Inspection on 10/10/06 for The Lady Verdin Trust Ltd - Stewart Street

This inspection was carried out on 10th October 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 -... 26/07/07

The Lady Verdin Trust Ltd -... 08/02/06

The Lady Verdin Trust Ltd -... 22/08/05

The Lady Verdin Trust Ltd -... 31/01/05

The Lady Verdin Trust Ltd -... 03/09/04

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 - Stewart Street 136 Stewart Street Crewe Cheshire CW2 8LY Lead Inspector Mr Val Flannery Key Unannounced Inspection 10 and 11 October 2006 09:00 The Lady Verdin Trust Ltd - Stewart Street DS0000006557.V298592.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 The Lady Verdin Trust Ltd - Stewart Street DS0000006557.V298592.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. The Lady Verdin Trust Ltd - Stewart Street DS0000006557.V298592.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Lady Verdin Trust Ltd - Stewart Street Address 136 Stewart Street Crewe Cheshire CW2 8LY 01270 666972 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) www.ladyverdintrust.org.uk The Lady Verdin Trust Limited Ms Tracey Skeldon Care Home 3 Category(ies) of Learning disability (3) registration, with number of places The Lady Verdin Trust Ltd - Stewart Street DS0000006557.V298592.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th February 2006 Brief Description of the Service: 136 Stewart Street is a care home for three adults with a learning disability. It is part of the Lady Verdin Trust organisation that operates a number of facilities for adults with a learning disability within Crewe and Nantwich. Located in a residential area of Crewe the semi-detached house is close to shops and other local amenities. The home has a mini bus that is used to transport residents. Access between the ground and first floors is by the stairway. The three bedrooms are single and are situated on the first floor. Each of the bedrooms has hand-washing facilities. Sufficient toilet and bathing facilities are provided. A large communal lounge/dining area and a smaller lounge are provided for the residents on the ground floor. There is a large well-maintained, secure garden to the rear of the home. A wheelchair is provided for a resident with mobility problems. Staff are on duty twenty-four hours a day to deliver care to residents. The Lady Verdin Trust Ltd - Stewart Street DS0000006557.V298592.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was carried out as part of the key inspection for the home. The visit took place, over five hours, on the 10 and 11 October 2206. The inspection included an analysis of information held about the service by CSCI. The manager for the home had provided information in a pre-inspection questionnaire prior to the visit taken place. CSCI survey cards were sent to the home to give to residents, relatives and other visitors to the home. Two relative and one general practitioner comment cards were completed and returned prior to the visit. Their comments have been included in the report. During the visit the three residents, three staff and the manager were spoken with. A number of records relating to the home and to residents were seen. Feedback on the findings of the inspection was given to the manager on the 11 October 2006. The fees for the home range from £1201.20 to £1382.73 per week. Further information on fees and funding can be obtained from the manager. What the service does well: Two residents said they like living in the home and that staff look after them. The Trust has provided a range of information about the services offered by the home. Although the current resident group have lived in the home for sometime the Trust has developed procedures to ensure prospective resident’s care needs will be met. This includes assessments carried out by staff from the home and by the care manager of the placing authority. Service user plans and risk assessment show how they want to live their lives. Regular meetings are held to review the placement to ensure that the placements continue to meet residents needs. The registered manager for the scheme is qualified and experienced; she is also the registered manager for another home within the Trust. Staff said the overall management of the scheme is ‘very good’ and that they are well supported. The Lady Verdin Trust has provided a range of policies and procedures including complaints and adult protection. The Lady Verdin Trust Ltd - Stewart Street DS0000006557.V298592.R01.S.doc Version 5.2 Page 6 The returned comment cards showed an overall satisfaction with the service offered by the home. 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 - Stewart Street DS0000006557.V298592.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 The Lady Verdin Trust Ltd - Stewart Street DS0000006557.V298592.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1/2/3/4/5 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 an informed 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. Documentation regarding the resident’s assessed needs is provided by the care manager. Staff from the home will also carry out pre-admission assessments that help determine if the home can meet the resident’s needs. As the current resident group has lived in the home for a number of years the pre-admission procedure has not being ‘tested’ in the home. 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 Nantwich Road, Crewe. The Lady Verdin Trust Ltd - Stewart Street DS0000006557.V298592.R01.S.doc Version 5.2 Page 9 The Lady Verdin Trust Ltd - Stewart Street DS0000006557.V298592.R01.S.doc Version 5.2 Page 10 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 adequate. This judgement has been made using available evidence including a visit to the service. Although residents plans show they are to be encouraged to be as independent as possible not all staff are aware of how this is to be achieved. EVIDENCE: During the visit to the home the personal development plans for one resident was seen. Included were plans of care, risk assessments, record of reviews and information provided by the care manager 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. The registered manager said that reading/updating residents plans is included as part of staff induction and individual supervision. Residents’ were seen approaching staff and were encouraged to do as much for themselves as possible. For example, one resident required help with his clothing so that he could use the bathroom independently. The Lady Verdin Trust Ltd - Stewart Street DS0000006557.V298592.R01.S.doc Version 5.2 Page 11 The Trust has provided a policy on the confidentiality of information. Staff spoken with were aware of the need to ensure the confidentiality of information about service users. During the visit one of the resident’s was having his breakfast and was sitting at the table in the dining area. A member of staff was mopping the kitchen and dining area floor at the same time. The cleaning routines for the home should be reviewed so that they avoid meal times. Also resident’s, where they choose, should be involved in the daily domestic routines of the home. The resident also received help with personal care when his care plan showed that this was not necessary. The member of staff who had carried out the assessment did not sign the resident assessment documentation seen during the visit. The Lady Verdin Trust Ltd - Stewart Street DS0000006557.V298592.R01.S.doc Version 5.2 Page 12 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The location of the home ensures residents are able to be part of the local community. This will offer residents opportunities for personal development. EVIDENCE: The three residents’ were seen receiving support and help from staff. For example, two residents were receiving help to prepare for their visit to a day care centre. Records seen showed residents’ weekly activity programme included trips to local shops, cinema and using other local amenities. 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 of, and their responsibilities to, residents. In discussion with staff, and from the records seen, one of the residents is being supported to make greater use of community facilities. For example using public transport and attending community events such as car boot sales. The Lady Verdin Trust Ltd - Stewart Street DS0000006557.V298592.R01.S.doc Version 5.2 Page 13 Risk assessments are in place to ensure the safety of residents’ when taking part in activities, both in the home and in the community. 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. The record of food offered to residents’ showed that they are offered choices at each meal. One of the residents was having his breakfast during the visit. He was sitting at the table whilst one member staff mopped the floor and the other staff member administered medication. The Lady Verdin Trust Ltd - Stewart Street DS0000006557.V298592.R01.S.doc Version 5.2 Page 14 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 adequate. This judgement has been made using available evidence including a visit to the service. Although the Trust have policies and procedures on providing support to residents not all staff understand the principles of giving personal support. EVIDENCE: During the visit staff were seen providing personal support to residents’ using the bathroom and getting ready for their daily activity. Staff were, on the whole, aware of the level of help residents’ required with these tasks and ensured their privacy and dignity was respected. 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. For example, plans were seen that showed the level of assistance residents required from staff with their general mobility. However, one resident was seen receiving help with a personal care task that his care plan showed he could carry out by himself. 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 The Lady Verdin Trust Ltd - Stewart Street DS0000006557.V298592.R01.S.doc Version 5.2 Page 15 to attend hospital appointments as necessary. Residents require full assistance from staff with the administration of medication. During the visit staff were seen administering medication to a resident. The procedure for ensuring the resident took his medication was not followed. The Lady Verdin Trust Ltd - Stewart Street DS0000006557.V298592.R01.S.doc Version 5.2 Page 16 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 available in the home. Details on how to contact the Commission for Social Care Inspection are included in the procedure. The staff spoken with during the visit 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’. The member of staff spoken with said they knew about the complaints and adult protection procedures and what to do if a problem arose. They said they would refer any concerns to the senior member of staff on duty. The Lady Verdin Trust Ltd - Stewart Street DS0000006557.V298592.R01.S.doc Version 5.2 Page 17 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The layout and appearance of the home ensures residents live in a homely and safe environment. EVIDENCE: A number of improvements have been carried out in the home. Bedrooms and the front lounge have been re-decorated. A raised garden has been created to the rear of the home. Residents’ single bedrooms are located on the first floor and contain handwashing facilities. They are also individually decorated and furnished. One toilet and bathroom is provided on the first floor and one toilet on the ground floor. Communal space consists of a large lounge/dining area and a smaller lounge. A wheelchair is provided for one of the residents. A secure well-maintained garden is located to the rear of the home and is easily accessible to residents. The area to the front of the home provides car parking space. The Lady Verdin Trust Ltd - Stewart Street DS0000006557.V298592.R01.S.doc Version 5.2 Page 18 On the day of the inspection the home was clean and free from unpleasant smells. Residents were seen moving freely about the home. The Lady Verdin Trust Ltd - Stewart Street DS0000006557.V298592.R01.S.doc Version 5.2 Page 19 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): 31/32/33/5/36 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. EVIDENCE: The staffing rota show that there are normally two staff on duty when all of the residents are in the home. A member of staff who sleeps in the home provides nighttime cover. There have been a number of personnel changes within the staff team since the last visit. Staff have either left the home or being redeployed to other services in the Trust. New staff have been employed to support residents, these staff are receiving support and supervision from the manager. The information provided in the pre-inspection questionnaire showed that three members of staff has achieved an NVQ Level 2 or above. 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 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. All staff have received training on the administration of medication. The Lady Verdin Trust Ltd - Stewart Street DS0000006557.V298592.R01.S.doc Version 5.2 Page 20 Staff spoken with said that, as part of their induction and on-going individual supervision, their roles and responsibilities in caring for the residents are reinforced. They also said regular staff meetings are held where resident and organisational issues are discussed. Records were seen to show that these meetings do take place. The Lady Verdin Trust Ltd - Stewart Street DS0000006557.V298592.R01.S.doc Version 5.2 Page 21 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is managed and run in the best interests of residents. The positive approach of the manager and staff will ensure the health and safety of resident’s. EVIDENCE: Since the last visit to the home the manager has had her application to be the registered manager confirmed by the Commission for Social Care Inspection. The manager has achieved the following qualifications: • NVQ Level 4 and Registered Managers Award • NVQ Level 3 • NVQ Level 2 • NVQ Assessor and Verifier • Safer Handling Instructors Training and has worked within the National Health Service and Social Services for over fifteen years. The Lady Verdin Trust Ltd - Stewart Street DS0000006557.V298592.R01.S.doc Version 5.2 Page 22 Since her appointment the manager has worked to improve the service offered to residents that includes further developing their personal plans and the training/supervision of staff. Staff spoken with were positive in their comments about the manager and her impact on the home. They said she discusses how the service to residents can be improved and will offer support/’hands on’ assistance as required. During the visit records were seen that showed that equipment is regularly serviced and that fire safety checks are carried out. The Trust has developed a range of policies and procedures, copies of which are available to residents and staff. The manager said she is in the process of developing a system whereby the residents can feedback on the quality of service offered. She has also attended a range of training courses that will help improve the service offered to residents. The Lady Verdin Trust Ltd - Stewart Street DS0000006557.V298592.R01.S.doc Version 5.2 Page 23 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 3 5 N/A 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 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 N/A 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 2 2 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 2 3 3 3 N/A N/A 3 3 N/A The Lady Verdin Trust Ltd - Stewart Street DS0000006557.V298592.R01.S.doc Version 5.2 Page 24 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. 2. 3 Refer to Standard YA6 YA7 YA20 Good Practice Recommendations All staff should be aware of the capabilities of residents, particularly in relation to personal care Residents should be encouraged to be involved in the cleaning routines for the home All staff should follow the procedures when administering medication to residents. The Lady Verdin Trust Ltd - Stewart Street DS0000006557.V298592.R01.S.doc Version 5.2 Page 25 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 - Stewart Street DS0000006557.V298592.R01.S.doc Version 5.2 Page 26 - 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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