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Inspection on 28/02/07 for 8 Lansdowne Road

Also see our care home review for 8 Lansdowne Road for more information

This inspection was carried out on 28th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 home consistently meets and exceeds the key national minimum standards ensuring positive outcomes for the service users. Care plans reflect assessed needs and are detailed and informative, ensuring that staff are able to support the service users to maintain their independence appropriately. Comprehensive risk assessments enable residents to take meaningful risks in a safe manner. The service users are actively supported to make decisions about their lives on a daily basis. Service users health and personal support needs are promoted via attendance at routine and more specialised healthcare appointments as necessary. Medication is managed safely on the service users behalf. The home has both a complaints policy and an adult protection policy in place. At the time of this inspection no complaints had been received by the home or the Commission for Social Care Inspection. Staff were aware of their responsibilities regarding adult abuse. No allegations or suspicions of abuse have been received by the Commission for Social Care Inspection. Staff numbers were satisfactory. Recruitment practices ensure that service users are safeguarded. Training undertaken by the staff team ensures that a competent and sufficiently knowledgeable team supports the service users. The home was well managed, however it must be noted that the manager at the time of the inspection was leaving following promotion within the organisation. Service users views regarding the quality of the service provided are sought, and acted upon thus ensuring that they are at the forefront of service delivery and development. Health and safety is managed well in the home.

What has improved since the last inspection?

No requirements were made at the previous inspection. The home continues to operate in such a way that ensures positive outcomes for the service users.

What the care home could do better:

No requirements or recommendations were deemed necessary at this inspection.

CARE HOME ADULTS 18-65 SCIC - Lansdowne Road, 8 8 Lansdowne Road Studley B80 7RB Lead Inspector Justine Poulton Key Unannounced Inspection 28th February 2007 14:00 SCIC - Lansdowne Road, 8 DS0000004461.V315032.R01.S.doc Version 5.2 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 SCIC - Lansdowne Road, 8 DS0000004461.V315032.R01.S.doc Version 5.2 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. SCIC - Lansdowne Road, 8 DS0000004461.V315032.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service SCIC - Lansdowne Road, 8 Address 8 Lansdowne Road Studley B80 7RB 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) 01789 298709 01789 296724 Stratford & District Mencap Ms Mandy Whitby Care Home 3 Category(ies) of Learning disability (3), Learning disability over registration, with number 65 years of age (2) of places SCIC - Lansdowne Road, 8 DS0000004461.V315032.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age Range of Residents People admitted to the home must be in the age range of 18 to 64 years. 12th December 2005 Date of last inspection Brief Description of the Service: Lansdowne Road is registered for 3 adults who have learning disabilities. Currently all residents are men. The home shares a staff group with other services run by SCIC in the neighbourhood. 8 Lansdowne Road is a four bed roomed detached house in a residential neighbourhood; it is indistinguishable as a care home from the neighbouring properties. On the ground floor is a large living/dining room. There are gardens to the front and rear of the house. The ground floor including the bedroom is wheelchair accessible, with a level access shower room. SCIC - Lansdowne Road, 8 DS0000004461.V315032.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the first key inspection in relation to Inspecting for Better Lives. Identified key standards were looked at. The pre fieldwork documentation was completed, as well as a site visit to the home, during which time staff, service users and the manager were spoken with. Two residents were identified for close examination by reading their care plans, risk assessments, daily records and other relevant information. This is part of a process known as ‘case tracking’ where evidence is matched to outcomes for service users. Records, policies and procedures were examined and the environment was looked at. All of the service users were at home for all or part of the inspection. Three service user surveys were received prior to the inspection being undertaken. All three were positive and indicated satisfaction with the service received. The inspector would like to thank the service users, manager and staff for their hospitality and co-operation during the inspection. The fee for this home was recorded as £290.00 per week in the pre inspection questionnaire received prior to the inspection. What the service does well: The home consistently meets and exceeds the key national minimum standards ensuring positive outcomes for the service users. Care plans reflect assessed needs and are detailed and informative, ensuring that staff are able to support the service users to maintain their independence appropriately. Comprehensive risk assessments enable residents to take meaningful risks in a safe manner. The service users are actively supported to make decisions about their lives on a daily basis. Service users health and personal support needs are promoted via attendance at routine and more specialised healthcare appointments as necessary. Medication is managed safely on the service users behalf. The home has both a complaints policy and an adult protection policy in place. At the time of this inspection no complaints had been received by the home or the Commission for Social Care Inspection. Staff were aware of their responsibilities regarding adult abuse. No allegations or suspicions of abuse have been received by the Commission for Social Care Inspection. SCIC - Lansdowne Road, 8 DS0000004461.V315032.R01.S.doc Version 5.2 Page 6 Staff numbers were satisfactory. Recruitment practices ensure that service users are safeguarded. Training undertaken by the staff team ensures that a competent and sufficiently knowledgeable team supports the service users. The home was well managed, however it must be noted that the manager at the time of the inspection was leaving following promotion within the organisation. Service users views regarding the quality of the service provided are sought, and acted upon thus ensuring that they are at the forefront of service delivery and development. Health and safety is managed well in the home. What has improved since the last inspection? What they could do better: 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. SCIC - Lansdowne Road, 8 DS0000004461.V315032.R01.S.doc Version 5.2 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 SCIC - Lansdowne Road, 8 DS0000004461.V315032.R01.S.doc Version 5.2 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): x EVIDENCE: No new service users have moved into the home since the last inspection in December 2005 therefore key standard 2 was not applicable on this occasion. SCIC - Lansdowne Road, 8 DS0000004461.V315032.R01.S.doc Version 5.2 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): 6, 7, 9 Quality in this outcome area is excellent. Comprehensive, detailed care plans and risk assessments ensure that the service meets the service users individual needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each service user continues to have a care plan which is reviewed on a regular basis. The last recorded review dates within the two care plans looked at for case tracking purposes confirmed that they had both been reviewed within the previous six months. Areas of care and support covered within these care plans included such things as general health, medication, exercise and diet, leisure and holidays and friendships and relationships. Also detailed within the plans were service users identified areas of need, the aim of the care plan and the action to be taken to meet the need. It was also noted that the service users are involved in their care planning, and sign them to say that they agree with them. Risk assessments also continue to be in place and updated regularly in line with the service users care plans. The homes approach to risk management SCIC - Lansdowne Road, 8 DS0000004461.V315032.R01.S.doc Version 5.2 Page 10 ensures that there is a balance between enabling the service users to retain their levels of independence within a safe framework. Areas covered by the risk assessments in the two care plans looked at included such things as travel and mobility, fire, security of medication, health and personal hygiene and vulnerability. It was apparent from talking to the service users and staff that they are fully involved in making decisions about their day to day lives, choosing what activities they wish to undertake, what to have for dinner and what to watch on the television were just three examples that were given during the inspection. SCIC - Lansdowne Road, 8 DS0000004461.V315032.R01.S.doc Version 5.2 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 the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome are is excellent. Service users participate in a variety of age, peer and culturally appropriate activities, ensuring that they have a varied lifestyle that meets their needs. A healthy nutritious diet which takes into account the needs of older people is provided. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two of the three service users resident in the home have retired, however they spoke of a variety of activities that they choose to take part in. Both told of how they enjoy taking themselves off on the bus for trips into nearby Stratford upon Avon. Other activities included attending church, going to a local gateway club, accessing local clubs for older people within the town, and generally retaining their independence out and about. All three of the service users have local bus passes, which assists them with their independence. In house activities included watching favourite programmes on the television, listening to music, collecting things and art and crafts. The third service user resident in the home spends his week working either as a volunteer at a local charity shop or a local workshop called “Where Next Industries”. During the inspection service users talked about holidays that they had been on or were planning. SCIC - Lansdowne Road, 8 DS0000004461.V315032.R01.S.doc Version 5.2 Page 12 All three of the service users are very much part of the local community. They have friends that live locally that see on a regular basis. Records of these were available within heir care plan files. The home has a functional domestic kitchen, that was clean and tidy on the day of the inspection. During the inspection the service users participated in planning the menu for the next week, with the staff member on duty ensuring that all three were able to choose at least 2 two evening meals, and a joint agreement for the remaining evening meal. One service user told of how he is on a healthy eating diet. This was encouraged by staff and reflected in the menus. The kitchen was well stocked with a varied selection of fresh, frozen and tinned foods available. Throughout the inspection the service users made themselves drinks as they wanted them, and also offered drinks to the manager and inspector each time. SCIC - Lansdowne Road, 8 DS0000004461.V315032.R01.S.doc Version 5.2 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 the following standard(s): 18, 19, 20 Quality in this area is good. Service users receive personal care and support in line with their assessed needs. Service users healthcare needs are monitored and addressed. Medication is managed safely. This judgement has been made using available evidence including a visit to the service. EVIDENCE: All three of the service users resident in the home have minimal personal care needs, being independent in this area for much of the time. However, their increasing age requires staff to be available to provide support and assistance as required. At the time of the inspection any personal care needs related to prompting only, but the manager said in discussion that this could change swiftly given the age of two of the service users. The current level of personal support required by two of the service users was detailed in their care plans. Information was available within the two service users plans looked at to confirm that their routine and more specialised healthcare needs are met. Visits to the Dentist and Opticians were recorded, as were visits to specialist clinics, the GP and hospital appointments. The results of health screens undertaken by the Community Learning Disability team were also available. The manager said that these are undertaken approximately every two years, and are due again sometime in the summer of this year. SCIC - Lansdowne Road, 8 DS0000004461.V315032.R01.S.doc Version 5.2 Page 14 The home manages the service users prescribed medication on their behalf. It is supplied by a local pharmacist in blister packs, and is accompanied by medication administration record charts. Only two of the service users were prescribed medication at the time of the inspection, and no concerns were highlighted with regards to the administration and recording of medication. The manager said that all staff have to undertake medication training before they are able to administer it to service users. This was confirmed by the staff training records. SCIC - Lansdowne Road, 8 DS0000004461.V315032.R01.S.doc Version 5.2 Page 15 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): 22, 23 Quality in this area is good. The homes policies, procedures and practices on complaints and abuse ensure that service users views are listened to and acted upon, and help to protect service uses from potential harm. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The home has both complaints and protection form abuse policies and procedures in place. Service users spoken with were quite clear about what they would do should they have a complaint about anything. The home maintains a complaints log which the manager audits on a regular basis. No complaints hade been received by the home or the Commission for Social Care Inspection at the time of the inspection. Staff training records informed that only 2 members of staff have received formal training in the protection of vulnerable adults from abuse, however eight staff have achieved their NVQ II or III, which would have incorporated training in protection from abuse. Staff spoken with were clear about their responsibilities should abuse be suspected or disclosed. SCIC - Lansdowne Road, 8 DS0000004461.V315032.R01.S.doc Version 5.2 Page 16 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, 30 Quality in this outcome group is good. The appearance of this home creates a pleasant, comfortable and homely environment that is well maintained. The presents as clean and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: 8 Lansdowne Road is a four bed roomed detached house in a residential neighbourhood. It is indistinguishable as a care home from the neighbouring properties. On the ground floor is a large living/dining room, downstairs bedroom with e suite and kitchen. The first floor has the remaining three bedrooms, a bathroom, toilet and office / sleep in room. There are gardens to the front and rear of the house. The ground floor including the bedroom and en suite are wheelchair accessible. On the day of the inspection the home presented as comfortable and homely. It was clean and tidy with no offensive odours evident. A policy on infection control is in place, and staff adhere to its principles. SCIC - Lansdowne Road, 8 DS0000004461.V315032.R01.S.doc Version 5.2 Page 17 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): 32, 34, 35 Quality in this outcome group is good. Service users benefit from sufficient numbers of competent, knowledgeable staff who have been recruited appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home continues to be staffed by a regular staff group that also work at other services belonging to the organisation. The manager said that given the abilities of the service users it is not necessary to provide staff 24 hours a day 7 days a week. Risk assessments were in place with regards to this. The manager also said however that if the needs of the service users require more staff support than is planned on a weekly basis, it is put in place immediately utilising the staff pool. One member of staff had been employed to work for the organisation since the previous inspection. Documentation to confirm that satisfactory recruitment processes that safeguard the service users was in place for this staff member. Staff records continue to be stored at another of the organisations larger homes. The manager forwarded copies of staff training records subsequent to the inspection. These records confirmed that staff received mandatory training and refresher sessions at the recommended intervals. These records also confirmed that 7 staff members have successfully completed their NVQ II in SCIC - Lansdowne Road, 8 DS0000004461.V315032.R01.S.doc Version 5.2 Page 18 Care or above, with a further 3 currently in the process of completing it. Staff are also registered on the Learning Disability Awards Framework. SCIC - Lansdowne Road, 8 DS0000004461.V315032.R01.S.doc Version 5.2 Page 19 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): 37, 39, 42 Quality in this outcome area is good. The home is well run, the views of service users are sought and promoted, and health and safety is managed effectively. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the time of the inspection an experienced, competent manager was managing the home. This manager was leaving shortly following promotion within the organisation. The manager advised that her replacement was another manager from within the organisation. Service users spoke of their sadness at the manager leaving, but said that they knew the replacement manager already. The home operates a quality monitoring system on an annual basis. This includes service users surveys, surveys fro staff and other professionals associated with the home. The results are collated and a report for action formulated from these. A sample of surveys from last tears survey were seen SCIC - Lansdowne Road, 8 DS0000004461.V315032.R01.S.doc Version 5.2 Page 20 during this inspection, as this years had not been undertaken at the time of this inspection. The service users do not hold formal meetings as they prefer to voice their concerns and wishes on an informal basis as they arise. A representative of the organisation undertakes regulation 26 visits on a regular basis. The reports from these were available in the home. Health and safety is maintained within the home. A sample of health and safety records within the home, which included Portable Electrical Testing(PAT), a landlords gas safety certificate, the water log, fire safety records and the control of substances hazardous to health, confirmed that they were all up to date. Generic risk assessments relating to the service were also in place. SCIC - Lansdowne Road, 8 DS0000004461.V315032.R01.S.doc Version 5.2 Page 21 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 Standard No Score 1 x 2 x 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 x 3 x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 x 15 x 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x SCIC - Lansdowne Road, 8 DS0000004461.V315032.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement 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. Refer to Standard Good Practice Recommendations SCIC - Lansdowne Road, 8 DS0000004461.V315032.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Leamington Spa Office 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 SCIC - Lansdowne Road, 8 DS0000004461.V315032.R01.S.doc Version 5.2 Page 24 - 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!