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Inspection on 04/07/05 for Polesworth Group Laurel End

Also see our care home review for Polesworth Group Laurel End for more information

This inspection was carried out on 4th July 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service continues to provide a warm, friendly home of exceptionally high environmental standards, where nine people of greatly varying needs and skills live together and are cared for in a very positive way by a dedicated, motivated, and well-organised staff team. What is particularly noteworthy is the supportive, respectful and tolerant way in which the people residing in the home live together.

What has improved since the last inspection?

Given that there were no requirements or recommendations following the last inspection, this is hard to judge. However, it is noted that the already high environmental standards have been further improved by the renovation and alteration of some bathroom and toileting facilities, so that they better meet service user needs.

What the care home could do better:

The home may benefit itself and service users by providing clearer evidence of the progress that people living in the home have made, and by having clearer aims, agreed with them as far as possible, for future development and achievements. Person-centred plans for all service users may help fulfil these aims.

CARE HOME ADULTS 18-65 Polesworth Group - Laurel End Laurel Avenue Polesworth Tamworth, Staffordshire B78 1LT Lead Inspector Martin Brown Unannounced 4 July 2005 3.30 pm 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. Polesworth Group - Laurel End E53 S4284 PG Laurel End V236699 040705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Polesworth Group - Laurel End Address Laurel Avenue Polesworth Tamworth Staffordshire B78 1LT 01827 896124 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) Polesworth Group Homes Limited Mrs Elizabeth Boucher PC - Care Home 9 Category(ies) of LD Learning disability - Number 9 registration, with number PD Physical disability - Number 2 of places Polesworth Group - Laurel End E53 S4284 PG Laurel End V236699 040705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 21 February 2005 Brief Description of the Service: Laurel End is part of Polesworth Group Homes which was established as a Limited Company in June 1991 with the aim of providing accommodation and support to adults with learning disabilities. The home cares for nine service users with medium to high levels of need, including two service users with physical disabilities as well as learning disabilities. The home is a large detached dormer bungalow in extensive grounds sited discreetlyon the edge of Polesworth. It offers seven single and one double bedroom. On the ground floor there are the shared facilities of a large conservatory and kitchen, dining room, lounge, laundry and bathroom. The bathroom is fully adapted to meet the disability needs with a walk-in shower and Parker bath. There are five bedrooms and a staff office also situated on the ground floor. On the first floor, extensions to the dormer roof space have created one double and three single bedrooms, one of which is a staff sleep in room. There is also another large bathroom with shower facility on this floor. Four bedrooms also have en-suite facilities.The Company’s offices and training room are based in the converted and extended former garages adjacent to the home. Land to the rear is used for an outdoor bowling green and agricultural and smallholding use where much of the fresh fruit, vegetables and eggs provided to all of the care homes in the Company is produced. Polesworth Group - Laurel End E53 S4284 PG Laurel End V236699 040705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection commenced at 3.30pm on July 4th 2005, lasting approximately four hours. The inspector was made welcome by staff, the assistant manager, and service users. What the service does well: What has improved since the last inspection? What they could do better: The home may benefit itself and service users by providing clearer evidence of the progress that people living in the home have made, and by having clearer aims, agreed with them as far as possible, for future development and achievements. Person-centred plans for all service users may help fulfil these aims. Polesworth Group - Laurel End E53 S4284 PG Laurel End V236699 040705 Stage 4.doc Version 1.40 Page 6 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. Polesworth Group - Laurel End E53 S4284 PG Laurel End V236699 040705 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 Polesworth Group - Laurel End E53 S4284 PG Laurel End V236699 040705 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 The most recent arrival at the home, who has lived here for six months or so, had settled in well. The home is able to meet the varying needs of the people living in the home in a satisfactory way. EVIDENCE: These standards were all met or exceeded at the previous inspection, and were not fully assessed on this occasion. Service user guides were available for each individual at the home, and contained general, clear information about the home, amply illustrated with photographs, as well as individual pictures and information concerning that user of the service. Polesworth Group - Laurel End E53 S4284 PG Laurel End V236699 040705 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) 6,7,9 A great deal of excellent work is obviously done with service users. This is apparent from the warm and positive interactions witnessed. More userfriendly individual plans and life stories with plenty of photographs might help show more clearly what service users have achieved, and provide a focus for them, and the home, for future development. Adoption of person–centred plans by all might also assist in focusing on individual aspirations for the future, or underline people’s satisfaction with their current lives. EVIDENCE: Individual plans contain up-to-date reviews and recordings about service users. Relevant medical details were seen. One file noted a service users’ diagnosis of autism, but contained little further information on how this impacted on her daily life and the implications for her care. The manager advised that the majority of this information is in the main office. All plans and files seen regarding service users tended to be about them, rather than giving a sense of being done with them. It was difficult to gauge from individual files what individual progress has been made, and what are the plans and aims for individual development in the future. Polesworth Group - Laurel End E53 S4284 PG Laurel End V236699 040705 Stage 4.doc Version 1.40 Page 10 The assistant manager advised that one person living at the home had had a person-centred plan. Risk assessments are listed, and the management of each assessment is listed following these. Service users were consulted on all aspects of their daily lives; staff took little, if anything, for granted in respect of service users’ wishes. One lady told me of her involvement in various groups and committees, where she can raise issues on behalf of other service users. Polesworth Group - Laurel End E53 S4284 PG Laurel End V236699 040705 Stage 4.doc Version 1.40 Page 11 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) 12,13,16,17 The atmosphere in the home indicated that it was one in which people led busy and fulfilled lives, and in which they were enjoying the early evening within the home after a worthwhile day. Staff worked hard for the service users’ benefit, particularly at mealtime. There may be scope for encouraging service users to help a little more with minor chores. EVIDENCE: Staff organised, with very little bother or fuss, dominoes before tea, and a game of bingo afterwards, which over half the service users either joined in or watched with interest. Over half the people living at the home attend regular day services, other have or attend activities organised more directly by the home. One service user is currently attending college. Staff advised that service users will often go fior a walk locally, and that the home is fortunate in being sited where both country and shops are within walking distance. Service users enjoyed each others’ company, with much good-natured banter going on. Meal time was a relaxed, long lasting affair, added to on this Polesworth Group - Laurel End E53 S4284 PG Laurel End V236699 040705 Stage 4.doc Version 1.40 Page 12 occasion by it being someone’s birthday. Healthy food, enjoyed by all was in evidence, with preferences and dietary needs being catered for within the overall provision of a ‘family’ meal. Polesworth Group - Laurel End E53 S4284 PG Laurel End V236699 040705 Stage 4.doc Version 1.40 Page 13 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 Staff offer personal support in a natural, efficient manner that contributes to the positive atmosphere within the home. EVIDENCE: Staff were seen to dealt with minor mishaps calmly and with the minimum of fuss. Service users appeared to take their cue from this, and were equally unflustered by them. Similarly, individual support needs were managed effectively and naturally. Professional support and involvement is detailed in individual files. Medication procedures, administration and recording was seen to be appropriate. It was noted that the pre-prepared medication packs, normally attached to be on vertical surfaces (usually the inside of the medication doors), were stacked flat. The manager advised that staff found this storage appropriate. Polesworth Group - Laurel End E53 S4284 PG Laurel End V236699 040705 Stage 4.doc Version 1.40 Page 14 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 Service user views are heeded and acted upon, and staff and the home act in the service users’ best interests. EVIDENCE: The complaints log was seen to contain one complaint, which had been dealt with and responded to by drawing staff attention to it at the regular staff meetings. The home has regular service user and quality assurance reviews to ascertain views and anticipate dissatisfactions, and one service user has a regular voice on various committees, representing service users. The concerns raised during the inspection concerned difficulties unconnected with the direct care of the home. Service users indicated to me either directly, or through other interactions, that they were happy with the care provided; either that, or they took good care for granted and had other pre-occupations. Polesworth Group - Laurel End E53 S4284 PG Laurel End V236699 040705 Stage 4.doc Version 1.40 Page 15 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 Service users benefit from a very well-maintained environment of a very high standard. EVIDENCE: The home continues to be very well maintained and of a very high standard, providing a comfortable, homely place where service users had plenty of space, and were free to be in company, and on their own as they wished. Aids are provided, where required, and the home is clean and hygienic throughout. When one service user was sick, the floor was cleaned quickly and effectively with the minimum of bother. On the day of the inspection, most service users preferred to spend their time around the kitchen area and in the conservatory area next to the kitchen. There is plenty of outdoor space that is obviously well-used, although the vagaries of an English summer limited its use on this occasion. Polesworth Group - Laurel End E53 S4284 PG Laurel End V236699 040705 Stage 4.doc Version 1.40 Page 16 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) 31,32,33 Staff very quickly pick up on the positive and supportive ethos of the home. EVIDENCE: Interactions between staff and service users were relaxed, and friendly. Staff were seen to deal with any difficulties in a calm, and positive, way. Staff were all very respectful of service users and their rights. Some of the staff on duty were relatively recent recruits to the home, but had already adopted the same positive, unflustered, approach of other, more experienced staff. Staff supported service users in leading activities, seeking to involve people, but leaving the choice very much up to individuals. Detailed staff minutes showed that staff meetings take place regularly, with the focus rightly being on improving the lives of service users. Polesworth Group - Laurel End E53 S4284 PG Laurel End V236699 040705 Stage 4.doc Version 1.40 Page 17 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) 37,38,39,42. The service users‘ positive, supportive attitude towards each other reflects the positive, supportive and consistent attitudes fostered by the home through its staff. EVIDENCE: The home has regular service user reviews, using service user- friendly questionnaires, to obtain evidence of service user views. In many instances, they are assisted in these by staff. Service users spoken to were happy with the care and opportunities at Laurel End. Good procedures were seen to be in place and practiced by staff to ensure the health and safety of service users. Fire doors have noise sensitive closures on them, installed after consultation with the local fire safety officer. The effectiveness of these are tested as part of regular fire tests. The manager advised that the night time fire procedure had been clarified after consultation with the fire officer. The home’s awareness of the particular importance of night time fire safety is indicated by the night safety routine prominently Polesworth Group - Laurel End E53 S4284 PG Laurel End V236699 040705 Stage 4.doc Version 1.40 Page 18 displayed next to the alarm system. One service user has a doorguard closure device on his bedroom door. Polesworth Group - Laurel End E53 S4284 PG Laurel End V236699 040705 Stage 4.doc Version 1.40 Page 19 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 x x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 x x x x x 4 Standard No 11 12 13 14 15 16 17 x 3 3 x x 3 3 Standard No 31 32 33 34 35 36 Score 3 3 4 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Polesworth Group - Laurel End Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 4 3 x x 3 x E53 S4284 PG Laurel End V236699 040705 Stage 4.doc Version 1.40 Page 20 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 Regulation Requirement There are no requirements following this inspection. Timescale for action 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 6 Good Practice Recommendations It is recommended that the home has person centred plans for all the people living at the home, that life story books are developed for each person, and that personal development, and individual aims are more clearly recorded, and are, as far as possible, from a service users point of view. It is recommended that the smoke seal on one service users’ bedroom fire door is regularly checked to ensure that it is not compromised by the opposing pressures of the spring closure at the top and the doorguard at the bottom. It is recommended that each risk assessment, and its management, is put together, rather than listed separately. 2. 42 3. 9 Polesworth Group - Laurel End E53 S4284 PG Laurel End V236699 040705 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Polesworth Group - Laurel End E53 S4284 PG Laurel End V236699 040705 Stage 4.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!