Inspection on 24/01/06 for The Lady Verdin Trust Ltd - Crewe Road

This inspection was carried out on 24th January 2006.

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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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

The Lady Verdin Trust Ltd -... 01/09/05

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

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

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

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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 Cheshire CW2 6PP Lead Inspector Mr Val Flannery Unannounced Inspection 02:45 24 and 31 January 2006 th st The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V270931.R01.S.doc Version 5.0 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 The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V270931.R01.S.doc Version 5.0 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. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V270931.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Lady Verdin Trust Ltd - Crewe Road Address 552 Crewe Road Wistaston Crewe Cheshire CW2 6PP 01270 650897 01270 256900 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) The Lady Verdin Trust Limited Patricia Mellor Care Home 4 Category(ies) of Learning disability (4) registration, with number of places The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V270931.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st September 2005 Brief Description of the Service: 552 Crewe Road is a care home for four adults with a learning disability. 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 ensure 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 hand-washing 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 DS0000006505.V270931.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over four hours on the 24th and 31st January 2006. One hour was spent planning the inspection; this included reading the previous inspection report and reviewing the service history for the home. During the inspection three residents, the registered manager, three staff from the home and one from the Trust’s daily options scheme were spoken with. Two residents’ care plans were seen as were a number of the home’s records. A partial tour of the building was carried out. Feedback on the findings of the inspection was given to the registered manager on the 30th January 2006. Residents have limited communication capabilities. What the service does well: The home provides a comfortable, well-maintained and safe environment for residents. A number of staff have worked in the home for over a year or more and have developed close relationships with residents. Records seen showed that the care needs of residents are identified, continually monitored and action taken to address any changes to their needs. Residents are supported by staff from the home and the Trust’s daily option scheme to be part of the local community. This involves using/visiting shops, places of interest and leisure facilities. Although residents have limited communication capabilities every effort is made by staff to find out how they wished to be cared for. Discussion also takes place with residents about any changes to the home; either to the environment or the way it is run. During the inspection staff were seen helping residents with their personal care, for example, dressing/undressing and toilet needs. This was carried out in a sensitive and caring manner and maintained their privacy and dignity. A separate healthcare file is kept on individual residents. This showed that residents are supported to visit their GP and local hospital as required. A complaints procedure has been provided by the Trust that includes pictures so that residents are able to make their feelings known. Staff said they receive a lot of support and guidance from the home manager and other senior staff in the Trust. They also said they receive induction and other training opportunities. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V270931.R01.S.doc Version 5.0 Page 6 The registered manager said she has almost completed her NVQ Level and is committed to ensuring the interests and welfare of residents is protected. 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 DS0000006505.V270931.R01.S.doc Version 5.0 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 The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V270931.R01.S.doc Version 5.0 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): 2/3/4/5/ The residents are regularly monitored to ensure the home can meet their assessed care needs. EVIDENCE: The four residents have lived in the home for a number of years. Their plans of care showed their needs are monitored and action taken to address any concerns. The Trust have a thorough pre-admission procedure in place that includes prospective residents visiting the home to meet other residents and staff, overnight stays, senior staff assessing the resident before they visit the home and meetings with other professionals. A block contract is in place with the funding authority. This includes terms and conditions of residency. Copies of the contract are kept in the main office for the Trusts main office in Crewe. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V270931.R01.S.doc Version 5.0 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): 6/7/8/9/10 Plans are provided which show how residents wish to be cared for. Risk assessments show how the well-being and safety of residents is to be addressed. EVIDENCE: Residents’ needs and choice are set out in the Personal Development Plans. Resident’s individual files also contained background information and personal histories. The plans also showed that any changes to residents’ care needs are recorded and addressed. 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. Although residents have limited communication capabilities staff do talk to them about day-to-day routines and activities. Also any changes that are to be made to the environment or to the way the home is run are shared with residents. Risk assessments are in place that showed how residents are to be supported with their well-being and safety. For example, when using the bathing facilities, eating and moving about the home. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V270931.R01.S.doc Version 5.0 Page 10 The Trust has provided a policy on the confidentiality of information, a copy of which I kept in the home. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V270931.R01.S.doc Version 5.0 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): 11/12/13/14/15/16/17 Residents receive support and encouragement that enables them to live fulfilling lives, both inside and outside the home. EVIDENCE: Although residents have limited communication capabilities staff were seen talking to residents and encouraging them to make decisions. For example, where they wished to spend their leisure time and answering the front door. One resident was supported by staff to visit a hairdresser in the local community. Other residents were seen returning from their daily activities that included a walk in the local area and attendance at a social service day care centre. A list of individual resident’s daily activities was seen in their personal files. As well as staff from the home residents are supported by staff from the Trust’s daily option scheme with their daily activities. Staff said residents are enabled to maintain contact their families. For example, one resident is supported by staff when visiting her mother who is in a nursing home. Records were seen that showed families are kept informed about the resident’s day-to-day activities/incidents. Letters were seen which The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V270931.R01.S.doc Version 5.0 Page 12 showed that relatives had written to residents and staff. Minutes of review meetings showed that relatives had been invited to attend. 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. On the day of the inspection a member of staff from the daily options scheme was seen carrying out this procedure. The manager said recently appointed staff have received training from other staff in the home (including the manager) in order to carry out this procedure. However, a nurse or other healthcare professional did not provide the training for these staff. The manager said she is in regular contact with healthcare staff from the local hospital with a view to them providing appropriate training for all staff. She said they have not, as yet, responded to her requests. (See Requirement Number 1). The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V270931.R01.S.doc Version 5.0 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): 18/19/20/21 Residents receive support with their personal and healthcare in a sensitive and caring manner. The manner in which this care is given helps ensure their dignity and privacy is respected. EVIDENCE: During the inspection staff were seen helping residents as they returned from their daily activities. This included toileting needs and dressing/undressing. Staff were aware of how residents should be cared for and respected their privacy and dignity whilst carrying out these tasks. Plans of cared showed that residents’ health and care needs are monitored. Also that action is taken to address these needs. A separate healthcare record is kept on individual residents. This showed that they are registered with a GP practice and receive input from other healthcare professions such as dentists, chiropodists and opticians. Staff spoken with were aware of the healthcare needs of individual residents and what action to taken in the event of illness. Residents require full assistance with their medication; two records were seen during the inspection. These were satisfactory. The care plans for a resident showed that she sometime requires soluble paracetamol via a PEG feed (See Requirement Number 1) The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V270931.R01.S.doc Version 5.0 Page 14 A policy on caring for residents who are ill and the death of a resident has been provided by the Trust. A copy of these policies are kept in the home. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V270931.R01.S.doc Version 5.0 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 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 been 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 DS0000006505.V270931.R01.S.doc Version 5.0 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): 24/25/26/27/28/29/30 A safe, well-maintained and homely environment is provided which adds to the overall high standard of care offered to 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. Doors have been provided between the toilet and bathing area, this will help ensure the privacy of people using these areas is protected. Although toilet facilities are The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V270931.R01.S.doc Version 5.0 Page 17 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 with mobility problems. The garden to the rear of the home is secure and accessible to residents. The improvements to the garden area have created a very pleasant area for use by residents On the day of the inspection the home was clean and free from unpleasant odours. Also workmen were in the process of upgrading the kitchen by replacing the cupboards and worktops. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V270931.R01.S.doc Version 5.0 Page 18 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): 31/32/33/35/36/3 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: The home has a number of staff that have worked in the home for a number of years. Staff spoken with during the inspection said ‘they work well together as a team’. They confirmed that their roles and responsibilities are discussed with them during staff meetings, one to one supervision and on the job monitoring. The staffing rotas seen showed that there are normally two staff on duty when the four residents are in the home. There are times during the day when there is only one member of staff in the home with one resident. This can be staff from the home or from the Trust’s daily option scheme that support residents with daily activities. A list of staff training was seen. This included a course on epilepsy, using the hoist and the administration medication. Staff are also in the process of doing NVQ training. A member of staff who has just completed his induction training was spoken with. He said he ‘feels well supported by the Trust and in particular the manager for the home’. He also said he had undergone checks before he commenced employment. This included references being sought, a criminal record check and completion of an application form. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V270931.R01.S.doc Version 5.0 Page 19 The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V270931.R01.S.doc Version 5.0 Page 20 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): 37/38/39/40/41/42/43 The best interests of residents underpins the overall management of the home. The views of residents on the day-to-day management of the home are sought. 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 the 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 team’s performance was seen during the inspection. Systems have been developed by the Trust to support the manager and ensure the well being of residents is promoted. For example, a representative of the management committee makes monthly visits to the home from the Trust. A The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V270931.R01.S.doc Version 5.0 Page 21 range of policies and procedures has 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 following safety procedures are in place, records were seen during the inspection: • Monthly safety audit carried out by the manager • Invoice re: service on gas boiler • Fire safety checks including checks on emergency lights, staff training and evacuation and weekly checks • Records of accidents and incidents The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V270931.R01.S.doc Version 5.0 Page 22 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 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 4 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 4 14 3 15 3 16 4 17 Standard No 31 32 33 34 35 36 Score 3 3 3 X 3 4 CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V270931.R01.S.doc Version 5.0 Page 23 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 YA20YA17 Regulation Requirement Timescale for action 01/04/06 18(1)(c)(i) All staff that administer Percutaneous Endosopic Gastrostomy (PEG feeding) must be deemed competent to do so by a community nurse or equivalent 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 The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V270931.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Northwich Local Office 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 DS0000006505.V270931.R01.S.doc Version 5.0 Page 25 - 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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