CARE HOME ADULTS 18-65
Linden Cottage 87 Byron Street Loughborough Leicestershire LE11 5JN Lead Inspector
Steve Hunnybun Unannounced 7 July 2005 at 9:30am
th 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. Linden Cottage C51 C01 S1759 Linden Cottage V237493 070705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Linden Cottage Address 87 Byron Street Loughborough Leicestershire LE11 5JN 01509 269637 01509 269637 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) Aspire Lifestyle Ltd Vacant Care Home 3 Category(ies) of LD - Learning disability (3) registration, with number of places Linden Cottage C51 C01 S1759 Linden Cottage V237493 070705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 22nd February 2005 Brief Description of the Service: Linden Cottage is a small home that is registered to provide care for three residents with learning disabilities. The home is a bungalow, located on a quiet residential road in Loughborough. All residents have their own bedrooms and there is a lounge/dining room. The home has a pleasant garden to the rear. All residents are supported to access a range of day care and leisure activities. Linden Cottage C51 C01 S1759 Linden Cottage V237493 070705 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the first statutory unannounced inspection this year and took place over three hours. All three residents were tracked, their files were examined, two of their rooms were looked at and the inspector spoke with staff. None of the residents can communicate verbally so it was not possible for the inspector to speak with them about the home. Time was spent with two of the residents and they appeared to be happy and well cared for. One resident has only been living at the home for a week and appears to have settled in well. Staff’s views supported this. What the service does well: What has improved since the last inspection? What they could do better:
Copies of any contract between the provider and residents must be placed in residents’ files. The manager has been proactive in producing an accessible residents’ guide. This piece of work needs to be completed as soon as possible. Staff are not receiving dedicated adult protection training and it would be advisable for the policy to be discussed in staff meetings. The remaining areas
Linden Cottage C51 C01 S1759 Linden Cottage V237493 070705 Stage 4.doc Version 1.40 Page 6 of improvement regarding the premises need attending to as soon as possible. The manager must apply for registration as soon as possible. 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. Linden Cottage C51 C01 S1759 Linden Cottage V237493 070705 Stage 4.doc Version 1.40 Page 7 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 Linden Cottage C51 C01 S1759 Linden Cottage V237493 070705 Stage 4.doc Version 1.40 Page 8 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) 1,2,5 The residents’ guide is not currently accessible to those with communication difficulties. Residents’ needs are assessed in order to inform the care planning process. Copies of residents’ contracts need to be kept in the home so that residents can be made aware of what their rights and responsibilities are. EVIDENCE: The home does have a comprehensive and useful statement of purpose. There is no residents’ guide that is written in an accessible format for people with communication difficulties. This has been recommended at previous inspections. This was discussed with the manager who stated that she has approached a speech and language therapist who will produce symbols to use with the statement of purpose/residents’ guide. All files tracked contained assessments that were comprehensive and useful. One resident’s needs have changed and he has had a full re-assessment completed. None of the files looked at contained contracts. The manager of the home stated that when this issue was raised with the provider it was stated that the company’s solicitors were happy with the contracts held for residents. It does, however, state in National Minimum Standard 5 and Regulation 5 that such contracts should be in a format that is accessible to residents and explained to them. Copies of contracts should, therefore, be in residents’ files. Linden Cottage C51 C01 S1759 Linden Cottage V237493 070705 Stage 4.doc Version 1.40 Page 9 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 Good care plans and risk assessments ensure that residents receive individual care meeting their needs. EVIDENCE: All files tracked contained very useful care plans. These had all been recently reviewed. All files tracked contained risk assessments that were individual to the needs of residents. Linden Cottage C51 C01 S1759 Linden Cottage V237493 070705 Stage 4.doc Version 1.40 Page 10 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) 12,13,15,17 Residents take part in appropriate activities and are enabled to be part of the local community. Residents are supported to maintain contact with friends and families. The food is healthy varied and nutritious. EVIDENCE: All files tracked contained a wealth of information regarding residents’ activities, both day care and leisure. These included college, horse riding, shopping and pub meals. Local facilities are used where possible and staff reported that the home has a good relationship with its immediate neighbours. Files contained reference to residents’ families and friends. The inspector joined residents for lunch and they all appeared to enjoy their meal. The food appeared healthy and nutritious, comprising of a snack lunch of sandwiches or soup. The inspector examined menu sheets that were displayed on the wall; these indicated a varied diet. Linden Cottage C51 C01 S1759 Linden Cottage V237493 070705 Stage 4.doc Version 1.40 Page 11 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) 18,19,20,21 Residents’ personal and healthcare needs are met sensitively and they are protected by the home’s medication procedures. Residents’ wishes in the event of their death are recorded so that this can be handled, as they would wish. EVIDENCE: Residents’ files contain a wealth of information regarding their personal and healthcare needs. They are all registered with a local GP and any appointments are recorded along with outcomes. Staff were observed supporting residents in a sensitive and caring manner. The inspector examined the provision of medication in the home and it was found to be stored, administered and recorded appropriately. Residents’ or their family’s wishes regarding their death are recorded in their files. Linden Cottage C51 C01 S1759 Linden Cottage V237493 070705 Stage 4.doc Version 1.40 Page 12 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 Residents’ and their families’ views are listened to and acted on. Residents are protected from abuse but the lack of training could mean that staff are not up to date with current policies. EVIDENCE: The home has a robust and comprehensive complaints procedure the inspector examined the book in which complaints are recorded and it was found to contain no new complaints since the last inspection. A copy of the revised Multi-Agency Vulnerable Adult Protection document No Secrets was present in the home. A member of staff was asked about vulnerable adult training and stated that he thought it was being arranged. He was unsure if it was covered in staff meetings. Linden Cottage C51 C01 S1759 Linden Cottage V237493 070705 Stage 4.doc Version 1.40 Page 13 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) 24,30 Substantial progress has been made to meet the previous requirements. The remaining areas need attending to as soon as possible. The home is clean and tidy. EVIDENCE: The bungalow is generally homely, comfortable clean and tidy. A requirement was made at the last inspection regarding a number of areas of maintenance; the following have been attended to • The lounge has a new carpet. • The garden fence has been repaired. • The house has been assessed for damp and remedial action is being taken. • Existing damp damage has been attended to. The following areas still need attending to and are planned • The lounge needs redecorating • The kitchen needs redecorating and the units need replacing • The bathroom needs redecorating and an assessment carried out for a new bath that can meet the needs of all residents • A risk assessment needs carrying out with regard to the stone steps in the garden.
Linden Cottage C51 C01 S1759 Linden Cottage V237493 070705 Stage 4.doc Version 1.40 Page 14 • The environmental health requirements regarding the kitchen are to be met. Linden Cottage C51 C01 S1759 Linden Cottage V237493 070705 Stage 4.doc Version 1.40 Page 15 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) 35 Appropriate training is to be arranged to enable staff to meet residents’ needs. EVIDENCE: Training in breakaway techniques has been arranged but was cancelled due to staff shortage. As the home is currently experiencing challenging behaviour from one particular resident it is essential that this is re-arranged as soon as possible. Linden Cottage C51 C01 S1759 Linden Cottage V237493 070705 Stage 4.doc Version 1.40 Page 16 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) 37,42 The manager must apply for registration as soon as possible. The home’s staff recognise and promote residents’ health and safety. EVIDENCE: The manager is still not registered. This needs to be rectified as soon as possible. The inspector was informed that the fire safety officer has assessed the home and due to its size there is no need to upgrade the fire alarm system. The manager has ordered some new signing as recommended by the fire officer. Linden Cottage C51 C01 S1759 Linden Cottage V237493 070705 Stage 4.doc Version 1.40 Page 17 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 2 3 x x 1 Standard No 22 23
ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 x x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x 3 Standard No 31 32 33 34 35 36 Score x x x x 1 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Linden Cottage Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 1 x x x x 3 x C51 C01 S1759 Linden Cottage V237493 070705 Stage 4.doc Version 1.40 Page 18 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 5 Regulation 5 Requirement The provider is required to provide each resident with a written contract. This is outstanding from previous inspections. it is required that staff receive training appropriate to the work they perform. this is outstanding from the last inspection. The manager is required to apply for registration immediately. Timescale for action August 31st 2005 2. 35 18 August 31st 2005 31st July 2005 3. 37 9 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. 3. Refer to Standard 1 23 24 Good Practice Recommendations it is recommended that the manager ensures that the symbols for the residents guide are in place as soon as possible. It is recommended that adult protection is commenced as soon as possible and that aspects of the policy are discussed at staff meetings. It is recommended that the remaining areas of maintenance are completed as soon as possible. Linden Cottage C51 C01 S1759 Linden Cottage V237493 070705 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection The Pavilions 5 Smith Way Grove Park, Enderby Leicester, LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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