Inspection on 19/12/05 for The Laurels

This inspection was carried out on 19th December 2005.

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 Laurels 23/03/07

The Laurels 03/06/05

The Laurels 03/11/04

The Laurels 09/06/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 The Laurels St Margaret`s Lane Titchfield Hampshire PO14 4BL Lead Inspector Laurie Stride Unannounced Inspection 19th December 2005 09:50 The Laurels DS0000028542.V265211.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Laurels DS0000028542.V265211.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Laurels DS0000028542.V265211.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Laurels Address St Margaret`s Lane Titchfield Hampshire PO14 4BL 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) Rivers Reach Care Limited Ms Catherine Mary Angela Sands Care Home 8 Category(ies) of Learning disability (8) registration, with number of places The Laurels DS0000028542.V265211.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd June 2005 Brief Description of the Service: The Laurels is a large family home on two floors, converted to meet the needs of the service user group. It is located in a quiet road, in a semi rural area several miles outside Titchfield Centre. Accommodation is provided in single bedrooms without en suites. Communal space comprises two lounges, dining room and a large fitted kitchen. There is a large enclosed garden at the rear of the property. The Laurels is part of Rivers Reach Care Limited which runs three homes for people with Learning difficulties. The home is registered for service users with moderate to severe learning difficulties aged 18 to 65 years. The aims and objectives of the home are to enable service users to participate fully in daily living and meeting their own identified needs. Service users are encouraged to participate in the day to day running of the home and to access opportunities for education, employment and activities within the local community. The Laurels DS0000028542.V265211.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of two unannounced visits and lasted five hours, during which the inspector spoke with two service users, the team leader on duty and two staff members and viewed some of the home’s records. The inspector looked at the key standards not assessed at the last inspection and therefore this report should be read in conjunction with the previous report. Since the last inspection one outstanding requirement had been met. There were no requirements made as a result of this visit. What the service does well: 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 Laurels DS0000028542.V265211.R01.S.doc Version 5.0 Page 6 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 Laurels DS0000028542.V265211.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The home has thorough systems in place for continually assessing resident’s needs and aspirations. EVIDENCE: The inspector viewed the assessment records in relation to two current service users. Service users are admitted to the home following the gathering of information from a range of sources, including Care Management Assessments where applicable, and the homes assessment and admission documentation. The manager has developed a thorough policy and procedure involving service users, their families and representatives, and external agencies in this process and information is then used to inform care planning. The home uses an assessment format that includes practical information such as details of important contacts, current and previous placements, multiagency involvement, other contacts/visits, practical and physical support, communication, behaviour, staff support, activities and interests, vulnerability and protection issues. The home arranges assessment visits to the prospective service user’s residence and the service user can visit The Laurels for periods of increasing length, circumstances permitting. Service user’s family or representatives are also able to take part in this process. Once admitted, service users continue to have their care needs assessed and a review is held after the first twenty-eight days to which service user’s relatives and representatives are invited to attend. The Laurels DS0000028542.V265211.R01.S.doc Version 5.0 Page 8 The Laurels DS0000028542.V265211.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 The home supports service users to make informed decisions. EVIDENCE: Staff reported that they respect service users rights to make their own decisions. Staff were observed to provide service users with assistance and support to make decisions where needed; and evidence of this is also included in individual care plans. These identify the preferred methods of communication used by individual service users. Any instances where staff make choices for service users are recorded, for example if a service user presented a risk to self or others before going out. Flexible support is offered if a more structured day does not work for individual service users. For example, activities can be re-scheduled or alternative activities arranged. There are monthly group meetings for service users that provide an opportunity to discuss with staff the things they would like to do, for example holidays, outings and other activities. The team leader reported that service users can choose to speak to staff on a one-to-one basis if they prefer. These meetings are then followed by a keyworker action planning group, where staff get together to discuss and plan around the matters raised by service users. The Laurels DS0000028542.V265211.R01.S.doc Version 5.0 Page 10 All meetings are recorded and it was seen that discussions and plans are followed up. Staff provide support to service users who need assistance with managing their finances, for example going with them to the bank or building society. Service users can choose to use their personal allowances as they wish. Staff check service users understanding of money matters and to see that they have enough for activities they take part in. Transactions are recorded and signed for and receipts are numbered and kept. The Laurels DS0000028542.V265211.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 15 and 16 The service is well organised in providing service users with opportunities for taking part in appropriate activities, maintaining relationships and being involved in the daily routines of the home. EVIDENCE: The home’s care planning approach takes account of service users interests, choices and aspirations. Weekly individual planners are drawn up by staff, based on activities service users have done before coming to the home and wish to continue, and also on the results of the service user and keyworker planning meetings. Planners include activities such as going to day services, visits with relatives, outings, relaxation, shops and car boot sales, in-house activities, karaoke nights, arts and crafts. Service users have their own copies of their care plans. Care plans include service user’s daily schedules and sections on living skills. The daily records showed that service users took part in ‘home based skill enhancement days’ two or three times a week, for instance through doing domestic tasks supported by staff. The Laurels DS0000028542.V265211.R01.S.doc Version 5.0 Page 12 Staff reported that there was now a more stable and consistent staff team in place, and also that there were more drivers available to ensure service users have access to activities outside the home. Significant relationship links are recorded in individuals’ care plans, and the home welcomes and encourages families, friends and representatives involvement in service users’ support. A written policy states that visiting times are flexible although visitors are asked to respect mealtimes, and that service users can choose whether to receive visitors or not. Visits are recorded in daily contact reports and staff support in maintaining contacts is provided if needed. Service users confirmed that they saw their families, friends and representatives. Staff confirmed that the daily routines of the home promoted service users’ participation, independence and choice. For example, choosing whether to go out or not, what to eat and whether to join in-house activities. Service users were seen to be able to choose when to be alone or in company, and were able to move about the communal areas of the house without restrictions. Staff were observed interacting in a friendly and respectful manner with service users. All service users have their own key to their bedroom and staff have access to a master key in an emergency. The team leader said that a service user collects the mail in the morning and hands it to relevant service users. Staff then assist service users as necessary with information such as bank statements and appointments. The Laurels DS0000028542.V265211.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed on this occasion. Please refer to the previous report of 03/06/05. EVIDENCE: The Laurels DS0000028542.V265211.R01.S.doc Version 5.0 Page 14 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): 23 The home’s clear policies and procedures ensure that residents are protected from abuse, neglect and self-harm, however relevant staff training could be better documented. EVIDENCE: The home had copies of relevant procedures such as the Hampshire Adult Protection guidelines, Whistle Blowing and Department of Health guidance on physical intervention. The inspector was informed that the home does not use any physical interventions and prefers to use communication techniques to diffuse any potentially difficult situations. A member of staff confirmed that breakaway training had been provided. There is also a written policy regarding aggression toward staff members. Staff are provided with information about the General Social Care Council (GSCC) code of practice. The home’s records showed that two-hour training courses in understanding abuse had been arranged and attendance certificates were available in respect of some staff members. It was not possible to ascertain whether all staff who had been booked on such courses had attended and this will be further assessed at the next inspection. Through discussion with members of staff it appeared that staff were aware of the home’s procedures for responding to any allegation or suspicion of abuse, keeping appropriate records and reporting to the manager and relevant agencies. The Laurels DS0000028542.V265211.R01.S.doc Version 5.0 Page 15 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): These standards were not assessed on this occasion. Please refer to the previous report of 03/06/05. EVIDENCE: The Laurels DS0000028542.V265211.R01.S.doc Version 5.0 Page 16 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 Service users benefit through the home encouraging staff to undertake relevant care qualifications. EVIDENCE: Through observation and discussion with staff it was evident that staff had the attitudes, skills and experience necessary for the tasks they were expected to do, for example knowledge and understanding of service users personalities, needs and abilities. Staff were aware of the importance of continuity across the team and of requesting specialist advice if necessary, and demonstrated ability to observe and analyse situations. The team leader reported that out of nine care staff, three had achieved qualifications to NVQ level 3 or equivalent, and the home’s records confirmed this. Another staff member had commenced this training in February 2005 and the remaining staff were due to start NVQ2 training in January 2006. Some staff were also undertaking VRQ training modules in medication and health and safety. Staff appeared well motivated and are also given time at work to further their work on NVQ training. The Laurels DS0000028542.V265211.R01.S.doc Version 5.0 Page 17 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 Service users and staff benefit from a well run home and the leadership of the registered manager. EVIDENCE: The registered manager has been in post since July 2003, is qualified as both a social worker and a learning disability nurse, and undertakes regular training to maintain and update her skills. In addition to training and qualifications the manager has a good deal of experience working with people with learning disabilities in a wide variety of settings. Since coming into post the manager has continually improved the organisation of the home and developed links with other relevant agencies. There are clear lines of accountability within the home and the organisational management structure. Staff comments confirmed that the manager is accessible and supportive. The Laurels DS0000028542.V265211.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X X X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Laurels Score X X X X Standard No 37 38 39 40 41 42 43 Score 3 X X X X X X DS0000028542.V265211.R01.S.doc Version 5.0 Page 19 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. Refer to Standard Good Practice Recommendations The Laurels DS0000028542.V265211.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. 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