Inspection on 09/03/09 for 8 Lansdowne Road

This inspection was carried out on 9th March 2009.

CSCI found this care home to be providing an Excellent service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

8 Lansdowne Road 28/02/07

8 Lansdowne Road 12/12/05

8 Lansdowne Road 23/08/05

8 Lansdowne Road 24/03/05

8 Lansdowne Road 26/02/04

8 Lansdowne Road 23/11/03

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10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: SCIC - Lansdowne Road, 8 8 Lansdowne Road Studley B80 7RB     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Martin Brown     Date: 0 9 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: SCIC - Lansdowne Road, 8 8 Lansdowne Road Studley B80 7RB 01789298709 01789296724 david@stratfordmencap.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Stratford & District Mencap care home 3 Number of places (if applicable): Under 65 Over 65 2 learning disability Additional conditions: 3 Age Range of Residents People admitted to the home must be in the age range of 18 to 64 years. Date of last inspection Brief description of the care home 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. Care Homes for Adults (18-65 years) Page 4 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This report has been made using information that has been gathered by the Commission for Social Care Inspection. The inspection visit took place on 9th March, 2009, between 2.45pm and 6pm. The home did not know we were coming. Two of the three people who live at 8 Lansdowne Road were seen during that time, as was the manager, and the member of staff on duty. A tour of the premises was made, relevant documentation was looked at, and observations of the interactions between residents, staff and their environment were made. Policies and procedures, and care records, were examined, and two people living in the home were case tracked. That is, their experience of the service provided by the home was looked at in detail. Specific elements of the other persons care and support Care Homes for Adults (18-65 years) Page 5 of 26 were also looked at in detail. The Annual Quality Assurance Assessment, containing information about the service, completed by the service, and returned before the inspection, also informed the inspection. The Annual Quality Assurance Assessment gives the services own assessment of what the service does well, and what it could improve on. The two people living at the home who were spoken with were able to offer their views on the service. The manager and staff were able to provide additional information. Residents, management and staff were welcoming and helpful throughout. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Anyone considering moving to Lansdowne Road can be confident of having an introductory process conducted at their pace. This helps all concerned to be confident that the service can reasonably meet their particular needs and wishes. Evidence: There have been no new admissions to this service for a number of years. No new admissions are anticipated in the near future. The Annual Quality Assurance Assessment returned by the manager outlined the process by which any prospective admission would be managed. This includes introductory visits, a settling in period and feedback from all concerned. Care Homes for Adults (18-65 years) Page 9 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Lansdowne road are supported by up to date care plans. They are able to make choices and decisions in their day-to-day lives, and take managed risks. Evidence: Each person living at 8 Lansdowne Road continues to have care plans that are regularly reviewed. The main documentation that guides and reflects support and care for each person are individual support plans, which details specific individual needs and risks and how support and risks are managed. These are clear, concise and regularly reviewed. However, there was a lot of material, relating to earlier reviews and records, which made these files rather bulky. This makes the more immediate information, such as the current care and support plans, a little less immediately accessible. The two people spoken with were clearly at ease in their own home, and were able to make decisions, supported by staff, concerning their daily lives. The only limit on their choices was if they wished to do things that required staff support, such as going to Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: unfamiliar places, and staff support for this was not available. Risk assessments showed individual risks being assessed and managed to allow individuals to maximise their independence. For example, individuals travel on familiar routes independently. Staff are aware of where they are going, of expected return times, and there is a clear missing persons procedure. Residents information is kept securely. It is locked away, but residents were aware of where the key was to access this information, if they wished to. Care Homes for Adults (18-65 years) Page 11 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Lansdowne road are a part of their local and wider community. They enjoy various leisure activities and relationships, and healthy varied meals. The service respects and promotes individual rights and responsibilities. Evidence: Two people living at the home spoke of contacts with local shops, clubs, and of regular trips on local buses to shops and local towns. One spoke of regularly winning prizes at a raffle at a local pensioner club. Both had their own routines that they were comfortable with, involving particular shops, churches and areas. One person was looking forward to a holiday in Disneyland, or Donald Duck land, as they referred to it as. Residents had hobbies and interests in the home, with one upstairs room having a Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: computer and painting materials, which are used by two residents. One resident was keen to show me their music and video collection. The television was on, during the inspection, with one person in particular enjoying a film, principally because it featured aeroplanes. Residents also spoke of friends and visitors, and one person made a brief visit during the inspection. The visitor book showed a wide variety of visitors at various times and dates. The people living in the home are supported in making meals and snacks, and staff cook the evening meal. The kitchen and fridge was well-stocked, and both residents spoken with said they were happy with the food. they prepare their own drinks when they wish. Care Homes for Adults (18-65 years) Page 13 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at Lansdowne Road receive sensitive, professional, and sympathetic support in line with their current needs. They can be confident that the service will continue to monitor to ensure that any increasing needs are properly managed. Evidence: The current level of personal support required by two of the service users was detailed in their care plans. All three of the service users resident in the home are independent in many aspects of their lives for much of the time. However, the increasing age of at least one of them requires staff to be available to provide support and assistance as required. Items such as a bath chair are in place for one person, as well as grab rails in the shower area. The manager discussed increasing and arguably age-related support needs for one person in the less clear cut area of mental and emotional well-being, being able to explain how this was being managed, and how the service hoped to carry on managing this in future. Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: The manager and staff showed a good awareness of potential difficulties arising from this, and how they were managed. A key worker system is in operation. Residents were aware of who their key workers were, although not, in one case, by name. Visits to the Dentist and Opticians were recorded, as were visits to specialist clinics, the GP and hospital appointments. The manager was able to explain how one persons health difficulties had been managed. The manager was also able to demonstrate in discussion how a particularly delicate area of one residents well being was dealt with in a sensitive, professional and sympathetic manner. Medication records were looked at. These showed medication being properly dispensed and accurately recorded. It was good to see that pharmaceutical advice regarding items to be avoided with one medication was highlighted and followed. Care Homes for Adults (18-65 years) Page 15 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Lansdowne Road can be confident that concerns are listened to and acted upon, and that the service protects them against potential harm. Evidence: The complaints log was seen. This principally detailed concerns recorded by staff where two people living at the home had highlighted concerns with each other. The manager and staff member was able to explain how they difficulties were managed and minimised. These difficulties aside, residents said they very much liked living at Lansdowne road. The complaints log showed that concerns and complaints were responded to. Staff and management showed a good awareness of abuse issues and what to do if there were concerns in this area. Records of residents monies were seen. The service supports those residents who require help with their finances by holding and recording it for them, and, where wished for, by giving out a daily amount. The resident signs, alongside staff, to show that this money, usually around two or three pounds daily, has been given, in accordance with agreed procedure. In two instances in recent weeks, there was only a staff signature. The manager agreed that this was unacceptable, and would ensure Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: that in future that all transactions are always signed by staff and resident, or if not, a clear reason is attached. Care Homes for Adults (18-65 years) Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at 8 Lansdowne Road continue to enjoy living in a clean, pleasant and homely domestic environment. There has been some renovation, and residents were very comfortable and at home in their house. 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, kitchen, and downstairs bedroom with en suite facilities. The first floor has the remaining three bedrooms, a bathroom, toilet and office cum staff sleep in room. The ground floor, including the bedroom and en suite, are wheelchair accessible. There are gardens to the front and rear of the house. The gardens are wellmaintained, by a visiting gardener. One resident in particular, was clear that he enjoyed the garden. The garden is nice, he said, and talked of how he enjoyed the birds that the bird feeder attracted. The home was fresh and clean. Two bedrooms seen were clean and personalised according to the wishes of the occupants. There is also a room dedicated to individual Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: activities, notably painting and computer use. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from sufficient numbers of competent, knowledgeable staff who have been recruited appropriately. As age related needs increase, staffing may have to change to take account of this. Evidence: The home continues to be staffed by a regular staff group that also work at other services belonging to the organisation. Recruitment and training records for these staff have been examined at recent inspections for these services and seen to be satisfactory. The staff on duty was spoken with and was happy with the level of training, support and supervision. The staff were knowledgeable about the needs of those living at the service and how to meet those needs, and how to manage risks. I like the staff, was one residents comment. Staffing is flexible to meet the needs of the residents, although the manager expressed a wish for more funding to enable staff to be more available at certain key times, to help forestall potential difficulties. These difficulties were discussed. At Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: present they are managed by staffing being flexible. The manager was concerned that an increase in age-related needs may require more intense staffing in future. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home benefit from a well run home that strives to maintain and improve on high standards. The service is sensitive to the varying needs of the people living at the home, and ensures they live in a safe environment. Evidence: The home is managed by an experienced manager who also has responsibilities for other services within the organisation. She demonstrated a very good awareness of the needs of all those living at 8 Lansdowne Road, of how these are likely to change in the future, and what will need to be done to ensure these will continue to be met. The Annual Quality Assurance Assessment returned by the manager showed a good awareness of the strengths and achievements of the service, as well as a good awareness of how the service could be improved, and how this could be done. Quality Assurance takes place through feedback from independent visits under Regulation 26 of the Care Standards Act, whereby a representative of the registered provider visits and comments on the service. Residents views, as well as relatives and others with a Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: valid interest in the well being of residents, are sought, in order that the service gets an overall view of how well it is doing. Residents do not have formal meetings, but express their views when issues occur, or when they are asked individually. The manager showed great sensitivity to the differing needs and views of those living in the home, and how these are best gathered and addressed. She also showed a good awareness of the possibility of changing needs and a determination that the service should be able to meet these. Health and Safety checks continue to be maintained, and no hazards were noted during the inspection. Staff discussed the purpose and frequency of fire drills. Fire safety arrangements were discussed, and the manager agreed to revisit those in place at night time. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 23 16 All records of monies 13/04/2009 handled on behalf of residents should adhere to agreed procedures, requiring both staff and resident to sign on all transactions. This is so that residents can be confident that their money is being handled properly. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 Older, less immediately relevant, material in individual care plans could usefully be archived, enabling care plans to focus on more immediate, relevant information. Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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