewed and updated. This enables the staff to provide consistent and sensitive support that is based on residents needs. Residents are supported to make decisions about their lives as much as their health conditions allow. Not all recording in care records is objective: this means that not all information about residents is being handled appropriately. EVIDENCE: The personal files of four of the residents were examined. The care files included the social workers assessment and care plan, an initial assessment completed by a senior manager of Voyage, and an individual care plan devised by the senior manager, which contained information on the residents’ health, medication, self help skills, daily living skills, activities and communication Lynwood House D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 Page 12 needs. These care plans were detailed and informative and set out action that needed to be taken by staff in order to meet the individual’s needs. Each plan had been reviewed recently. The recommendation made at the last inspection to introduce and maintain a recording system for demonstrating that care plans are still relevant i.e. by using a proforma for recording review dates had been met. The monthly summaries by residents’ key workers showed that the residents’ needs were being monitored. There was some linkage to the care plan although this could be improved further. Personal files also included colour coded risk assessments, which described how identified risks are to be managed. A system that demonstrates that these are also being regularly reviewed has been put in place. Records of chiropody, optician, dental and medical checks (which included visits made by the G.P.) carried out were seen, as were day to day records which were being maintained using a proforma which allowed for a recording to be made by staff in the morning, in the afternoon and by night staff. The requirement made at the last inspection to remind staff to be consistent in their recording in care files so that residents’ conduct and progress in the home can be case tracked had been carried out but the outcome was not yet satisfactory. For example, one family have asked the home to use a diary so that they can be aware of the activities the resident has been involved in but this has not been consistently maintained. Many entries in care records were full and informative, particularly for handover purposes but some were minimal. A few entries were still subjective and not supported by evidence – for example, such entries included the phrases “bossy” and “tantrums”. Lynwood House D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 17 Residents continue to be supported by staff to pursue activities which they enjoy, which are tailored to their needs and which enable them to have an interesting lifestyle. Staff continue to support residents to participate in their local community and to develop their potential. Staff continue to enable and support family contact and the residents have benefited from being able to see their relatives regularly. The views of family members have been acknowledged and in most cases accommodated where practicable. Residents are offered meals, which take account of nutritional, balance needs and their individual health needs. Lynwood House D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 Page 14 EVIDENCE: The home’s activities schedule and observation during the inspection evidenced that residents continue to be supported to enjoy a range of activities, which include both social and educational opportunities. A number of residents attend local colleges to pursue a wide range of interests. Residents continue to use a hydrotherapy pool at Fosseway School (two residents were taken to hydrotherapy on the day of this inspection). Individual/groups of residents are also regularly supported to enjoy such things as trampolining, horse riding, ten pin bowling, dog walking, visiting the local library, shops or cafes, or enjoying day trips with staff members to places of interest. The home has its own sensory room facilities in the annexe, which is very well equipped and used by all of the residents. The home had a selection of videos for the residents to watch in the comfort of their own bedroom or in the main lounge area. Staff members were observed supporting residents to select a video of their choice to watch. With a resident’s permission the Inspector was able to sit in on part of a music therapy session. The resident was observed thoroughly enjoying the session and was supported by the music therapist to strum a guitar, which is specially adapted to maximise the effect that can be created and to select songs by his favourite artist. Most of the residents have regular contact with their families. Some residents regularly go to stay with their parents for weekends and some residents’ parents visit the home on specific days each week. Due to the severe communication restrictions on some of the residents due to their medical conditions, parents have inevitably become their ‘interpreters’ and naturally have a wealth of knowledge about their son or daughter to bring to the provision of their care and support. Some parents have expressed this in specific guidelines for staff to follow in certain aspects of their care and the evidence of this inspection is that these guidelines are respected and accepted and are followed although not with 100 consistency. The requirement from the last inspection to label food stored in the annexe’s fridge in order to clearly show the date of opening was not evaluated at this inspection. The requirement made at the last inspection to maintain comprehensive records of meals eaten by residents has been met. One resident has a separate menu plan. Lynwood House D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 Page 15 Observation of lunchtime meals served during this inspection showed evidence of nutritional balance, responsiveness to individual preferences, and where necessary adherence to health needs – for example, one resident with a very specific diet and a very specific way in which food has to be given. Staff have received training and guidelines from the company who supply the meals and equipement and form health professionals for residents who need PEG feeding due to their medical conditions. The manager reported that there is very good support from both these sources should any queries arise. Lynwood House D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 21 Residents’ personal care needs are met. A wide range of professional expertise is actively used in order to support and maintain residents’ health and well-being. The expertise of families is also acknowledged and there is an openness to this vital partnership. The recent illness and death of a resident was handled with sensitivity and respect. EVIDENCE: Staff were observed discreetly encouraging and providing support to residents who needed assistance with their personal care. All personal hygiene care was being carried out in their bedrooms. One resident has remained registered with the G.P. she had prior to her admission to the home. This was the choice of the resident’s parents and this decision has been respected by the home. Other residents are registered with a local G.P. practice and this particular G.P. practice has a dispensing Pharmacy on site. Lynwood House D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 Page 17 Residents continue to receive support from the range of professionals employed by the Community Learning Disability Team (CLDT) based at St Martins Hospital in Bath. Consultants are accessed through GPs or this team as necessary. Due to their profound disabilities none of the residents are self-medicating any prescribed medication. One resident had sadly died in August 2005 after a sudden acute illness related to her medical condition. The written notification to the Commission at the time and the records seen at this inspection both demonstrated the care and support given to the person themselves at the time and to the staff team and family subsequently. This person’s death had clearly impacted on the home and records evidenced recognition of the possibility of this impact on other residents. Lynwood House D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, 23 Staff members advocate on behalf of residents when residents cannot do so for themselves. Residents feel their views are listened to and acted on. EVIDENCE: There have been no further complaints from neighbours since the last inspection. There have been no complaints received by CSCI regarding Lynwood House. One resident spoken with who is able to communicate verbally was open about their views about the home and said that their views were listened to by the manager and staff and had been acted on where possible – for example, in the activities they wished to do. Records confirmed this. Residents observed who are unable to communicate verbally or manually seemed relaxed and happy in the company of staff. The recommendation made at the last inspection to review the in-house protection of vulnerable adult procedure to make it clearer to staff that their responsibility is to report and to only ask what they need to ask in order to know what to do next had been met. Staff spoken with were clear about the advocacy role they have where a resident’s medical condition precludes verbal communication and showed clear commitment to protecting and safeguarding the very vulnerable adults who live at Lynwood House through this role. Lynwood House D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 29, 30 Lynwood House offers clean, pleasant and homely accommodation with essentially good quality furniture, fixtures and fittings although internal redecoration of communal areas in the main house should be kept on a rolling programme in anticipation of the inevitably high levels of wear and tear. Despite the amount of specialist equipment necessary to meet health needs in many of the bedrooms and bathrooms, these rooms have been personalised by residents with the help of parents and /or staff to an impressive degree. An alternative means to the passenger lift of transferring between the ground and first floors of the main house is needed. Residents could be involved in ideas for making the back garden of the main house more visually interesting and developing its use. Lynwood House D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 Page 20 EVIDENCE: Between them, the main house and annexe offer fourteen single bedrooms, all with ensuite facilities. Within the main house there are four bedrooms on the ground floor and six bedrooms on the first floor. There is a passenger lift between the two floors. There are two communal lounge areas, two adjoining dining areas, an activity room with kitchenette and a domestic style kitchen. Within the annexe there is one ground floor bedroom and three further bedrooms on the first floor. There is no passenger lift between floors and service users who accommodate bedrooms on the first floor of the annexe need to be able to manage stairs. There is a dining room, a communal lounge, and a domestic style kitchen in the annexe. Both properties provide a ground floor communal toilet and both properties have laundry facilities. In addition there is a sensory room available in the annexe, which all service users are able to use. Improvements to be made to the ventilation in the kitchen in the annexe had been carried out. The requirement made at the last inspection to provide some pictures in the communal lounge in the annexe in order to make this communal space more homely in appearance had been well met. Both the main house and the annexe were clean and tidy. Bedrooms within both the main house and the annexe were viewed with the agreement of residents where possible. Each bedroom had been furnished and decorated to a high standard and personalised through photographs and other personal possessions, even in those rooms which had of necessity had to have tracking hoists and other equipment installed to meet care needs. This level of personalisation, with the evident involvement of the person themselves where possible, showed that their individuality is respected and promoted. Almost all of the bathrooms had had a similar degree of personalisation. The inspector was informed that funding has been agreed for the installation of stair equipment to enable those residents on the first floor to have an alternative to the shaft lift. This needs to be an organisational priority as the shaft lift is of an age and type that leaves it susceptible to breakdowns and difficulty in obtaining spare parts. Lynwood House D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 Page 21 Some communal areas in the main house – notably corridors and skirting boards – were showing signs of wear and tear: this is understandable given the amount of use of wheelchairs and other equipment in these areas but should be considered for a more frequent redecoration cycle to maintain the sense of a well-looked after property. The back gardens for both houses are private areas; whilst the annexe garden is established with plants and shrubs as well as a lawned area, the back garden for the main house was affected by renovation work before the home opened and has not had any creative attention since. The possibilities for involving residents in the ideas for, and development of, this area should be explored. Lynwood House D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 34, 36 There is a strong core of committed staff who have worked at the home since its opening and who are very focussed on their responsibilities. Staff are well supported by the manager. Staffing levels were sufficient at this inspection but will need to match anticipated increases in occupancy and be kept under continual review to reflect identified needs. Staff recruitment, selection and disciplinary processes are robustly maintained and this supports and protects residents. EVIDENCE: The staff rotas examined for October 2005 showed that the day staff team had been split into two teams, which work opposite each other. The rota showed that between 7 and 9 staff had been rostered to be on duty between the hours of 8 a.m. and 8.30 p.m. From 8.30 p.m. to 8 a.m. there were either three or four waking night staff rostered and a sleep-in person. There were sufficient staff on duty to provide support to the residents on the day of this inspection. Lynwood House D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 Page 23 6 staff have left since the last inspection; of these, 1 person was dismissed following a disciplinary investigation into concerns raised. Recruitment to these posts has occurred using the organisation’s processes and procedures. The requirement to make full CRB clearances available for inspection in the home had been met and CSCI verification of these clearances had occurred on 1 August 2005. The outcome of CRB clearances for staff employed since then was seen at this inspection; a new log page will need to be started. 6 members of the staff team hold an NVQ Level 2 qualification and 5 others are registered for this award. One person is registered for an NVQ Level 3 award. Both Deputy Managers hold an NVQ Level 3. The home manager holds an NVQ Level 4 qualification and has qualified as an NVQ assessor and internal verifier. This means 9 out of the 31 staff (or 29 ) have an NVQ award: as the national minimum standard expects 50 by the end of 2005, the organisation will need to inform CSCI how they intend to reach this target. The recommendation made at the last inspection to provide a space on the staff induction checklist to date each topic covered in order to provide evidence of time spent inducting staff had been met. This is incorporated into the new corporate induction folder. Staff training and induction will be evaluated in depth at the next inspection. Staff members spoken with during this inspection stated that they felt supported and listened to by their manager. It was evident from interactions witnessed that the staff team were supportive of each other. Lynwood House D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 41, 42, 43 The home is well run and ably managed. The recently revised management structure assists this. There is an open and accountable ethos and management approach and this enables residents and their representatives to be assured that their views matter. The service is highly regarded by health and social care professionals and in almost all aspects by parents who in most instances have to advocate the views of residents about the development of the home. The organisation has and uses relevant mechanisms to seek those views. Record keeping has improved but can improve further. The health and safety of residents is promoted through the systems and procedures in place. Lynwood House D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 Page 25 EVIDENCE: Since the last inspection, the management structure of the home has been revised: in addition to the manager, there are now 2 deputy managers and 3 senior care assistants. Evidence from discussion, observation of a shift handover meeting, and documentation showed that this change has been beneficial in terms of improving communication and consistency. This is especially important in relation to the way the day and night staff teams work together as there are a number of residents who have significant night time needs, hence the number of waking night staff. Prior to this inspection, health and social care professionals and parents were sent questionnaires by the organisation and the responses received and evidence of non-response were made available to CSCI. Surveys and comment cards were also used by CSCI. Feedback from health and social care professionals was universally positive and was very positive in most aspects by parents. Where there are ongoing issues, these relate essentially to the consistency of approach used by staff, as illustrated earlier in this report. Comments elsewhere in this report indicate the progress made in relation to record keeping in relation to care and meals and the further improvements needed. In general, the recording systems in place to support the maintenance of health and safety in the home are now being used consistently. However, although the requirement made at the last inspection to streamline recording systems for checks on the homes fire alarm system and emergency lighting had been met, and although a weekly audit form to make sure fire safety procedures are carried out is now in use, the most recent recorded monthly check of the emergency lighting system was dated 28 July 2005. All other fire safety checks were up to date and the home’s fire safety risk assessment had been reviewed in August 2005. Lynwood House D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 4 3 3 x 2 3 Standard No 11 12 13 14 15 16 17 3 3 4 4 x x 3 Standard No 31 32 33 34 35 36 Score 3 x 3 3 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Lynwood House Score 3 4 x 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 x 2 3 3 D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 Page 27 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 10 Regulation 12(4), 12(5), 15, 17 23(4) 23(2)(n) Requirement Ensure staff consistently record in an objective way in care records and support their views with evidence. Ensure emergency lighting checks are carried out at stipulated frequencies Provide an alternative means to the passenger lift of transferring between the ground and first floors. Inform CSCI how the national target for the percentage of care staff achieving NVQ awards will be reached. Timescale for action From 17/10/05 From 17/10/05 By 30/06/06 By 31/12/05 2. 3. 42 29 4. 35 18(1)(c) (i) 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. 2. Refer to Standard 24 24 Good Practice Recommendations Implement a rolling programme of internal re-decoration of communal areas in the main house. Involve residents in ideas to develop the back garden of the main house. Lynwood House D56_D05_S52026_LynwoodHse_V247083_171005_Stage4.doc Version 1.40 Page 28 Commission for Social Care Inspection 300 Aztec West Almondsbury South Glos. BS32 4RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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