Inspection on 13/07/06 for The Larkins

This inspection was carried out on 13th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 Larkins 26/06/08

The Larkins 09/11/05

The Larkins 02/06/05

The Larkins 16/11/04

The Larkins 23/08/04

The Larkins 19/06/03

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 The Larkins Hill Top Brown Edge Staffordshire Moorlands Staffordshire ST6 8TX Lead Inspector Lynne Gammon Key Unannounced Inspection 13 and 27 July 2006 09:00 The Larkins DS0000005106.V306013.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 Larkins DS0000005106.V306013.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 Larkins DS0000005106.V306013.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Larkins Address Hill Top Brown Edge Staffordshire Moorlands Staffordshire ST6 8TX 01782 504457 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) Mrs Yvonne Proctor Mrs Yvonne Proctor Care Home 5 Category(ies) of Learning disability (5) registration, with number of places The Larkins DS0000005106.V306013.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th November 2005 Brief Description of the Service: The Larkins is a private, registered home providing a residential care service for up to five people with a learning disability. The home is a detached dormer bungalow set in its own spacious grounds that are found to the front and rear of the property. It is of domestic design and reflects the model of service it intends to provide, which is based on ordinary life principles. The home is located in a semi-rural area in the village of Brown Edge, with the town of Biddulph in the Staffordshire Moorlands, and the city of Stoke-on-Trent, within easy driving distance. No public transport is available, but the home has its own people carrier to enable access to the wider community and its facilities. Brown Edge is a typical village and there are a number of pubs and shops providing necessities. Social life is also typical of that provided in other villages, with various fetes and a well dressing ceremony taking place during the year. The residents are well integrated into the community life of the village, and join in all of the events enjoyed by the rest of the local inhabitants. Accommodation at the Larkins is spacious and three of the five bedrooms have an en-suite facility and there is one bathroom and one shower room also available. There is a comfortable lounge, a modern kitchen, a dining room/visitors room, an office and a staff room. The property has recently been extended to increase the number of places within the home from 3 to 5. This extension has been carried out to a high standard and complies with all regulatory requirements. On 20/06/06 information from the provider identified that the fees for the service were from £518 to £650 for basic care costs plus, for one to one care, an additional charge was made depending on the needs of the individual service user. Other additional charges were made for toiletries, magazines, newspapers, holidays etc. The Larkins DS0000005106.V306013.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit was made over 2 days (due to the service users going out on a pre-arranged trip) and carried out by one inspector who used the National Minimum Standards for Adults (18 – 65) as the basis for the inspection. The total time spent for the inspection, including pre and fieldwork, amounted to 9 hours. The inspection included a tour of the building, inspection of records, observation, and discussions with service users and staff. Service users spoken to stated that they were very happy living at the Larkins. One commented as follows: ‘‘It is good living at the Larkins, I am happy here, I like the food and I can do my own jobs, I want to stay at the Larkins”. What the service does well: The home provided sufficient information to enable the prospective service users to see if the home was suitable for them. Individual contracts were in place for the service users in picture and word format. The care planning processes within the home were well-documented and informative to enable staff to meet the needs of the service users. Service users were able to make their own decisions and choices about their lives and were consulted and involved in all aspects of living in the home. The service users were supported and enabled to maintain appropriate and fulfilling lifestyles in and outside the home. A well balanced and nutritious diet was provided in a relaxed and homely setting. The care planning processes and procedures were proactive in promoting the health and welfare of service users. Records and observation evidenced that service users were provided with the necessary support and assistance to access regular medical health services. A robust complaints procedure was in place and service users were listened to with their views taken into account. The homes’ Adult Protection procedure and staff training ensured they were protected from abuse. The home provided service users with an attractive and homely place to live, which was very clean and hygienic. The Larkins DS0000005106.V306013.R01.S.doc Version 5.2 Page 6 Sufficient numbers and skilled staff were provided in the home at all times to meet the needs of the service users. Recruitment and selection procedures were robust for the on-going protection of the service users. Staff received regular supervision for the benefit of the service users. The home was well managed and a positive, relaxed and happy atmosphere existed in the home for the benefit of the service users. The record keeping and policies and procedures protected the rights and best interests of the service users. The health, safety and welfare of the service users and staff were 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 Larkins DS0000005106.V306013.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 Larkins DS0000005106.V306013.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, 3, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provided sufficient information to enable the prospective service users to determine the suitability of the home for them. Written confirmation was provided to service users that the home could meet their needs and visits were encouraged before moving into the home following in-depth preadmission assessments. Individual contracts were in place for the service users in picture and word format for the benefit of the service users. EVIDENCE: The Statement of Purpose and Service User Guide were detailed and informative and together provided sufficient information to enable potential service users and their families to make a decision about the suitability of the home for them prior to moving in. The service user guide was extremely well laid out and designed with pictures and words to enable service users to have an easy understanding of its content. A letter of confirmation that needs could be met was seen and this was particularly well done. It contained pictures and words and was signed by the provider of the services and by the service user. The Larkins DS0000005106.V306013.R01.S.doc Version 5.2 Page 9 Service users and documentation evidenced that trial visits took place prior to moving into the home and the home had a 3 month trial facility to ensure both service user and provider were satisfied that needs could be met. The individual written contracts for each service user were also in picture and word format providing a document which could be easily understood by the service user. The service user and provider also signed these. The provider is to be commended for the effort in making these documents user friendly. The Larkins DS0000005106.V306013.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 and 8 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care planning processes within the home were well-documented and informative to enable staff to meet the needs of the service users. Service users were able to make their own decisions and choices about their lives and were consulted and involved in all aspects of living in the home. EVIDENCE: Service users knew all the detail in their care plans. One service user specifically wanted to tell the inspector about the difficulties that she had before she moved to the Larkins, which were recorded in her care plan. She found the exact part of her care plan outlining the concerns and was happy to talk about the plans which she said she agreed with. Observation and examination of documents showed that service users were able to make their own decisions about their lives. The care plans were detailed and reviewed monthly. Risk assessments were also in place and reviewed regularly. Service users had access to various professionals such as a GP, dentist, speech therapist etc. The Larkins DS0000005106.V306013.R01.S.doc Version 5.2 Page 11 Daily records were completed and areas of concern were recorded well. Service users had access to an independent advocacy service when requested. Service users were encouraged and supported to be involved in the decisions made in the home. The Larkins DS0000005106.V306013.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 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users were supported and enabled to maintain appropriate and fulfilling lifestyles in and outside the home. A well balanced and nutritious diet was provided in a relaxed and homely setting for the benefit of the service users. EVIDENCE: Service users confirmed that they had access to a range of activities appropriate to them such as: attending youth club, swimming at the local leisure centre, visiting the pub every other week, meeting friends, shopping, outings to places of interest such as the Dagfields Craft Centre and Trentham Gardens, garden centres, walking etc. Also, some of the service users attended college each week for art and craft, music and movement in drama sessions. Personal relationships and family relationships were supported and relatives were very complimentary about the home. One relative wrote ‘From the first day our daughter entered the care of Yvonne Proctor at the Larkins we have been treated with the utmost courtesy and friendliness by all the staff. The Larkins DS0000005106.V306013.R01.S.doc Version 5.2 Page 13 We believe our daughter is receiving the best possible care and consistent attention that she needs at this particular difficult time of her life’. Throughout the inspection it was observed that the rights of service users were respected and upheld and they had clear responsibilities within their daily lives. Lunch was served and seen to be a relaxed and happy event with a well balanced and nutritious meal provided for the service users. The Larkins DS0000005106.V306013.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 and 19 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care planning processes and procedures were proactive in promoting the health and welfare of service users. Records and observation evidenced that service users were provided with the necessary support and assistance to access regular medical health services. EVIDENCE: Discussions with service users and general observations throughout the course of the inspection identified that they were given personal support in the way that they wished and was responsive to their changing needs. One service user did not like to be touched, even on the hand by people she did not know or feel comfortable with, and the staff made sure that visitors to the home were aware of this. Other examples of respecting the service users wishes were observed throughout the inspection. Care plans provided information regarding the support and assistance that each individual service user required in ensuring and promoting their wellbeing. Health needs were closely monitored and the service users were supported to access the appropriate medical services. The Larkins DS0000005106.V306013.R01.S.doc Version 5.2 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A robust complaints procedure was in place and service users were listened to with their views taken into account. The homes’ Adult Protection procedure and staff training ensured they were protected from abuse. EVIDENCE: The home and the Commission for Social Care Inspection had not received any complaints since the last inspection. Service users confirmed that they did not have any complaints but did have copies of the procedure if they needed it. The complaints procedure was also available in the hall for visitors and relatives which had photographs of all the staff who could be the first point of contact for a complaint plus full details, including the telephone number of the local office, of the Commission for Social Care Inspection. No allegations of abuse had been received and staff training in abuse awareness contributed to the protection of service users. However, it is recommended that all staff undertake refresher training in the Protection of Vulnerable Adults reporting procedures. The Larkins DS0000005106.V306013.R01.S.doc Version 5.2 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, 26, 27 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provided service users with an attractive and homely place to live, which was very clean and hygienic. EVIDENCE: The home was comfortable, well furnished and very clean, and provided the service users with a ‘homely’ environment in which to live. The service users’ rooms were personalised with photographs and personal possessions. A service user said ‘my room is lovely, beautiful’. Another had posters on her bedroom wall of well known footballers and pop stars and a range of cd’s, dvd’s etc. Another service user said ‘I like living at the Larkins and am happy here’. Improvements to the home since the last inspection were: a new flooring laid in the dining room, a new dishwasher, larder fridges, hob and worktops had been purchased for the kitchen and the dining room, and the hallway and front door had been newly painted. The Larkins DS0000005106.V306013.R01.S.doc Version 5.2 Page 17 Three bedrooms had en-suite facilities. The home also had a bathroom and toilet on the ground floor and a shower room with toilet on the first floor. The home had a large rear garden with outdoor seating for the benefit of the service users. The Larkins DS0000005106.V306013.R01.S.doc Version 5.2 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, 34 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. NVQ training continued to ensure that qualified staff supported service users. Sufficient numbers and skilled staff were provided in the home at all times to meet the needs of the service users. Recruitment and selection procedures were robust for the on-going protection of the service users. Staff received regular supervision for the benefit of the service users. EVIDENCE: The home employed 5 care staff and at the time of the inspection 3 members of staff had obtained NVQ level 2 and 1 other was going to undertake training for NVQ level 3. Therefore the home had met the recommended target of having 50 of NVQ trained staff working in the home. LDAF training had commenced by 3 staff members including the registered care manager and Units 1 and 2 of Developing Competence in Care had been completed as part of this programme. Also staff had undertaken Blister Pack Medication training at Boots the Chemist and 2 staff members had undertaken Management of Actual or Potential Aggression (MAPA) on 17/03/06. Staffing rotas were examined and evidenced that satisfactory numbers of skilled staff were on duty at all times to meet the needs of the service users. The Larkins DS0000005106.V306013.R01.S.doc Version 5.2 Page 19 Inspection of staff files confirmed that recruitment and selection procedures ensured the safety of the service users. All POVA 1st and CRB checks had been completed for each member of staff prior to commencing employment and each staff file contained a photograph, an application form, 2 references and proof of identity. Records showed that staff had regular supervision sessions with the registered care manager which were very detailed and thorough. The Larkins DS0000005106.V306013.R01.S.doc Version 5.2 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, 40, 41 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered care manager was fit to be in charge, responsible and of good character. The open and transparent management of the home created a positive atmosphere for the benefit of the service users. The record keeping and policies and procedures protected the rights and best interests of the service users. The health, safety and welfare of the service users and staff were protected. EVIDENCE: The registered care manager was also the registered provider and set up the home in 2001. She confirmed that she was in the process of undertaking NVQ Level 4 in Care and the Registered Manager’s Award and had one module left to complete. She was very experienced in managing her responsibilities and staff to meet the needs of the service users in the home and service users benefited from her open, inclusive approach. The relationship between the registered care manager and the service users was positive and interactive; it The Larkins DS0000005106.V306013.R01.S.doc Version 5.2 Page 21 was clear that the service users felt safe and comfortable with her, and she promoted a positive, friendly and homely atmosphere. The policies and procedures within the home were examined and were found to be accessible to staff and complied with current legislation. Records for the protection of service users were up to date, accurate and secure and service users had access to their records and any information held about them. Documentation was inspected which confirmed that the health, safety and welfare of the service users were protected. These included: Fire alarm system inspection and service certificate 31/08/05, Fire Extinguisher/Blanket service on 20/06/06, Weekly smoke detector test, Monthly evacuation log completed, emergency lighting testing monthly etc. Most staff also had Health and Safety certificates dated May 2005. The Larkins DS0000005106.V306013.R01.S.doc Version 5.2 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 4 2 X 3 3 4 3 5 4 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 X 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 4 X X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 4 3 X 3 3 3 X The Larkins DS0000005106.V306013.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 YA23 Good Practice Recommendations For all staff to receive refresher training in the POVA referral procedures. 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