Inspection on 15/01/08 for 25 Old Mill Park

This inspection was carried out on 15th January 2008.

CSCI found this care home to be providing an Adequate 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

25 Old Mill Park 22/05/06

25 Old Mill Park 30/01/06

25 Old Mill Park 28/07/05

25 Old Mill Park 19/03/05

25 Old Mill Park 18/10/04

25 Old Mill Park 22/03/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 25 Old Mill Park Louth Lincolnshire LN11 ONY Lead Inspector Ken Hague Key Unannounced Inspection January 08:30 2008 15th 25 Old Mill Park DS0000002310.V339810.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 25 Old Mill Park DS0000002310.V339810.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. 25 Old Mill Park DS0000002310.V339810.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 25 Old Mill Park Address Louth Lincolnshire LN11 ONY 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) 01507 608052 www.sense.org.uk Sense, The National Deafblind and Rubella Association Acting manager in post Care Home 6 Category(ies) of Learning disability (6), Sensory impairment (6) registration, with number of places 25 Old Mill Park DS0000002310.V339810.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories:Sensory Impairment (SI) 6 Learning Disability (LD) 6 The maximum number of service users to be accommodated is 6. 2. Date of last inspection 22nd May 2006 Brief Description of the Service: 25 Old Mill park is one of a number of homes within the county that is operated by SENSE East. It is registered to provide care and accommodation for up to six service users between the ages of eighteen to sixty-four years who have been affected by a dual sensory impairment (deaf/blindness) caused by rubella and who also have a moderate or severe learning disability. The home is located in the market town of Louth, which has a range of services and facilities. It is a domestic style house providing six single bedrooms, one on the ground floor. There are stairs but no lift facility so service users at this home who are accommodated on the first floor need to be able to manage stairs. There is a lounge, dining room, kitchen and sensory/activity room on the ground floor. The home is fully occupied and there have been no new admissions since the last inspection. Transport for service users is provided in the form of a minibus. The current yearly charges for the service as confirmed by the manager range from £72020 - £86788. The acting manager stated that there are no additional charges. Information about the day-to-day operation of the home, including a copy of the last inspection report, can be found in the home statement of purpose and service user guide. These documents are made available in a number of formats for all new potential residents and their families they explain the resources and services offered, by the care home. Home visits are made by the manager to all new residents to ensure the maximum information is given to new residents and their extended family. The decision to offer a placement is taken by a multiagency panel. A dedicated intermediate care service is not provided by the home. 25 Old Mill Park DS0000002310.V339810.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The inspection took place over 10 hours. Two visits were made to the home. All of the residents have a visual impairment and are not able to communicate verbally they communicate using British sign language. All of the residents have a learning disability. It was therefore important that observation was used as an important assessment tool as part of this inspection. The residents do not like to feel that visitors are intruding into their home. It was therefore considered to be more appropriate to use two site visits rather than one long day. This was to respect the dignity and privacy of the residents and their home. It was important that relatives had the opportunity to contribute in writing to the inspection process. Comment forms were sent out to all relatives of residents. One relative rang to discuss the inspection with the inspector. The opinions of the relatives are reflected within this report. The acting manager was present throughout the inspection. Feedback was given at the conclusion of the site visit. The main method of inspection used was called ‘case tracking’ which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them and the staff, and where more appropriate observation of interaction between staff and residents and related care practices. A sample of care records was inspected. Two members of staff were interviewed. An (AQAA) Annual quality assurance assessment was completed by the care home and sent to the Commission for Social Care Inspection prior to the site visit. This is a self- assessment document completed by the providers of the care home. It sets out evidence from the provider to demonstrate that they are meeting the Care Home Regulations. What the service does well: The home provides a comfortable, safe and homely environment for people to live in. The care home is well managed. Residents have detailed care plans, which enables staff to know how residents needs are to be met. Staff, are well trained and supported by the registered manager and have a sound knowledge of residents needs. The staff team work well together and 25 Old Mill Park DS0000002310.V339810.R01.S.doc Version 5.2 Page 6 have established a good working relationship with the community health care teams and local GPs. 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. The summary of this inspection report can be made available in other formats on request. 25 Old Mill Park DS0000002310.V339810.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 25 Old Mill Park DS0000002310.V339810.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An assessment of all new residents is completed which ensures that all of their personal care, health care and social needs are met. EVIDENCE: Three individual resident’s files were examined as part of the case tracking process. They all contained a full assessment including a risk assessment for each individual resident completed prior to them entering the care home. Any identified risk was transferred onto their care plan and a risk management plan put in place.The assessments set out the care needs, social needs and health needs of each individual resident. The assessments were detailed and included the choices and wishes of residents. The acting manager confirmed that resident’s families are involved in the completion of care plans and in their review. Signatures on care plan supported this statement . Assessments were recorded in plain English making them easy to follow. All documents were signed and dated 25 Old Mill Park DS0000002310.V339810.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 6,7 & 9 Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. Care plans identify all areas of need and provide detailed care instructions for staff; this enables staff to provide appropriate care. The actions and care provided by staff ensures that residents privicy and dignity is maintained. EVIDENCE: Three resident’s care records were studied each had a comprehensive care plan on their individual file. These were signed and dated by both resident and the assessor. Care plans include the dietary needs of each resident which included their likes and dislikes in respect of their food. Social life opportunities have been discussed with each resident. Their choices of activities are recorded. 25 Old Mill Park DS0000002310.V339810.R01.S.doc Version 5.2 Page 10 There are comprehensive risk assessments on files. Where a risk had been identified the management of that risk was transferred onto their care plan. Care plans are being reviewed with the resident and their family in line with National Guidelines. All residents have a key social worker identified by the funding authority that is actively involved in all reviews of the individual residents care plans. The files of residents being case track all contained the health care needs of each resident. Care Records provided evidence of visits by community Healthcare visitors including general practitioners. Quality assurance documents supplied by the care home substantiated that residents were happy with the health care services provided to them. A relative states in the have your say document state “my son has total support he has a tailor-made support program. I have total confidence that all of my sons needs and requirements are being met by the care home. All residents are treated as individuals. I have peace of mind that my son’s needs are being met and he can be himself.” The acting manager confirmed in the Annual Quality Assurance assessment (AQAA) that it is an expectation that “ Residents dignity and privacy is always respected. Observations made on the days of the site visits supported this statement. Staff were seen to treat all residents in a sensitive manner and take steps to retain their dignity and privacy. The evidence from the returned “have your say documents from relatives provides evidence that they believe resident’s dignity and privacy is respected. 25 Old Mill Park DS0000002310.V339810.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,15,16 7 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. A range of activities are provided for residents which enables them to have an active and interesting social life. The home’s menu offer choices and meets the dietory needs of residents. EVIDENCE: The acting manager stated the choices and wishes of the residents regarding their social life are identified at the initial assessment. She described the range of activities, which are made available for residents to participate in. This includes archery, swimming and bowling. Residents are taking out into the community for activities and often go for a meal in local restaurants. Residents are involved in the planning of activities. All residents attend a local day centre, which offers daytime activities. 25 Old Mill Park DS0000002310.V339810.R01.S.doc Version 5.2 Page 12 A relative stated in the “ have your say document” we are constantly surprised and pleased at the innovations used in making our son’s life more confident and enjoyable” A second relative states “they look after our son and ensure his ever need is cared for giving him a care and the quality of life that we cannot provide.” 25 Old Mill Park DS0000002310.V339810.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19 & 20 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The medication procedural of the care home is has not being consitently followed which could have placed a residents at risk. EVIDENCE: There have been three incidents since July 2007 of the mal- administration of medication. It is of particular concern that one incident resulted from a member of staff failing to look at the medical administration records before given a painkiller. This resulted in the resident receiving an overdose. The failure to complete the medical records when given out this medication also contributed to a delay in identifying the fact that an overdose has been given. The company have retrained all staff in the Administration of medication in February 2008. The home’s managers have checked that all staff are now competent to give out medication. Staff have been told that the medication procedure of the care home must be followed. 25 Old Mill Park DS0000002310.V339810.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 & 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Resident’s benefit and are protected by updated comprehensive complaints and adult protection procedures. EVIDENCE: The acting manager confirmed that the complaints procedure is explained and discussed with every resident. Staff check out on a daily basis that residents are happy and have no complaints. The manager monitors this process. The complaints procedure is also explained to advocates and extended family. Staff demonstrated knowledge of the complaints procedure and stated that in their opinion residents are able to raise concerns. No formal complaints have been received by the home since the last key inspection. Training records and discussion with staff confirmed that all members of staff have received training in the identification and protection of residents from potential abuse. There are procedures in place to guide staff what action should to be taking in the event of them having any suspicion of abuse taking place. A whistle blowing procedure in place, which staff confirmed they would be happy to use if they had that any concerns about care practice. A staff member has used this procedure in the last year. 25 Old Mill Park DS0000002310.V339810.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 & 30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Residents live in a clean care home, which provides them with safe comfortable accommodation. EVIDENCE: There has been some maintenance carried out since the last inspection but this has been limited. The general appearance of the interior the home is of a worn environment. Areas of the home have not been decorated for a number of years. Carpets were identified at past inspections as in need of a replacement. There were however, no negative comments made by relatives of residents regarding the environment of the care home. The company has written to the Commission for Social Care Inspection since the site visit giving a list of improvements, which are to be made to the home’s environment. They confirm that an ongoing maintenance problem has now been put in place. 25 Old Mill Park DS0000002310.V339810.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. Residents are supported by well-trained staff, who has been recruited safely using the up-to-date recruitment policy of the care home. EVIDENCE: Staff stated that in their opinion there are always sufficient staff on duty to meet the needs of residents. “Have your say documents raised no issues with staffing levels or staff training. A relative stated, “the company goes to great lengths to ensure that they get the right people to look after our relatives “. Staff confirmed that they have been provided with training opportunities since the last key inspection include some specialised courses. These statements were supported by the training plan and training records of the care home. There was evidence of all new care staff being given inductions. The inspection of a recruitment records for one member of staff provided evidence that the homes recruitment policy is being consistently followed. All 25 Old Mill Park DS0000002310.V339810.R01.S.doc Version 5.2 Page 17 of the documents required by the care home regulations had been obtained prior to any member of staff commencing employment. Staff stated the home is a safe environment in which to work. There were no health and safety or infection control issues identified. 25 Old Mill Park DS0000002310.V339810.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. There is positive leadership; guidance and direction to staff to ensure residents receive consistent quality care. Good working practices promote the health and safety of residents. EVIDENCE: The acting manager has recently obtained the registered managers award, but has yet to apply for registration. Staff stated that she is very approachable and supportive and is committed to ensuring services provided by the home are of a good quality. Resident’s relatives stated that the home is run in their best interest of residents The acting manager demonstrated throughout the day of the site 25 Old Mill Park DS0000002310.V339810.R01.S.doc Version 5.2 Page 19 visit a sound knowledge of the care home regulations and the commitment to ensuring quality care is provided by the home. There are updated policies and procedures in place, which ensure the financial interest of all resident’s are safeguarded. The home only manages the personal allowance for some residents. Records are kept to demonstrate that the homes policy is being followed. No health and safety issues were identified other than the problem recorded under medication standard 20. All staff are being provided with supervision and appraisals in accordance with national guidelines. The evidence for this statement was found in staff records and discussions with members of staff and the acting manager. 25 Old Mill Park DS0000002310.V339810.R01.S.doc Version 5.2 Page 20 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 3 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 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x 2 x 3 x 3 x x 3 x 25 Old Mill Park DS0000002310.V339810.R01.S.doc Version 5.2 Page 21 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 YA20 Regulation 13-2 Requirement Medication must be administered to residents in a safe and appropriate manner to ensure that they received the treatment needed and are not put at risk. Timescale for action 16/01/08 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 25 Old Mill Park DS0000002310.V339810.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 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 25 Old Mill Park DS0000002310.V339810.R01.S.doc Version 5.2 Page 23 - 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. 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