Inspection on 26/06/08 for The Larkins

This inspection was carried out on 26th June 2008.

CSCI found this care home to be providing an Good service.

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 13/07/06

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 28/09/2008.

CARE HOME ADULTS 18-65 The Larkins Hill Top Brown Edge Staffordshire Moorlands Staffordshire ST6 8TX Lead Inspector Pam Grace Key Unannounced Inspection 26th June 2008 10:00 The Larkins DS0000005106.V366888.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.V366888.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.V366888.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.V366888.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th July 2006 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. The fees charged for the service at The Larkins, are from £937.40 - £1,910 per week. The fee information included in this report applied at the time of inspection, the reader may wish to obtain more up to date information from the care service. Other additional charges were made for toiletries, magazines, newspapers and holidays. The Larkins DS0000005106.V366888.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use the service experience good quality outcomes. This visit was an unannounced key inspection and therefore covered the core standards. The inspection took place over approximately 7.5 hours by one inspector who used the National Minimum Standards for Younger Adults as the basis for the inspection. Prior to the inspection, the care manager completed an Annual Quality Assurance Audit (AQAA) for us. There were also five “Have Your Say” questionnaires received from people who use the service. A tour of the home was undertaken. On the day of the inspection, the home was accommodating 5 people. We spoke with people who use the service, examined records, carried out indirect observation, and spoke with two staff on duty. Three care plans and three staff records were examined and observation of daily events took place. Medication procedures were inspected so that we could see how safe they were. We did not make any requirements, but made 1 recommendation as a result of this unannounced inspection. What the service does well: Observation of staff showed positive attitude and relationships with people who used the service. Staff continue to strive for high standards within the home and have supported people who use the service in a sensitive and supportive way. The Larkins DS0000005106.V366888.R01.S.doc Version 5.2 Page 6 Each person using the service has a plan of care, which they have helped to develop. Some people living in the home need support to communicate with others. People are involved in a variety of leisure and work activities. Staff support people to identify what activities they want to be involved in on a daily basis. People are able to develop life skills, staff said they are committed to supporting people to achieve identified goals. People are supported to maintain their interests and hobbies, and to go on holidays, visits, or out for meals, or to the pub. Staff enable and support people to keep in touch with their family and friends, either by arranging visits, and or by phone or letter. What has improved since the last inspection? Built an aviary and each service user chose a budgie to care for Supported service users in starting a business enterprise to earn more money to add to their allowance. (breeding budgies) Bought two donkeys and a pony for service users to achieve their wish of doing animal care which we keep at a local farm Built a pond and waterfall in the back garden to add to the sensory garden project and to provide fish care as an activity and sensory therapy Changed staff rotas to suit activities service users wished to do e.g. from 9am-6pm on Monday to 1pm-9pm on Monday to enable a service user to attend a beginners tap dancing class Organised and provided transport for one service user’s boyfriend to come and visit Changed horse riding schools as one lady was unhappy with the service she was receiving Supported a service user in changing the colour scheme in her bedroom Requested the Maintenance Co-ordinator to create a canopy for a service user’s bed to make a princess bed Employed an experienced Activities Co-ordinator on request of service user’s to do more activities Returned to the same destination for the annual holiday Increased one services user’s activities in walking and painting The Larkins DS0000005106.V366888.R01.S.doc Version 5.2 Page 7 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 summary of this inspection report can be made available in other formats on request. The Larkins DS0000005106.V366888.R01.S.doc Version 5.2 Page 8 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.V366888.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 5 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Information provided to people about the service enables them to make the decision about the suitability of the service and it’s ability to meet their needs. However the statement of purpose did not contain information in relation to charges made for holidays. EVIDENCE: We looked at 2 care plans, and saw 2 contracts. The fees had been reviewed. Pre-admission assessments were included in care plans seen. Individual written contracts for people using the service were available in picture and word formats. The Annual Quality Assurance Assessment (AQAA) document, which is completed by the care manager, confirmed that people wishing to use the service would undergo an assessment prior to moving into the home. “The home would then offer a three-month settling in period. During the three months, a comprehensive care assessment, risk assessment and activities programme are discussed with service users, including restrictions to independence. A key worker is allocated to the service user.” People had a copy of the Statement of Purpose and Service user Guide, which had been recently updated to include new information about the service, including the revision of fees. However, it is recommended that this The Larkins DS0000005106.V366888.R01.S.doc Version 5.2 Page 10 information should also include the costs for individual holidays. This was highlighted and discussed at the time with the care manager. People who provided feedback from our surveys, and people spoken with, said that they were “asked if they wanted to move into the home”, and they “were given information before they moved into the home”. One person said “yes – before I moved in the home my social worker told me the information I needed to know”. All five surveys received from people who use the service supported the view that they were asked if they wanted to move to this home, and five said they received enough information about the home before deciding if it was the right place for them. The Larkins DS0000005106.V366888.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 and 9 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Individuals are involved in decisions about their lives, and play an active role in planning the care and support they receive. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) document, provided by the care manager, confirmed the following: 1. “Produce a comprehensive person-centred Care and Risk Assessment covering Areas of Concern, Medical Health, Physical Skills, Mobility and Transport, Personal Care and Daily Routines, Communication, Accommodation, Financial Affairs, Leisure/Recreation and Personal Fulfilment, Religion and Culture and Other Needs Risk assessments take full account of individual abilities, health and aspirations Operate a key worker system DS0000005106.V366888.R01.S.doc Version 5.2 Page 12 2. 3. The Larkins Service users are informed of the different roles and responsibilities of the Care Manager and Care Team verbally and have access to information about advocacy services 5. The service user plans/care and risk assessments are reviewed as and when necessary or at least every six months. Service users know this from their contract. Professionals are involved when necessary and their involvement either is instigated from service users or agreed with them when the manager and care team feel it necessary 6. Service users are encouraged and supported to make their own decisions and choices and decisions made for them by others are explained 7. Service users are given the support they need to manage their finances and any restrictions in spending are discussed 8. Service user rights are respected and limitations are clearly documented in their care and risk assessment. The home’s duties and responsibilities under the law are taken very seriously 9. Service users are given opportunities daily in 1:1 discussions and during more formal house meetings to participate and contribute to the day to day running of the home 10. The home’s complaints and fire procedure is included in the service user guide in user friendly format 11. The home’s philosophy on risk taking is one of normal life risks and discussions concerning risks that service users wish to take are positive and balanced 12. The home has a missing persons policy and the level of staff and day to day activities of the home ensure prompt action would be taken if a service user was absent for an unreasonable amount of time The home has a policy on Confidentiality, which is part of all staff induction training. The policy is available for families and friends to view and it is explained to all service users ”. We looked at two care plans, both of which contained a client profile, with person centred information. Risk assessments seen identified in detail the risks for each individual. Evidence of health services input was also seen. Each plan was individualised, and recognised the personality and needs of the person. The plans were reviewed on a regular basis; any changes to the skills achieved were recorded. Evidence contained within care plans seen pointed to there being six monthly reviews held for each person. People spoken with said that they were consulted and encouraged to be involved in their care plan. This consultation was also confirmed when we spoke with staff during the inspection. Surveys received from people who use the service confirmed that people do make decisions about what they do each day – People spoken with said “I like going out with my key-worker, we go to the shops, and visit places.” Another person said “I choose my clothes each day, I like to wear pink and blue.” The Larkins DS0000005106.V366888.R01.S.doc Version 5.2 Page 13 4. We saw that people were asked by staff if they wanted drinks, food and snacks, which were made available throughout the day, with a choice of options for hot or cold food and or drinks. Some people chose to help staff prepare food for meals and snacks during the day. The Larkins DS0000005106.V366888.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,15,16 and 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use this service are able to make choices about their life style, and supported to develop their life skills. Social, educational, cultural and recreational activities meet individual’s expectations. EVIDENCE: The Annual Quality Assurance Assessment document (AQAA), completed by the care manager, confirmed the following: 1. 2. “The home promotes and respects service users to be individuals with their own abilities, interests, aspirations and goals in life The home is very willing to research job and education opportunities and organise attendance within the resources available. The home is in the process of setting up The Larkins Enterprise of breeding budgies to enable service users to supplement their income as well as supporting one service user to achieve paid work within the home’s administration DS0000005106.V366888.R01.S.doc Version 5.2 Page 15 The Larkins department with a view of taking her skills to other job opportunities once she has gained skills and experience 3. The home accesses the community almost everyday and service users are aware of the facilities in the local community. Service users use the banks, shops, cinema, library, leisure centre, pubs, ten-pin bowling, horse riding schools, dance schools youth club and restaurants 4. The home provides a people carrier for transport but service users will be supported if they choose to travel using other forms of transport 5. Service users have a full activities programme which they help to devise. The programme is reviewed every three months and service users have the option of changing, increasing or decreasing their activities within the hours available. Activities cover day and night, group and individual and are both in-house and out in the community. Refusal of activities and the reasons why are also recorded to help the home identify any areas concern 6. Service users help choose and plan the annual holiday 7. The home welcomes all visitors, friends, family and boyfriends and service user’s need for privacy is respected subject to restrictions agreed in service user’s care assessment. Visits to friends houses and family homes are also encouraged 8. Two of the ladies living at The Larkins have boyfriends who visit the home. Relationship guidance is given if requested or if the home feels its necessary 9. The home promotes a very, relaxed and friendly atmosphere where service users have full access to all communal parts of the home and garden and they feel free to join in on planned or impulsive activities or to be alone 10. House rules are limited and only serve to protect the rights of service users and staff 11. Each individual is encouraged to maintain their practical life skills e.g. cooking, cleaning, and such activities are part of their activities programme Pets are welcome and the home already has a cat, a koi carp pond in the garden and budgies 12. A six week menu was created from service user choice and the need for a balanced, nutritional and healthy diet. Changes are made in response to service users’ views Mealtimes are relaxed and enjoyable where all service users help out either by setting the table, clearing the table, cleaning the dishes etc. and are supported if needed.” We looked at two care plans. Information regarding triggers to any known behaviour, for example what may upset a person, or known fears were included within the care plan. Information was recorded in regard to how the person communicated. Assessments covered all aspects of daily living for example: mobility, traffic awareness, personal care. The Larkins DS0000005106.V366888.R01.S.doc Version 5.2 Page 16 Information relating to the person’s culture and religious needs were included in the plan, and how these were to be met. People at the home are able to express their own sexuality with appropriate support. For example: one person talked about staff supporting her with her relationship with her boyfriend, and said “I like visiting my boyfriend and going out to the pub”. Personal risk assessments recorded identified risk, level of risk and how to support the person. Individual timetables were available for us to view, these were clear and in a pictorial format. Surveys received from people who use the service all supported the view that they can do what they want to do, during the day, evenings and at weekends. Discussion took place with people who use the service throughout the visit, and in the dining room during lunch. This covered their daily programmes, activities, visits to see their families and friends. Daily activities and life continued as normal during our visit. Staff explained the inspection process to people using the service, during the inspection visit. People spoken with said that they “do shopping”, “choose their own meals”, that they “enjoyed their food very much”. “We go to the pub, and staff take us out on trips”. People also spoke about the pets that the home supports, they included a horse and pony, and budgies. One person discussed her hobbies and interests with us, these included collecting dvd films, listening to music, and making cards. There is a recently recruited activities person employed at the home on a full time basis. The Larkins DS0000005106.V366888.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) document, completed by the care manager, confirmed the following: 1. “The statement of purpose sets out the specialisms the home offers. Such as our ability to manage challenging behaviour through our policies and procedures, care planning process, multi-agency network, experienced and qualified staff and documented positive outcomes for existing service users Our fully trained and experienced staffs provide person-led, flexible and dignified personal support and respect the choices made by service users. E.g. choice of clothing, hairstyle etc. Our care assessments detail all healthcare needs and preferences. Service users are involved in meeting their needs and encouraged to be as independent as possible. Individual risk assessments ensure safety is not compromised DS0000005106.V366888.R01.S.doc Version 5.2 Page 18 2. The Larkins The home has a policy of knocking before entering to ensure privacy and respect 4. All our service users are proud of their appearance every day 5. All service users have the option to register with a GP of their choice as long as the GP is in agreement. They are currently happy with their local GPs, health clinics and frequency of check-ups 6. Service users are fully protected by our policies and procedures and upto-date training for dealing with medicines 7. Service users are fully protected by our policies and procedures and upto-date training when dealing with aging, illness and death The manager ensures all policies and procedures are adhered to.” We looked at two health care plans, these recorded health care needs and how people were to be supported. For example: if a person had epilepsy, a record would be kept of any seizures, and actions taken. Each person was registered with a local General Practitioner (GP). There were good relationships fostered between the home, the learning disabilities service, the GP and the local pharmacist. Other specialists maintain further contact and support. For example: Speech and Language Therapist, and where necessary, district nurses were approached for advice, information and any equipment necessary. People using the service attend surgery and or clinics as appropriate to their health needs. The evidence to support this was contained within daily records, and care plans seen. Medication was stored appropriately, and correct administration of medication was observed on the day of the inspection visit. Discussion took place in relation to medication that is taken out of the home, for example when people are staying overnight with relatives or friends. People spoken with during the inspection visit told us, “I can see my doctor if I’m poorly”, “staff will take me in the car to the hospital”. Discussion with staff revealed that they knew people well, and how to support each individual. 3. The Larkins DS0000005106.V366888.R01.S.doc Version 5.2 Page 19 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. 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. People who use the service are able to express their concerns and have access to a robust, effective complaints procedure. People are protected from abuse, and have their rights protected. EVIDENCE: The Annual Quality Assurance Assessment document, which was completed by the care manager, confirmed the following: “We have a robust complaints procedure and a comprehensive system of gaining the views of our service users which we value and action 2. Service users have included in their service user guide a written and pictorial complaints procedure illustrating timescales and exactly how complaints are dealt with and by whom 3. Staff are trained to support service users in making a complaint and to presume service users have the capacity to make all their own decisions unless proved otherwise 4. If we had a complaint we would fully record all details and actions taken 5. Our care and risk planning, policies and procedures, up-to-date training and quality assurance system fully protect service users from abuse, neglect and self-harm 6. Procedures are in place to respond to evidence of suspicion of abuse Advocacy information is available in written and DVD format for easy access to all service users. One service user has used the service in the past.” The Larkins DS0000005106.V366888.R01.S.doc Version 5.2 Page 20 1. The care manager and the complaints log confirmed that the service had not received any complaints since the previous inspection. The statement of purpose and service user guide did not contain adequate information in relation to making a complaint. Discussion took place in regard to the introduction of a “Grumbles book”, which could be used on a daily basis for minor grumbles. The care manager said that they encourage relatives to approach them if they have a problem. It would be discussed and addressed where appropriate at a time convenient to the family. There had been no complaints and no safeguarding issues reported to us since the previous inspection. Surveys received by us from people who use the service all confirmed that they knew who to speak to if they were not happy. One person spoken with said “I am very happy here”. People who use the service confirmed that they were very aware of whom to tell if they had a complaint. One person said “ I just speak to my key-worker”, another person said “everyone is very friendly here”. Two staff recruitment records evidenced that staff are recruited following robust procedures, which included Criminal Records Bureau and Protection of Vulnerable Adults (POVA) checks prior to commencement of employment. Staff spoken with at the time of the inspection confirmed this. Staff we spoke with were very aware of the need to Protect Vulnerable Adults. A spot check of two people’s finances revealed that the home appropriately records and receipts all personal monies held for people who use the service. The Larkins DS0000005106.V366888.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25 and 30 - Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables people who use the service to live in a safe, and comfortable environment, which encourages independence. EVIDENCE: The home is located in a semi-rural area and is set in pleasant gardens, with a fish-pond and well established shrubs, lawns and flower beds. Which are also well maintained. The Annual Quality Assurance Assessment (AQAA) document completed by the care manager commented on the following: 1. “The Larkins is good at creating a homely, comfortable and safe environment which is both clean and hygienic and tailored to the lifestyles and needs of our service users The home is located in a semi-rural location, which is appropriate for our service services. It is within a village community and is in close proximity to a small town and a larger town offering all community facilities and DS0000005106.V366888.R01.S.doc Version 5.2 Page 22 2. The Larkins 3. 4. 5. 6. 7. 8. 9. 10. 11. The services for our service users The home has spent considerable funds on ensuring fixtures and fittings are of the highest quality with temperature controls on most taps The home has spent considerable funds on ensuring the outside space is comfortable and entertaining with a barbecue area, grassed area, shed and sensory garden with koi carp pond, fountain, scented flowers and herbs, tactile grasses, colourful flowers and aviary with colourful budgies All service user bedrooms are above 12sqm and are furnished individually to how each service users desired Service users are free to decorate their bedrooms as they wish. They can lock their room from the inside and out. All service users love their bedroom and are free to spend as much private time as they wish in their bedroom Each bedroom have been risk assessed for its particular occupant The home has one shower room and one bathroom and three bedrooms have en-suites so technically all service users could bath/shower at the same time if they chose Service users have free access to all parts of the home except the office including a large lounge, dining/activities room, sitting area upstairs, kitchen and greenhouse The home contracts with a local maintenance firm who ensure the home is fully maintained and are available for all emergency situations. They keep a program of routine maintenance works within the home Systems are in place according to relevant legislation and best practice to control the spread of infection home complies with the requirements of the local fire service.” The AQAA document also confirmed that appropriate safety checks had been undertaken. Since the previous inspection, we saw that the service had plans drawn up for an extension and have recently received confirmation of full planning permission and work will start in the next 6 months. A sensory garden had been created in the back garden including a koi carp pond, fountain, scented flowers and herbs, tactile grasses, colourful flowers and aviary with colourful budgies. A vegetable patch had been created and people who use the service have each planted their own plants. A water fountain has been added to the front of the house, which can be heard by people whilst sitting in the dining room. The lounge, hallway and three service user bedrooms had been decorated. During a tour of the building, we saw that the home provides adequate communal space in the lounge, and dining room, both rooms are well used by people who use the service, and have comfortable and modern furnishings. The Larkins DS0000005106.V366888.R01.S.doc Version 5.2 Page 23 Bedrooms seen, evidenced that people have been supported to personalise them, with evidence of family memorabilia and photographs, evidence of hobbies and interests, people had their own televisions and radio’s. One person discussed her love of music and films. All bedroom doors were fitted with locks, keys are provided to people who choose to have one. One person said that they “could have visitors any time, if they wanted to”, and “I can watch television any time”. Surveys received from people who use the service confirmed that the home is always fresh and clean. The kitchen is fitted and modern, people who use the service are able to prepare and to cook meals within a risk-assessment framework and with support from staff. The Larkins DS0000005106.V366888.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 and 36 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff are trained, skilled and provided in sufficient numbers to support the people who use the service and to ensure the smooth running of the service. EVIDENCE: The Annual Quality Assurance Assessment document (AQAA), which is completed by the care manager, confirmed the following: 1. 2. 3. 4. 5. 6. “The Larkins takes great care to recruit staff who are caring, loyal and dedicated to improving the lives of our service users All necessary checks are carried out on possible employees, e.g. CRB, references, employment history The Larkins is very good at supporting and supervising its staff The Larkins prides itself on training its staff to a higher than average level, directly benefiting service user safety and happiness The Larkins is always willing to discuss staff personal training goals and works hard to gain available funding from the market place The Larkins ensures that the correct number of skilled staff are employed to meet service user needs at all times DS0000005106.V366888.R01.S.doc Version 5.2 Page 25 The Larkins The Larkins ensures all service users are aware that all staff are responsible for and have to be able to carry out all duties required to ensure the smooth running of the home. Due to the small size of the home all staff have to be multi-skilled The Larkins ensures that the care team always respects and promotes the liberty of service users.” The AQAA also confirmed that the home employed an experienced activities co-ordinator in February, and an additional support worker in March 2008. Four members of staff have completed their NVQ Level 3 Unit in Administrating Medication to Individuals. One new staff member is in the process of completing the NVQ level 2 award. Training in relation to the Mental Capacity Act 2005 had been scheduled for all staff. New members of staff would receive a full induction package, which is signed off by a senior member of staff during the induction period. From our discussions with staff, the care manager, and the examination of staff recruitment and training records, we were assured that the recruitment and training provided, promoted an effective staff team. Staff spoken with confirmed that staffing levels were flexible to meet the needs of the people who use the service, and their commitment to daily activities, for example: attendance at college, transport to an appointment, or a shopping trip. The staff rota for weeks commencing 15/06/08 and 22/06/08, confirmed that staffing levels had been maintained. Two staff records were examined. They evidenced that there is a robust system of recruitment in place. Recruitment records seen included an application form, two references, and Criminal Records Bureau/POVA checks. To ensure the protection of people who use the service. We spoke with staff, and saw individual staff training records for 2008, which confirmed that mandatory and update training was current, and that they received regular supervision via their line manager. Discussion took place in relation to the introduction of a staff training matrix. Staff meetings are held wherever possible on a three monthly basis. Staff meeting minutes were available for us to view. Surveys received from people who use the service confirmed the view that staff always listen and act upon what people say. 7. The Larkins DS0000005106.V366888.R01.S.doc Version 5.2 Page 26 The Larkins DS0000005106.V366888.R01.S.doc Version 5.2 Page 27 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect. The service has effective quality assurance systems which; have been developed by a qualified, competent manager. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) document completed by the care manager, contained good information in all outcome areas. The Annual Quality Assurance Assessment (AQAA) document completed by the care manager confirmed the following: 1. 2. “The Larkins is a well run home The leadership is strong and stable and the management approach is open and transparent. The care manager has a very positive and interactive DS0000005106.V366888.R01.S.doc Version 5.2 Page 28 The Larkins 3. 4. 5. 6. 7. relationship with all service users and has recruited and trained staff to develop the same beneficial relationships. Service users feel safe and comfortable with the care manager and staff The manager is fully qualified and has seven years experience in managing this home The manager/proprietor is visionary and has invested funds into the service year on year including expanding the home from three to five service users To date the policies and procedures and record keeping policies and procedures of The Larkins has safeguarded the rights and best interests of service users The health, safety and welfare of service users is a top priority for The Larkins Service users have full access to their records and are involved every step of the way. They trust the home implicitly in the handling of their money and have a safe place to keep their money and valuables with account book to record every penny spent and paid in.” People who use the service are well supported by the sensitivity, training, and experience of the staff employed by the company. Meetings for people who use the service, and for staff are held on a regular basis. People are encouraged and supported to speak out at meetings, and to take part in the recruitment process. There is evidence that the service has a robust recruitment procedure in place. This evidence came from the staff we spoke with and records we sampled. The ethos of the home was reflected in the policies and procedures, the records, attitude and competence of the staff in addition to comments received from the people who use the service. People’s citizenship and their rights, are protected by the staff and the training that they undertake. Records seen confirmed that the practice and procedure for weekly fire alarm testing and fire drills were current. There is a rolling programme of refurbishment and re-decoration, which is monitored by the care manager. The care manager quality assures the service by sending out questionnaires every 6 months to people who use the service. We discussed the need to feedback to people any action plan/outcome resulting from quality assurance of the service. This will expand and improve upon the quality assurance system already in place. Feedback could take place during resident and staff meetings. The Larkins DS0000005106.V366888.R01.S.doc Version 5.2 Page 29 The Larkins DS0000005106.V366888.R01.S.doc Version 5.2 Page 30 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 X 4 X 5 3 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 4 25 4 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 4 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 3 X X 3 X The Larkins DS0000005106.V366888.R01.S.doc Version 5.2 Page 31 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 YA1 Good Practice Recommendations Information provided in the statement of purpose, and service user guide should include the costs for individual holidays. The Larkins DS0000005106.V366888.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Larkins DS0000005106.V366888.R01.S.doc Version 5.2 Page 33 - 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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