This inspection was carried out on 8th November 2005.
CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.
CARE HOME ADULTS 18-65
Linden Cottage 87 Byron Street Loughborough Leicestershire LE11 5JN Lead Inspector
Steve Hunnybun Unannounced Inspection 8th November 2005 1400hr Linden Cottage DS0000001759.V264815.R02.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Linden Cottage DS0000001759.V264815.R02.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Linden Cottage DS0000001759.V264815.R02.S.doc Version 5.0 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 Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Aspire Lifestyle Limited Vacant Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Linden Cottage DS0000001759.V264815.R02.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. No additional conditions of registration. Date of last inspection 7th July 2005 Brief Description of the Service: Linden Cottage is a small home that is registered to provide care for three residents with learning disabilities. Two residents lived at the home at the time of this inspection. 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, bathroom and kitchen. 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 DS0000001759.V264815.R02.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the second statutory unannounced inspection this year. The inspector spent time with both residents and spoke with a team leader and a member of the care staff. Ten of the National Minimum Standards were looked at on this occasion. What the service does well: What has improved since the last inspection? What they could do better:
The residents’ guide needs to be produced in a format that is accessible to people with a learning disability. Residents need a copy of their contract that is in an accessible format and is explained to them. The provider needs to review the amount of money available for food. The medication drawer was
Linden Cottage DS0000001759.V264815.R02.S.doc Version 5.0 Page 6 unlocked on the day of the inspection, which is potentially dangerous. Staff have not yet received training regarding the protection of vulnerable adults. The remaining areas of improvement regarding the premises need attending to as soon as possible. The manager needs to complete the registration process as soon as possible. A risk assessment needs to be completed regarding fire safety at night for the deaf resident. 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 DS0000001759.V264815.R02.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Linden Cottage DS0000001759.V264815.R02.S.doc Version 5.0 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 the following standard(s): 1,5 Residents are not able to access information about the home at the point of referral. Residents do not have access to information about the terms and conditions at the home. EVIDENCE: None of the residents’ files contained a guide to the home that was accessible to people with a learning disability. Staff present confirmed that this piece of work has not yet been completed. Residents have not been issued with copies of contracts as required by Regulation 5. The above items have been subject to recommendations and requirements at previous inspections. Linden Cottage DS0000001759.V264815.R02.S.doc Version 5.0 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 the following standard(s): 7 Residents are supported to make decisions about their lives. EVIDENCE: Residents are enabled to make choices in their everyday lives. Staff stated that this is done and it was observed during the inspection when drinks were made. Care plans state residents’ preferred communication methods and these are used. Residents have communication difficulties, one being profoundly deaf, and symbols are provided throughout the home to enable them to communicate their needs and wishes. Linden Cottage DS0000001759.V264815.R02.S.doc Version 5.0 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 the following standard(s): 16,17 Residents’ rights are respected and they are given responsibilities where appropriate. The food budget does not appear to be sufficient to provide a healthy, nutritious diet. EVIDENCE: Access to all areas of the home is only limited by residents’ risk assessments. Symbols are displayed throughout the home to enable those with communication difficulties to find their way round. The deaf resident who has recently moved to the home has a push button light for his room to alert him when a member of staff wishes to enter. Staff were observed using residents preferred form of address during the inspection. Residents’ files contained information about domestic tasks that they like to help with. The budget for food equates to an average of £1.20 per resident per meal. This needs to be reviewed to ensure that it is enough to provide a balanced nutritious diet. Linden Cottage DS0000001759.V264815.R02.S.doc Version 5.0 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 the following standard(s): 20 The medication drawer being unlocked potentially placed residents at risk. EVIDENCE: Although medication was not specifically looked at on this occasion it was noted that the medication drawer was not locked when the inspector arrived. This is unacceptable and potentially dangerous. Linden Cottage DS0000001759.V264815.R02.S.doc Version 5.0 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 the following standard(s): 23 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 adult protection policy and has a copy of the MultiAgency Vulnerable Adult Protection document No Secrets. Staff present stated that they have not yet received training on the protection of vulnerable adults. Linden Cottage DS0000001759.V264815.R02.S.doc Version 5.0 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 the following standard(s): 24 Further progress has been made to meet the previous requirements. The remaining areas need attending to as soon as possible. EVIDENCE: The lounge has been decorated since that last inspection. The following areas still require attention: • • The kitchen needs redecorating and the units need replacing The environmental health requirements regarding the kitchen are to be met. Staff present stated that the following items would be attended to prior to the third bed being filled: • • 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 DS0000001759.V264815.R02.S.doc Version 5.0 Page 14 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34, 35 Residents are protected by the home’s recruitment policy. Staff are generally appropriately trained (see standard 23). EVIDENCE: The home has a robust recruitment and selection procedure. All candidates are required to provide two satisfactory references and a clear CRB check. Staff present stated that candidates are encouraged to look round the home and meet the residents when they attend for interview. Staff stated that they are offered a comprehensive training package. The team leader present stated that she and the manager are currently undertaking NVQ 4 and the registered manager’s award. Several other staff are completing NVQ courses. In addition staff have attended breakaway training, health & safety and care planning. Adult protection training is not currently offered, this has been recommended under standard 23. Linden Cottage DS0000001759.V264815.R02.S.doc Version 5.0 Page 15 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39,42 The home has no registered manager. Residents and stakeholders views are sought. There is potential risk to the deaf resident of not being aware of fire at night. EVIDENCE: The manager is not yet registered. The head of care monitors the home regularly and reports are sent to the commission. Questionnaires are left for visitors to complete. There is no visual alert for the deaf resident in the event of a fire, however the home is currently considering introducing waking night staff. It would be desirable for a risk assessment to be completed in the meantime. Linden Cottage DS0000001759.V264815.R02.S.doc Version 5.0 Page 16 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 X X X 1 Standard No 22 23 Score X 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X X X Standard No 24 25 26 27 28 29 30
STAFFING Score 2 X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X X X X 3 X CONDUCT AND MANAGEMENT OF THE HOME 1 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Linden Cottage Score X X 1 X Standard No 37 38 39 40 41 42 43 Score 1 X 3 X X 2 1 DS0000001759.V264815.R02.S.doc Version 5.0 Page 17 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 YA5 Regulation 5 Requirement Timescale for action 31/12/05 2. YA17 16(2)(i) 3. 4. YA20 YA37 13(2) 9 The provider is required to provide each resident with a written contract. This is outstanding from previous inspections. The provider is required to 31/12/05 review the budget for food within the home and increase it accordingly. It is required that the medication 30/11/05 drawer is kept locked at all times when not in use. The manager is required to apply 30/11/05 for registration immediately. This is outstanding from previous inspections. 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. Refer to Standard YA1 Good Practice Recommendations It is recommended that the manager ensure that the symbols for the residents guide are in place as soon as possible.
DS0000001759.V264815.R02.S.doc Version 5.0 Page 18 Linden Cottage 2. 3. 4. YA23 YA24 YA42 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 be completed as soon as possible. It is recommended that a risk assessment be completed in relation to the deaf resident and the risk of fire at night. Linden Cottage DS0000001759.V264815.R02.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Leicester Office 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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