Inspection on 23/05/05 for Lynwood House

This inspection was carried out on 23rd May 2005.

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 8 statutory requirements (actions the home must comply with) as a result of this inspection.

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 17/10/05

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 Bath BA3 2UA Lead Inspector Angela Smith Draft - Unannounced 23 May 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_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Lynwood House Address Lynwood Close, Modsomer Norton, Bath & N E Somerset BA3 2UA 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) 412 026 Voyage Ltd Mrs Angela Czerny CRH-PC 14 Category(ies) of LD 14 registration, with number of places Lynwood House D56_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 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 and also, subject to compliance with the relevant supplementary National Minimum Standards, accommodate people aged between 16 and 18 years on admission. Date of last inspection 3 February 2005 Brief Description of the Service: Voyage Limited, who are part of the Paragon Healthcare Group, operate Lynwood House. Lynwood House is actually a spacious detached property situated in a quiet residential cul de sac in Midsomer Norton. A modern neighbouring property also forms part of the registration and is known as Lynwood Annexe. Lynwood House and Lynwood Annexe provide easy access to local shops and facilities in the town of Midsomer Norton. Bath city centre is also approximately nine miles away. The house and the annexe are set within their own grounds backing onto school playing fields. Both the main house and the annexe have been furnished and decorated to a good standard and 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. Lynwood House D56_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place over one day. The Inspector was initially assisted by a newly appointed senior staff member, and then subsequently by the home manager on her arrival at the home following a meeting. The Inspector gained information for this report from her discussion with the home manager and senior staff member and from reading a number of records maintained by the home relating to both young adults, staff, and maintenance records. Care plans, daily records of care provided, staff records, and relevant policies and procedures were all seen. The Inspector was also able to gather information for the report from observing and talking with six of the young adults during the inspection and from talking to four staff and observing their interaction with the young adults. What the service does well: What has improved since the last inspection? Staff records maintained in the home had improved and this enabled the home to demonstrate a more robust recruitment and selection process and procedure, which met national minimum standards. Full CRB clearances for Lynwood House D56_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 Page 6 staff must however be available in the home for the next announced inspection. Staffing levels had improved and according to the weekly staff rota inspected there were sufficient staff rostered to provide care and support to the young adults being accommodated. What they could do better: There were a number of shortfalls identified during this inspection with regards to the maintenance and upkeep of records in the home. It was not easy, for example, to track the conduct and progress of two young adults in the home by reading their case files as recording had not been consistent and this therefore needs to improve. Staff need to be reminded to write regularly and objectively in young adults day to day records. Systems need to be put in place, which will clearly show that the young adults care plans and comprehensive risk assessments have been regularly reviewed and are still current. Comprehensive records of meals eaten by young adults need to be introduced and maintained, which will demonstrate the home’s commitment to providing young adults with a healthy balanced and nutritional diet. Food stored in the home’s fridge should be dated in order to clearly show the date of opening. Ventilation in the kitchen in the annexe would benefit from being improved, as this kitchen was uncomfortably hot during lunch preparation. The communal lounge in the annexe would benefit from some pictures as the walls look a little bare and a few pictures would present a more homely appearance. Staff induction checklists should provide for the date to be recorded next to each topic covered, as this will provide evidence of the time spent inducting new staff into their role within the home. The home’s in-house protection of vulnerable adult procedure would, however, benefit from a minor amendment. There are a number of good systems and procedures in place in the home, which if built on and administered consistently would help to stabilise and improve the service at the point of delivery. For example, the day-to-day recording system, meal recording systems, and maintenance check recording systems. Lynwood House D56_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Lynwood House D56_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Lynwood House D56_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 & 3 Residents had been fully assessed and their needs fed into a detailed care plan, which did inform staff members on how to best support residents’. EVIDENCE: The home’s statement of purpose sets out the range of needs to be met by the home, and includes paths to compliance with the relevant supplementary National Minimum Standards for care homes accommodating young people aged between 16 and 17. All the residents accommodated were, however, 18 years old and the supplementary standards did not therefore have to be considered at this inspection. 11 young adults were being accommodated and there were 3 vacancies within the main house. All residents had been placed by Local Authorities and had a care manager overseeing their placement in the home. No admissions had taken place since the last inspection. A senior manager from Voyage Ltd was responsible for all the necessary discussions about each of the young adults placements 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 each of the young adults accommodated within their previous home environment prior to their admission to Lynwood House or Lynwood annexe. A transitional plan was subsequently agreed and this transitional process enabled the home to further Lynwood House D56_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 Page 10 assess whether the home would be able to meet the individual resident’s needs. Two young adults have moved to live in residential homes closer to their parents since the last inspection. Both have continued with placements within homes operated by the Paragon Healthcare Group. A transitional plan was put in place for each of these young adults. One other young adult is also likely to be moving out of the home in the near future. This had been fully discussed and agreed with the placing authority. This young adult will more than likely be moving to another Voyage home and is moving because the home has found that it is unable to meet all of the young adults needs within the current resident group and it is felt that the young adult would benefit from living with a more able group of residents. Lynwood House D56_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 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 & 9 Care plans and associated records are detailed and informative enough to enable the home to provide consistent and sensitive support that is based on residents needs. However, action needs to be taken to demonstrate through written evidence that care plans and associated records are being regularly reviewed and updated as appropriate and all recording needs to be objective. EVIDENCE: The personal files of two of the young adults were examined in detail. 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 young adults’ health, medication, self help skills, daily living skills, activities and communication needs. These care plans were detailed and informative and set out action that needed to be taken by staff in order to meet the young adults needs. However, one of the young adults care plans was dated January 2004 and the other November 2004. It is therefore recommended that a system for demonstrating that these detailed care plans are still relevant be introduced. The young adults’ key workers (named members of staff who play more of a central role in co-ordinating the service that residents receive) had written monthly summaries and these did show that the young adults’ needs were Lynwood House D56_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 Page 12 being monitored. However, they did not specifically refer to the care plan and its current relevance or whether any amendments were needed. 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 needs to be put in place, as these were dated in line with both of the young adults care plans. Records of chiropody checks, dental checks, medical checks (which included visits made by the G.P.), and optical checks having been 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. Gaps were seen in both of the young adults’ day to day records and there was an entry in one of the young adult’s records that was subjective and needed further clarification from the person who wrote it as it was not clear what exactly the staff member meant. Staff must be reminded to be more consistent in their recording so that a young adult’s progress and conduct in the home can be case tracked, and they should avoid making subjective comments in their recordings. Staff should be reminded of the importance of writing objectively and their recordings should be supported by evidence. Also writing entries such as ‘home’, for example, should be avoided. It was assumed that ‘home’ referred to the young adult having gone to stay at their parent’s home. This, however, should to be clearly specified. Lynwood House D56_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 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) 12, 13, 14, 15, & 17 Young adults are supported by staff to pursue activities that they enjoy and which enable them to have an interesting lifestyle. Activities are tailored to the individual preferences and needs of the young adults. There were no records of meals eaten by young adults. EVIDENCE: The home had an activities schedule and young adults were being regularly supported to enjoy a range of activities, which included both social and educational opportunities. Six young adults attend local colleges. Four were attending Radstock College, one for five days per week (studying engineering, food technology, IT, self-presentation skills and socialisation skills), and three for one day per week (two studying horticulture and one IT). Two residents were attending Trowbridge College and were doing arts and crafts sessions and socialisation skills sessions. Arrangements were regularly being made for young adults to use a hydrotherapy pool at Fosseway School (two young adults were taken to Lynwood House D56_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 Page 14 hydrotherapy on the day of this inspection). Individual/groups of young adults have also regularly been supported to enjoy such things as trampolining at Wells Sports Centre, horse riding at Wellow Trekking Centre, ten pin bowling in Longwell Green, dog walking at the local dogs home, visiting the local library or local cafes, or enjoying day trips with staff members to places of interest such as Longleat in Wiltshire or Wells. The home has its own sensory room facilities in the annexe, which is well equipped and used by all of the young adults. A computer was available for the young adults to use in the art and crafts room of the main house. Those young adults particularly interested in using the computer have been allocated specific times during the week when they can use it in order to avoid any disappointment. The home had a selection of videos for the young adults to watch in the comfort of their own bedroom or in the main lounge area. Staff members were observed supporting young adults to select a video of their choice to watch. With a young adult’s permission the Inspector was able to sit in on a music therapy session. The young adult was observed thoroughly enjoying the session and was supported by a staff member and the music therapist to strum a guitar and to select songs by his favourite artist. Most of the young adults have regular contact with their families and staff members spoken with explained how some young adults regularly go to stay with their parents for weekends and how some young adults’ parents visit the home on specific days each week. The home has two adjoining dining areas in the main house and a dining area in the annexe. There was a six weekly rotating menu in place, but this was not being followed and there were no records of the actual meals being served or eaten by the young adults either in the main house or the annexe. Comprehensive records of meals eaten therefore need to be introduced and maintained. However, despite the lack of records young adults in the annexe were served a freshly prepared nicely presented Shepherd’s pie and accompanying vegetables for lunch, which had been cooked by one of the staff members on duty in the annexe. One of the young adults was heard complimenting the staff member on her cooking skills and the young adult told the Inspector how much she enjoyed the lunch. Lynwood House D56_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 & 19 Young adults health and personal care needs were being met. EVIDENCE: Young adults receive personal and health care support as needed. Staff were observed discreetly encouraging and providing support to young adults who needed assistance with their personal care. All personal care was being carried out either in the young adults bedrooms or in one of the home’s communal toilets. Arrangements had been made for young adults to be registered with a local G.P. practice and this particular G.P. practice has a dispensing Pharmacy on site. One young adult has remained registered with the G.P. she had prior to her admission to the home. This was the choice of the young adult’s parents and this decision has been respected by the home. Young adults have received support from the range of professionals employed by the Community Learning Disability Team (CLDT) based at St Martins Hospital in Bath. One young adult was under the care of a Consultant Neurologist and another was receiving regular professional input with regards to her epilepsy from a Consultant at Frenchay Hospital. A district nurse had been involved in providing regular support to young adults who were being peg fed. Lynwood House D56_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 Page 16 Due to their profound disabilities none of the young adults were selfmedicating any prescribed medication. One young adult was in hospital and staff were being rostered to provide support to this person whilst they remained in hospital. Staff were only not providing support at the hospital when a family member was there and the family felt that staff from the home were not needed. Lynwood House D56_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Staff members advocate on behalf of young adults and young adults have been protected by appropriate action being taken by the home manager in response to an incident that occurred in the home. EVIDENCE: There have been two complaints from local neighbours recorded in the home’s logbook. One related to noise when the home’s vehicles were being cleaned on a Sunday morning and another related to damage to a wall due to a tree in the home’s garden. Appropriate action had been taken by the home manager to resolve these issues. One young adult spoken with was able to speak openly in front of staff about what it was they liked about the home and what they would like the home to arrange for them. This young person was not afraid to air their views. This person told the Inspector that they would like to be able to go to a particular club once a week and this was shared with the home manager. Young adults observed seemed relaxed and happy in the company of staff. The home’s complaints procedure included timescales for action and the contact number of CSCI to who concerns can also be made. There have been no complaints received by CSCI regarding Lynwood House. A Protection of Vulnerable Adult strategy meeting and subsequent follow-up meeting had been held with the Local Authority with regards to one of the young adults since the February inspection. These meetings occurred following an incident, which had been appropriately reported by the home manager to Social Services and CSCI. Members of staff spoken with said they had received training about protecting vulnerable adults and there was written Lynwood House D56_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 Page 18 information about how they should report suspected abuse available in the office. It is, however, recommended that the home’s in-house procedure be reviewed to ensure that it makes it clear 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 if an incident were reported to them so as not to contaminate evidence. Lynwood House D56_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 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 & 28 Young adults benefit from a homely and comfortable environment equipped with good quality fixtures, fittings and furniture throughout. Young adults can personalise their bedrooms with the support of their parents and/or staff, which demonstrates that their individually is being respected. The main house and the annexe were both clean and tidy. EVIDENCE: Lynwood House D56_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 Page 20 The opportunity was taken to see three young adults’ bedrooms within the annexe with their agreement. Each bedroom had been furnished and decorated to a high standard and it was nice to see that each of the young adults had been able to personalise their bedrooms with personal possessions indicating that their individuality had been respected and promoted. The communal areas of the main house include two lounges (one of which offers ramped access to the rear patio garden), two connecting dining areas, an activity room with kitchenette, which is available for young adults to use with supervision and support from staff, and a separate domestic kitchen. Communal areas in the annexe include a lounge with patio doors providing access to and overlooking an enclosed rear garden, a dining area and a domestic kitchen. A well-equipped sensory room is also available in the annexe and this was being regularly used by all of the young adults. The kitchen in the annexe was noted to be very hot whilst the lunch was being prepared and it is recommended that ways of improving the ventilation in this area be explored. As stated following the last inspection the communal lounge in the annexe would benefit from some picture, as the walls look a little bare. Both the main house and the annexe offer their own laundry facilities. The main house’s laundry facilities are in the basement and are therefore only accessible to staff members. Laundry equipment was found to be satisfactory. Lynwood House D56_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34, 35 There were sufficient staff on duty to provide support to the young adults on the day of this inspection. Staff were responsive to the needs of the young adults. Young adults were seen to be relaxed and happy in the company of staff. EVIDENCE: The staff rota examined for week ending the 28 May 2005 showed that the 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 2 p.m. and 8 were rostered from 2 p.m. to 8.30 p.m. From 8.30 p.m. to 8 a.m. there were four waking night staff rostered and a sleep-in person. The arrangement for walking night staff is for three to be in the main house and one in the annexe. Two of the waking night staff team were off sick at the time of this inspection. The Inspector was, however, informed that the staff team were generally able to cover and that agency staff had only being used on the odd occasion. Three young adults have a contract requiring 1:1 staff support, which means that 5 staff per shift were caring for the remaining 7 young adults. Staff were also being rostered to provide support to the service user who was in hospital. There were sufficient staff on duty to provide support to the young adults on the day of this inspection. Lynwood House D56_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 Page 22 A new senior staff member had been appointed since the last inspection and two full-time support workers commenced employed in the home in March 2005. Two full-time support workers were also due to commence employment in the home on the 29 May 2005. A senior support worker position is due to be advertised as one of the senior staff team left on the 8 May 2005. Copies of application forms, references and evidence of CRB clearances being requested were seen for the new staff members. However, the outcome of CRB clearances was not seen for all new staff. An induction checklist had been used with new staff. It is, however, recommended that space be included onto the checklist for the date to be included in order to provide evidence of the time spent inducting new staff into their role within the home. Two members of the staff team held an NVQ Level 2 qualification and 9 others were working towards their award. Two senior staff members held an NVQ Level 3. New staff members had been provided with manual handling, health and safety and PoVA training. Food handling and First Aid training had been planned for June 2005. Lynwood House D56_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 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 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, 41 & 42 The home is generally well run, but some improvement in record keeping is needed. There are potentially effective systems and procedures in place to maintain good standards of lifestyle and health and safety for the young adults, which would help them maximise their potential and minimise any potential risks if all members of the staff team administered the systems in place consistently and maintained efficient recording systems. EVIDENCE: The home manager holds an NVQ Level 4 qualification and has qualified as an NVQ assessor and internal verifier. 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_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 Page 24 Progress has been made in relation to record keeping, and in particular staff records have improved. However, further improvements with regards to record keeping is still needed in order to clearly evidence that a consistent service which is tailored to individual needs is being provided. There are recording systems in place to support the maintenance of health and safety in the home, but these are not being used consistently. This could be because one specific recording system has not been adopted. For example, there were two systems in operation for the recording of weekly in-house checks on the home’s fire alarm system. Recording systems for checks on such things as the home’s fire alarm system therefore need to be streamlined. It was not clear from the records available whether or not the fire alarm system in the annexe had been checked since the 10 May 2005, and the emergency lighting in the annexe did not seem to have been checked since the 14 December 2004. Food in the fridge in the annexe had not been appropriately labelled with the date of opening. . Lynwood House D56_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 4 3 4 4 x x Standard No 11 12 13 14 15 16 17 x 3 3 3 3 x 2 Standard No 31 32 33 34 35 36 Score x x 3 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Lynwood House Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 x x x 2 2 x D56_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 Page 26 No 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 YA9 Regulation 13(4)(b), 15, 17 Requirement Introduce and maintain a recording system on the premises which shows that young adults risk assessments are being regularly reviewed. Staff to be reminded to be consistent in their recording in young adults care files so that young adults conduct and progress in the home can be case tracked. Comprehensive records of meals eaten by young adults to be maintained. Recording systems for checks on the homes fire alarm system and emergency lighting to be streamlined. Ensure food kept in the fridge is appropriately dated when opened. Timescale for action 31/07/05 2. YA6, & YA41 15, 17 FROM 23/05/05 3. 4. 5. YA17 & YA41 17(2), Sch 4.13 16(2)(i) 23, 17(2), Sche 4.14 13(4) FROM 23/05/05 YA42 & YA41 YA17 31/07/05 6. FROM 23/05/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations D56_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 Page 27 Lynwood House 1. 2. Standard YA41 & YA6 YA41& YA6 3. YA23 4. 5. 6. YA24 YA24 YA35 Introduce and maintain a recording system for demonstrating that care plans are still relevant i.e., proforma for recording review dates. Staff to be reminded to write objectively and clearly and their recordings should be supported by evidence. Staff should avoid making subjective comments in their recordings. In-house protection of vulnerable adult procedure to be reviewed 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. Improvements to be made to the ventilation in the kitchen in the annexe. Provide some picture in the communal lounge in the annexe in order to make this communal space more homely in appearance. Provide a space on the staff induction checklist to date each topic covered in order to provide evidence of time spent inducting staff. Lynwood House D56_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 Page 28 Commission for Social Care Inspection 300 Aztec West Almondsbury South Gloucestershire 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. Extracts may not be used or reproduced without the express permission of CSCI Lynwood House D56_52026_LynwoodHouse_226738_180505_Stage4.doc Version 1.30 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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