Inspection on 01/09/05 for The Lady Verdin Trust Ltd - Crewe Road

This inspection was carried out on 1st September 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.

Other inspections for this house

The Lady Verdin Trust Ltd -... 27/06/06

The Lady Verdin Trust Ltd -... 24/01/06

The Lady Verdin Trust Ltd -... 19/01/05

The Lady Verdin Trust Ltd -... 03/08/04

The Lady Verdin Trust Ltd -... 11/03/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 The Lady Verdin Trust Ltd - Crewe Road 552 Crewe Road Wistaston Crewe CW2 6PP Lead Inspector Val Flannery Unannounced 1 September 2005 15:00 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. The Lady Verdin Trust Ltd - Crewe Road F51 F01 S6505 The Lady Verdin Trust - Crewe Road V247709 010905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Lady Verdin Trust Ltd Address 552 Crewe Road Wistaston Crewe CW2 6PP 01270 650897 01270 256900 (Main Office) mellorp@ladyverdintrust.com The Lady Verdin Trust Limited 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) Patricia Mellor Care Home 4 Both Category(ies) of Learning disability (LD) 4 registration, with number of places The Lady Verdin Trust Ltd - Crewe Road F51 F01 S6505 The Lady Verdin Trust - Crewe Road V247709 010905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19 January 2005 Brief Description of the Service: 552 Crewe Road is a care home for four adults with a learning disabilithy. It is part of the Lady Verdin Trust which operates a number of facilities for adults with a learning disability in Crewe and Nantwich. Located in a residential area on the outskirts of Crewe the domestic type bungalow is close to shops, pub and other local amenities. It is on the bus route to Nantwich and Crewe town centre. The trees and shrubbery to the front of the home ensures the privacy of the residents is protected from the busy main road. A secure well maintained garden is provided to the rear of the home. All the bedrooms are single and contain handwashing facilities. Sufficient bathing facilities are provided for residents. Lifting aids are provided for residents with mobility problems. Communal space consists of one large open lounge and a dining room. Staff are on duty twenty four hours a day to deliver care to residents. The Lady Verdin Trust Ltd - Crewe Road F51 F01 S6505 The Lady Verdin Trust - Crewe Road V247709 010905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over three hours as part of the yearly inspection process. One hour was spent planning the inspection, this included reading the previous inspection report and reviewing the service history for the home. During the visit four residents and four staff were spoken with. Two of the care plans were seen as well as a sample of the home records. A partial tour of the building was carried out. Residents have limited communication capabilities. What the service does well: Staff were seen caring for residents and meeting their assessed needs. Although residents have limited communication staff showed that they knew when residents required support and guidance. Information on the range of services provided by the Trust is available, this included a statement of purpose and service user guide. Resident files contained background information, family contacts, record of resident finances and plans for resident’s daily living. A list of daily activities was available for individual residents. The record of menus and the meal prepared during the inspection showed that residents are offered a choice of meals. A separate healthcare file showed residents receive visits from doctors, nurses and other healthcare professionals. Policies and procedures have been provided by the organisation on, for example, how to deal with complaints and adult protection issues. A homely and safe environment is provided for residents. They are accommodated in single bedrooms which are individually decorated and furnished. The manager has worked for the Trust for a number of years and has gained the experience, and attended training, necessary to manage the home. The Lady Verdin Trust Ltd - Crewe Road F51 F01 S6505 The Lady Verdin Trust - Crewe Road V247709 010905 Stage 4.doc Version 1.40 Page 6 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 Lady Verdin Trust Ltd - Crewe Road F51 F01 S6505 The Lady Verdin Trust - Crewe Road V247709 010905 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 The Lady Verdin Trust Ltd - Crewe Road F51 F01 S6505 The Lady Verdin Trust - Crewe Road V247709 010905 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) 1/2/3/4/ Information is provided which will help residents make an informed choice about the service offered by the home. Residents are fully assessed prior to admission, this helps ensure the home is able to meet their needs. EVIDENCE: The current resident group has lived in the home for a number of years. A copy of the statement of purpose and service guide is available in the home. Parts of the service user guide contain pictures which is of assistance to residents who cannot read. It is the policy of the Lady Verdin Trust that prospective users of the service are enabled to visit the home before making a decision about moving in. The Lady Verdin Trust Ltd - Crewe Road F51 F01 S6505 The Lady Verdin Trust - Crewe Road V247709 010905 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) 6/7/8/9/ Residents are enabled to make decisions about their daily lives and are consulted about the day-to-day running of the home. EVIDENCE: Residents’ needs and choice are set out in the Personal Development Plans. Two of the plans were seen during the visit, these included residents’ personal details, family contacts, plans for daily living including activities and daily record of events. During the inspection staff were seen talking to residents and asking them where they wished to spend their leisure time and if they had enjoyed their daily activity. Residents’ needs are such that they require help and supervision with the tasks of daily living. Risk assessments showed that residents require staff supervision and guidance when using community facilities. The Lady Verdin Trust Ltd - Crewe Road F51 F01 S6505 The Lady Verdin Trust - Crewe Road V247709 010905 Stage 4.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11/12/13/14/15/16/17 Residents are encouraged and supported to be part of the local community. They are able to take part in activities that meet their assessed needs. Staff should receive training from a healthcare professional on the PEG feed. EVIDENCE: A list was on display that showed individual residents have a weekly activity programme. This included attendance at a community day centre, walks, trips in the mini bus and shopping. As the home is located between Crewe and Nantwich there is easy access to local community facilities such as shops and leisure opportunities. Staff spoken with, and records seen, showed that families are kept informed of accidents/incidents. The registered manager said that relatives are informed of any alterations/maintenance work carried out in the home. Relatives are also able to visit the home as they wish. The Lady Verdin Trust Ltd - Crewe Road F51 F01 S6505 The Lady Verdin Trust - Crewe Road V247709 010905 Stage 4.doc Version 1.40 Page 11 During the inspection staff were seen providing personal care and talking to residents in a quiet and respectful manner. The plans of care showed that residents’ preferences on how they are cared for has been identified. Staff were observed helping residents with their evening meal. They sat at the table with residents and allowed them to eat at their own pace. Two residents are on a Percutaneous Endoscopic Gastrostomy (PEG) feed. This ensures residents who cannot chew or swallow, because of their disability, receive food and drink. A member of staff was seen carrying out this procedure. The manager said recently appointed staff have received training in order to carry out this procedure. However, the training for these staff was not provided by a nurse or other healthcare professional. (See Recommendation Number 1) The Lady Verdin Trust Ltd - Crewe Road F51 F01 S6505 The Lady Verdin Trust - Crewe Road V247709 010905 Stage 4.doc Version 1.40 Page 12 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 Residents’ health and personal cared needs are well looked after. Staff give full support to residents with their emotional and personal needs. EVIDENCE: Although residents have limited communication capabilities staff are aware of way they wish to be supported. For example, staff were seen helping residents with personal care tasks and eating their evening meal. This help was offered in a sensitive and caring manner. Plans of care also showed that residents’ physical and emotional needs are monitored and action taken to address any changes. A separate file is kept of residents’ contact with healthcare professionals. This includes visits by doctors, nurses and others. The reason for the visits and the recommended treatments are also recorded. Residents require full assistance with the administration of medication. The record of medication administered by staff was seen during the inspection and was satisfactory. The Lady Verdin Trust Ltd - Crewe Road F51 F01 S6505 The Lady Verdin Trust - Crewe Road V247709 010905 Stage 4.doc Version 1.40 Page 13 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) 22/23 Satisfactory arrangements are in place for the protection of residents. There is a complaints procedure in place which ensures that issues raised will be responded to in an appropriate manner. EVIDENCE: A copy of the complaints procedure was available on the day of the inspection. Details on how to contact the Commission for Social Care Inspection were included. The registered manager said no complaints have being received about the home. CSCI have not received any complaints about the home. The Lady Verdin Trust has provided an adult protection procedure, a copy of which is kept in the home. It included a copy of the government guidelines ‘No Secrets’. Staff spoken with were aware of the complaints and adult protection procedures and what action to take if they had any issued were raised. The Lady Verdin Trust Ltd - Crewe Road F51 F01 S6505 The Lady Verdin Trust - Crewe Road V247709 010905 Stage 4.doc Version 1.40 Page 14 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) 24/25/26/27/28/29/30 A safe, well maintained and homely environment is provided for residents. Single bedrooms are suitable for the needs of residents. EVIDENCE: The domestic type bungalow is homely, comfortable and provides a safe environment for residents. Located in a residential area between Crewe and Nantwich the home ‘fits’ in with the other properties. Single bedrooms are provided for residents, each one is individually furnished and decorated. All the bedrooms were seen during the inspection they contained personal possessions like ornaments, pictures and television/hi-fi equipment. The rooms contained hand-washing facilities. Two of the bedrooms also had lifting aids and other equipment for the residents who have severe mobility problems. There are plans, according to the registered manager, to replace the furniture in the bedrooms. Bedrooms are arranged to allow for easy access by staff when assisting residents. One adapted bath, with a lifting aid, is provided for residents. The registered manager said there are plans to improve the appearance of the bathroom. The Lady Verdin Trust Ltd - Crewe Road F51 F01 S6505 The Lady Verdin Trust - Crewe Road V247709 010905 Stage 4.doc Version 1.40 Page 15 Although toilet facilities are provided the assessed care needs of residents is such that they are unable to use this facility. In addition to the lifting aids in the bedrooms hoists and wheelchairs are provided for residents. The garden to the rear of the home is secure and accessible to residents. Since the last inspection this area has been improved and provides a well maintained and relaxing area for residents. On the day of the inspection the home was clean and free from unpleasant odours. The registered manager said there are plans to re-fit the kitchen in the near future. The Lady Verdin Trust Ltd - Crewe Road F51 F01 S6505 The Lady Verdin Trust - Crewe Road V247709 010905 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) 31/32/33/35/36 Staff are employed in sufficient numbers to meet the needs of residents. Staff receive training and supervision in order to develop their caring skills. EVIDENCE: Staff spoken with said they are aware of their roles and responsibilities. This is re-enforced by individual supervision, on-the-job monitoring by senior staff and staff meetings. The registered manager said the home is now fully staffed which has lessened the need for staff from the organisation’s staffing bank to staff the home. There are normally two staff on duty when the residents are in the home. One member of staff sleeps in the home overnight. One resident is supported during the day by staff from the home or from the organisation’s daily option scheme. Staff said they receive induction training when they first come to work in the home. This can either be in the home or in the organisation’s main office in Crewe. They also said they are offered regular training opportunities including NVQ in care. An on-call system is in place whereby staff, in the absence of the manager, can get advice and guidance from another senior member of staff from the Trust. The Lady Verdin Trust Ltd - Crewe Road F51 F01 S6505 The Lady Verdin Trust - Crewe Road V247709 010905 Stage 4.doc Version 1.40 Page 17 Staff records, as required by the regulations, are kept in the home. The Lady Verdin Trust Ltd - Crewe Road F51 F01 S6505 The Lady Verdin Trust - Crewe Road V247709 010905 Stage 4.doc Version 1.40 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 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) 37/38/39/42/43 There are satisfactory arrangements in place for managing the home. Health and safety issues are addressed to ensure the well being of residents. EVIDENCE: The registered manager has worked for the organisation, in a senior capacity, for a number of years. She is also responsible for the management of another home within the Trust. The manager confirmed that she is in the process of completing NVQ Level 4, also that she has attended/has access to training on the day to day running of a care home. Staff spoken with said their views and those of the residents are sought and listened to with regard to running of the home. They also said they receive support, supervision and guidance from the manager and other senior staff in the organisation. A copy of the yearly review of the teams performance was seen during the inspection. The Lady Verdin Trust Ltd - Crewe Road F51 F01 S6505 The Lady Verdin Trust - Crewe Road V247709 010905 Stage 4.doc Version 1.40 Page 19 Systems have been developed by the Trust to support the manager and ensure the well being of residents is promoted. For example, monthly visits are made to the home by a representative of the management committee from the Trust. A range of policies and procedures have also been provided as well as meetings with the chief executive for the Trust. A tour of the building showed that health/safety and maintenance issues are addressed and that the home is geared to providing a safe environment for residents. The Lady Verdin Trust Ltd - Crewe Road F51 F01 S6505 The Lady Verdin Trust - Crewe Road V247709 010905 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 4 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Lady Verdin Trust Ltd - Crewe Road Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x 3 3 F51 F01 S6505 The Lady Verdin Trust - Crewe Road V247709 010905 Stage 4.doc Version 1.40 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 Regulation None 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. 1. Refer to Standard 17 Good Practice Recommendations Staff training with regard to Percutaneous Endoscopic Gastrostomy (PEG feeding) shouild be part of their induction training and be provided by a medically qualified person The Lady Verdin Trust Ltd - Crewe Road F51 F01 S6505 The Lady Verdin Trust - Crewe Road V247709 010905 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 The Lady Verdin Trust Ltd - Crewe Road F51 F01 S6505 The Lady Verdin Trust - Crewe Road V247709 010905 Stage 4.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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