Inspection on 27/06/06 for The Lady Verdin Trust Ltd - Crewe Road

This inspection was carried out on 27th June 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 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 -... 24/01/06

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 Key Unannounced Inspection 27th June 2006 03:00 The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V291797.R01.S.doc Version 5.1 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.V291797.R01.S.doc Version 5.1 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.V291797.R01.S.doc Version 5.1 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.V291797.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th January 2006 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. Resident accommodation weekly fees range from £1004.18 to £1407.08. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V291797.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This • • • key inspection report was written using evidence gathered from the Pre-inspection questionnaire Service history for the home Visit to the home on the 27th June 2006 The visit to the home was carried out over four hours and involved talking with four residents, the home manager and three staff. A number of resident and home records were seen. A partial tour of the building was carried out. Feedback following the visit to the home was given to the manager on the 27th June 2006. What the service does well: The pre-admission assessment procedure combined with the information provided by the Trust on the service offered ensures residents and their relatives are able to make an informed choice about the home. During the visit records were seen that showed residents assessed and changing needs are included in their plans of care. Although residents have limited communication capabilities every effort is made to ensure they are consulted about issues that affect them and the overall running of the home. Residents are supported and encouraged to take part in activities that are appropriate to their abilities. The daily option scheme, run by the Trust, gives residents additional opportunities for personal development. Records seen during the visit showed that the healthcare needs of residents are monitored and action taken to address any concerns. Residents receive visits from doctor and other healthcare professionals. A staff team that are aware of the needs of residents and how these needs are to be met cares for residents. Residents’ benefit from the leadership offered by the registered manager, particularly in relation to ensuring residents’ best interests underpin the overall running of the home. Following the visit to the home two relatives/visitors and one health and social professionals comment cards were returned. Comments included ‘ the home is The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V291797.R01.S.doc Version 5.1 Page 6 managed as a friendly, homely environment’, ‘care has been of the highest standard and consideration tome and my family has been superb’, ‘I am confident that every care is taken to support and protect (my daughter)’. 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.V291797.R01.S.doc Version 5.1 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.V291797.R01.S.doc Version 5.1 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): 1/2/3/5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The Trust provides information on the level of service offered by the home. This ensures residents are able to make a choice about moving into the home. EVIDENCE: The Lady Verdin Trust has developed a pre-admission procedure that ensures residents’ and their relatives have the necessary information to make an informed choice about the home. As part of this process residents’ are able to visit and ‘test’ drive the home. As the current resident has lived in the home for a number of years the preadmission procedure has not being ‘tested’. However, the resident records seen during the visit showed that their needs, and aspirations, are monitored to ensure the home can still meet those needs. The residents’ residency in the home is subject to a contract between the Trust and Social Services. Copies of the contract are kept in the Trusts main office that is located in Crewe. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V291797.R01.S.doc Version 5.1 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Personal Development Plans, including risk assessments, are in place for individual residents. Included is the level of support required from staff to ensure these needs are being met. EVIDENCE: During the visit to the home two residents’ personal development plans were seen. Included were plans of care, risk assessments and information from social services. These also showed that residents’ needs are monitored and any changes are included in their care plans. Risk assessments are in place to ensure the safety and well being of service users, both when they are in the home and in the local community. Residents’ were seen approaching staff for assistance with daily living tasks. Staff were seen communicating with residents and encouraging them to do as much for themselves as possible. Although residents have limited verbal capabilities staff were seen talking to them about what they wanted for tea, where they wished to spend their leisure time and what they had done at the The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V291797.R01.S.doc Version 5.1 Page 10 day centre. Residents’ were comfortable approaching staff and were at ease in their company. The Trust has provided a policy on the confidentiality of information. Staff spoken with were aware of the need to ensure information about service users is confidential. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V291797.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12/13/14/16/17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents have opportunities to engage in suitable activities, both in the home and in the local community. These opportunities will help improve their personal development. EVIDENCE: Three residents’ were seen returning from their daily activities. One resident was being support by staff from the Trusts’ daily option scheme. Records seen showed residents’ weekly activity programme that included trips to local shops, cinema and attending a disco. The needs of residents’ are such that they require assistance with all aspects of daily living. The home has a people carrier that is used to take residents’ on outings to local places of interest. Staff spoken with were aware of the needs and abilities of individual residents. They were also aware of the rights and responsibilities of residents. Risk assessments are in place to ensure the safety of residents’ when taking part in activities, both in the home and in the community. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V291797.R01.S.doc Version 5.1 Page 12 Staff said residents’ relatives and friend are able to visit the home at any reasonable time and are made welcome. Residents’ record contained details of family contacts and relationships. During the visit staff were seen caring for residents’ by, for example, helping them with personal care and moving about the home. Residents were also seen approaching staff and communicating their needs to them. The record of food offered to residents’ showed that they are offered choices at each meal. During the visit staff were seen asking residents what they would like for their tea. The mealtime observed during the visit was relaxed and staff were seen helping residents with their meal. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V291797.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18/19/20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents receive support from staff with their personal and healthcare needs. This support is offered in a way that respects, and encourages, residents’. EVIDENCE: During the visit staff were seen offering personal support residents’ with, for example, using the bathroom/toilet and having a drink. Staff were aware of the level of help residents’ required with these tasks. Records seen during the visit showed that the personal care needs of residents’ have been assessed and plans are available that show how these needs are to be met. A separate healthcare file is kept on individual residents; these showed that residents’ receive visits from doctors, nurses and other healthcare professionals. Letters were seen that showed residents’ are supported by staff to attend hospital appointments as necessary. The record of medication administered by staff to two residents’ was seen and was satisfactory. During the visit to the home staff were seen caring for residents’ and responding to their requests for help. Staff spoken with were aware of the The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V291797.R01.S.doc Version 5.1 Page 14 likes and dislikes of residents’ and how they wished to be cared for. For example, they were seen transferring a resident from his bedroom to the lounge using lifting equipment and caring fro a resident who was distressed. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V291797.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22/23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Satisfactory procedures are in place to ensure residents’ are protected from abuse. Residents’, and other visitors to the home, have access to a complaints procedure that enables them to raise issues of concern. EVIDENCE: A copy of the complaints procedure is on display in the home. Details on how to contact the Commission for Social Care Inspection are included in the procedure. The manager and staff spoken with said the home has not received any complaints since the last inspection. CSCI has not received any complaints about the home. A copy of the complaints procedure has been provided in a format that makes it easier for residents’ to understand. The Lady Verdin Trust has provided an Adult Protection Procedure, a copy of which is kept in the home. Included in the procedure is a copy of the government guidelines ‘No Secrets’. Staff spoken with said they knew about the complaints and adult protection procedures and what to do if a problem arose. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V291797.R01.S.doc Version 5.1 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): 24/25/26/28/29/30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The layout of the home allows residents’ to move freely between their bedrooms and communal areas. This helps ensure they be independent, and, safe, when in the home. EVIDENCE: The domestic type bungalow provides a homely, comfortable and safe environment for residents. The home is located in a residential area between Crewe and Nantwich Single bedrooms are provided for residents that have recently been refurnished and re-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. Bedrooms are arranged to allow for easy access by staff when assisting residents. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V291797.R01.S.doc Version 5.1 Page 17 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 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 and secure area for use by residents. The re-fitted kitchen has improved the internal appearance of the home. On the day of the inspection the home was clean and free from unpleasant odours. The following issues were identified during the visit to the home • • The water from the tap in the bath and the sink in the toilet was very hot The carpets in the communal area was stained and marked. Following the visit the registered manager for the home confirmed, in writing, that these issues have been addressed. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V291797.R01.S.doc Version 5.1 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): 32/33/35/36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Staff receive induction, training and supervision that ensures they are aware of the care needs of residents. It also ensures they are able to deliver a high standard of care to residents. EVIDENCE: The staffing rota show that there are normally two staff on duty when all of the residents are in the home. At other times residents’ can be cared for by staff from the Trust’s daily option scheme who provide individual support and supervision. A member of staff who sleeps in the home provides nighttime cover. Monitor equipment is provided in residents’ bedroom with a link to the sleeping in room. Most of the staff time has worked in the home for at least a year. This continuity in the delivery of care ensures staff that are aware of their roles and responsibilities supports residents. During the visit staff were seen caring for residents’ and were aware of how the care should be delivered. The information provided in the pre-inspection questionnaire showed that all of the staff team has received NVQ training. One of the staff spoken with confirmed that he has an NVQ Level 2 and is doing NVQ Level 3. Records were seen that showed staff receive induction training and one-to-one supervision from the manager. The staff spoken with also confirmed that they receive The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V291797.R01.S.doc Version 5.1 Page 19 support from the manager and other senior staff in the Trust. As well as NVQ training staff said they have received training that included first aid, fire safety, manual handling and epilepsy. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V291797.R01.S.doc Version 5.1 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): 37/38/39/42/43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. A competent and experienced manager is responsible for the overall running of the home. This ensures the home is run in the best interest of the residents. EVIDENCE: The registered manager said she is in the process of completing her NVQ Level 4 and Registered Managers Award. In discussion she said the staff team is more settled and that ensures a greater consistency of care is delivered to the residents. It was evident during the visit that the manager has developed her management skills, and is more confident, in managing a care home. Staff spoken with said they receive supervision, support and guidance from the manager and that she is always available for advice. The senior support worker said he meets with the manager weekly to discuss the overall running of the home. During the visit the manager was seen supporting staff and advising them on resident issues. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V291797.R01.S.doc Version 5.1 Page 21 The manager provided written evidence that showed the fees and benefits for individual residents. The Trust has a member of staff, based at the main office in Crewe, who deals with resident’s incomes and benefits. The following health and safety and service records were seen • Fire Safety Records including Fire Risk Assessment • Boiler Checks • Bath and hoist service information • Gas Safety Certificate • Service on a residents’ specialist bed. A yearly improvement plan and a team yearly audit were seen during the visit. Also seen were records of visit by members of the Trust committee. The home does not have a system whereby the views of residents’ and their relatives can be sought on a yearly basis (See Recommendation Number1) The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V291797.R01.S.doc Version 5.1 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 Standard No Score 1 3 2 3 3 3 4 X 5 3 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 3 26 3 27 X 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 2 X X 3 3 The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V291797.R01.S.doc Version 5.1 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA39 Good Practice Recommendations The views of residents’ and relatives on the quality of service offered should be sought. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V291797.R01.S.doc Version 5.1 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.V291797.R01.S.doc Version 5.1 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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