Inspection on 03/06/05 for The Laurels

This inspection was carried out on 3rd June 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 19/12/05

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 Margarets Lane Titchfield Hampshire PO14 4BL Lead Inspector Laurie Stride Unannounced 03/06/05 9.30am 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 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 Stationary 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 H54 S28542 The Laurels V231112 030605.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Laurels Address St Margarets Lane, Titchfield, Hampshire, PO14 4BL Telephone number Fax number Email 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 CRH 8 Category(ies) of LD registration, with number of places The Laurels H54 S28542 The Laurels V231112 030605.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 03/11/04 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 H54 S28542 The Laurels V231112 030605.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit that lasted five hours, during which the inspector met two service users, spoke with the manager and staff member and viewed some of the home’s records. Since the last inspection two of the previous requirements had been met, and it is anticipated that the requirement that remains outstanding will be completed within the given timescale. What the service does well: What has improved since the last inspection? What they could do better: The organisation has been working on the implementation of a quality assurance survey involving all stakeholders. This remains a requirement as at the previous two inspections, as only partially met, with some stakeholder questionnaires still to be issued, returned and collated. The Laurels H54 S28542 The Laurels V231112 030605.doc Version 1.30 Page 6 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 H54 S28542 The Laurels V231112 030605.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Laurels H54 S28542 The Laurels V231112 030605.doc Version 1.30 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 standard(s) These standards were not assessed on this occasion. EVIDENCE: The Laurels H54 S28542 The Laurels V231112 030605.doc Version 1.30 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 standard(s) 6 and 9 There is a clear and consistent support planning system in place to provide staff with the information they need to satisfactorily meet service user’s needs and promote an independent lifestyle. EVIDENCE: The home continues to demonstrate a person centred approach to care planning, and records were seen of care plan reviews, updates and weekly evaluations. Daily reviews were made possible through good organisation and systems that staff found easy to use and which provided at-a-glance information. These records were taken to appointments with specialists who could then use the information to take appropriate actions. Records clearly showed that the home maintained the continuous assessment and monitoring of individual service user’s needs. Comment slips received from service users and relatives indicated that they were satisfied with the care and support provided. The manager was keeping in contact with relevant agencies regarding a service users’ care package and specific training had been arranged through them in relation to better equipping staff to meet the individuals’ needs. The Laurels H54 S28542 The Laurels V231112 030605.doc Version 1.30 Page 10 The home was further developing its risk assessment and management framework in relation to, for example, promoting health and wellbeing, social skills, self-care, hydration and diet. Management plans identified the risks and vulnerability (to self and others), the level of the risk, measures currently in place, action to be taken, evaluations and reviews. The Laurels H54 S28542 The Laurels V231112 030605.doc Version 1.30 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 standard(s) 13 and 17 Service users have opportunities to be part of the local community and have their dietary needs and preferences catered for. EVIDENCE: Service users had opportunities to access the community on a daily basis. For example, daily contact sheets showed that staff took residents out for drives, visits to relatives, shopping in Portsmouth and other towns, trips to the beach, and attendance at day services. Information is made available about political parties and service users are supported to exercise their right to vote if they wish. Staff rotas provided suitable cover to assist service users to access services and facilities outside of the home. The manager reported that the rota was not ‘set’ and remained flexible around resident’s needs. The home’s menus appeared to offer nutritional, varied and balanced meals and took account of service user’s specific needs. For example, staff were The Laurels H54 S28542 The Laurels V231112 030605.doc Version 1.30 Page 12 monitoring the calcium intake of one resident. According to the manager, a dietician from the health authority had approved the home’s menus, particularly with regard to containing lower sugar and salt levels. Records also showed agreed diet action plans, reviews and checks by the dietician, information on special diets and lists of alternative meals. The menu includes a free choice option and a resident was observed choosing to have a take away. Service user comments indicated that they liked the food. The dining room provides an attractive and comfortable setting in which to eat. The Laurels H54 S28542 The Laurels V231112 030605.doc Version 1.30 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 standard(s) 18,19 and 20 The personal support and health needs of residents are well met with multi agency working taking place. The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure service user’s medication needs are met. EVIDENCE: Staff reported that personal support to service users mostly took the form of verbal encouragement with personal hygiene and daily routines. Care plans contained information about service users’ preferences with regard to how staff provide support and evidence of external specialist support and guidance. A risk assessment regarding cross-gender care was in place for one service user who preferred to be supported by female staff. Service users’ comments indicated that staff treated them well and respected their privacy. A day file contained daily observation records, accident and incident reports, weight charts, menstrual charts and health visits. Daily contact sheets included records of individual residents’ appetites and food intake, medication taken, sleep patterns, personal support carried out and by whom, mood, The Laurels H54 S28542 The Laurels V231112 030605.doc Version 1.30 Page 14 behaviour, appointments with health professionals and care managers. One resident had recently had access to a speech and language therapist. The manager had completed an extensive report, backed by recent research, regarding one service user’s needs and had sent copies of it to relevant health and social care professionals. The home had a medication policy and procedures for the receipt, disposal, safe storage and administration of medication. The policy enables residents to manage their own medication if appropriate although no service users currently did so. The staff at the home were all assessed with regard to competency in administering medication. Staff doing NVQ level 3 awards also completed modules in the administration of medication and all staff were given guidance on the effects of different medications. Information was available about medications in general and specific to service users, allergies and homely remedies. A record was kept of the pharmacists’ visits and checks. PRN (as required) medication guidelines were comprehensive, describing trigger factors, behaviours, actions to take, side effects and monitoring guidance. A separate cabinet and suitable recording procedure was in place regarding a limited amount of controlled drugs held on site. The records of medication given matched the stocks held in a sample inspected. The Laurels H54 S28542 The Laurels V231112 030605.doc Version 1.30 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 standard(s) 22 The home has a suitable complaints procedure to ensure that service users views are listened to and acted upon. EVIDENCE: The homes complaints procedure was displayed in the home, and response timescales were inside twenty-eight days. The procedure is issued to service users and other stakeholders as part of the Service User Guide, and includes the name, address and telephone number of the Commission for Social Care Inspection. The home keeps a record book of complaints with forms for recording the date and nature of the complaint, action taken and if rectified, and the manager’s signature. The home had received one complaint since the last inspection and a written response had been provided within the timescale and a resolution recorded. Service users’ comments indicated that they knew who to speak to if they were unhappy with the care provided. Resident’s relatives stated that they were aware of the complaints procedure. The Laurels H54 S28542 The Laurels V231112 030605.doc Version 1.30 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 standard(s) 24, 28 and 30 The service provides a homely, safe and comfortable environment, with suitable laundry facilities and infection control procedures to safeguard residents. EVIDENCE: The home was free from visible hazards, clean, comfortable, well maintained and suitable for purpose. The furnishings and fittings were all good quality and domestic in appearance. The premises are in keeping with the local community and have a style and ambience that reflect the home’s purpose. The home provides transport for service users to access services and facilities. The environmental health officer visited the home during the week previous to the inspection and action had been taken to meet the recommendations made in the subsequent report. A new cooker and strip light cover had been fitted and new kitchen flooring was to be supplied. The fire officer had visited the premises on 05/05/05. A new ground floor bath/shower room had recently been completed. The Laurels H54 S28542 The Laurels V231112 030605.doc Version 1.30 Page 17 The home has a large well-maintained garden. There are two lounges and a separate dining room. Service users have suitable space to meet visitors in private. The kitchen and laundry room are well equipped and domestic in scale. A ground floor room provides space for staff to perform administrative duties and the manager has a small office on the upper floor. On the day of the inspection the home was clean and hygienic. The laundry is suitable for purpose being sited away from the kitchen and with easily cleanable walls and impermeable flooring. Staff are trained in infection control procedures and are equipped with gloves and aprons. The Laurels H54 S28542 The Laurels V231112 030605.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34, 35 and 36. Residents are supported and protected by suitable numbers of trained staff and the home’s recruitment and supervision policies and practices. EVIDENCE: The staff rota clearly showed who worked in the home on each day and in which capacity, for example support worker, night support worker or team leader. Staff on training were also clearly indicated. A pictorial rota was displayed in the dining room so that service users could see who was coming on duty. At the time of the inspection the home was unexpectedly short staffed and unable to obtain agency staff, so the manager was also supporting residents. Staff from another of the homes in the group also assist in providing cover from time to time. Staffing levels were being kept under review. The current cover was two support workers on each morning / afternoon shift and the manager working from 07:00 until 15:00 or 16:00. There are currently three service users living in the home and the manager and staff member both felt this was sufficient to meet resident’s needs. This arrangement left two support workers on duty when one of the service users attended day services. Another resident then had one-to-one support during these times. The Laurels H54 S28542 The Laurels V231112 030605.doc Version 1.30 Page 19 Recruitment records were seen for an ex-employee who had returned to work and for another full-time member of staff. Staff files contained a completed application form with a declaration of fitness and rehabilitation of offenders disclosure form, interview notes, qualifications and previous experience, proof of identity, two written references, employment contracts, Criminal Records Bureau (CRB) checks, training schedule, NVQ status, induction and supervision records. The schedule of planned staff training included dates when statutory training was next due, such as food hygiene, fire safety, first aid, moving and handling and infection control. Understanding abuse was also counted as mandatory training and understanding and managing challenging behaviour was compulsory for all staff. A staff member’s file also contained evidence of other training such as management of compulsive behaviours, valuing people and health action planning, stress management and breakaway techniques. Staff took part in structured induction training, based on a Training Organisation for the Personal Social Services (TOPSS – now called Skills for Care) induction and foundation standards workbook. There was a schedule of staff supervisions and individual staff supervision records were held on file. A member of staff confirmed that supervisions took place as well as team / key worker meetings. The manager was also conducting staff appraisals. A communications book was in place and the manager used this to keep all staff informed. The manager said she liked to give staff the reasons for doing things, for example a message in the communications book requested that staff read one section a week of the National Minimum Standards for care homes. The Laurels H54 S28542 The Laurels V231112 030605.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42 The home is putting systems in place to obtain views and promotes safe working practices to protect residents and staff. EVIDENCE: The company Operations Manager had developed a quality assurance questionnaire survey aimed at obtaining stakeholders’ views about the services provided. This system had not been fully implemented at the time of the visit. Some questionnaires had still to be returned so that a full report could be made and any subsequent action taken. The requirement for a quality assurance monitoring system was made at the previous two inspections. Another extension has been given in order for the organisation to complete the process, collate all the evidence and report on the findings. Senior managers were conducting regulation 26 visits. There was ongoing liaison with the community learning disability team and social services. Evidence was seen of safe working practices being promoted and upheld in the home. The kitchen was clean and equipped with coloured chopping boards, liquid soap and hand towel dispenser. Notices about the Food Safety Act 1990 The Laurels H54 S28542 The Laurels V231112 030605.doc Version 1.30 Page 21 gave guidance on the prevention of cross-contamination and information was held regarding the Food Safety Regulations 1995. A record was kept of fridge and freezer temperatures, defrosting and reheated food temperatures, and daily food stock checks. The fire safety log-book contained records of breakpoint tests, fire alarm services, staff drills and evacuation practices. Every three months the fire officer conducts an in-house check on fire safety systems. All staff attend the Hampshire Fire and Rescue service fire safety training as well as the in-house instruction. Other records held in the home demonstrated that gas and electrical appliances were tested. There was a house maintenance folder and health and safety risk assessments had been carried out for the premises. The Laurels H54 S28542 The Laurels V231112 030605.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x 3 x 3 Standard No 11 12 13 14 15 16 17 x x 3 x x x 3 Standard No 31 32 33 34 35 36 Score x x 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Laurels Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 3 x H54 S28542 The Laurels V231112 030605.doc Version 1.30 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 39 Regulation 24(1)(3) Requirement A quality monitoring system is developed to ensure feedback from service users and their representatives is obtained to assist the home in meeting its stated aims and objectives. This was a requirement at the previous two inspections. Timescale for action 11/07/05 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 Good Practice Recommendations The Laurels H54 S28542 The Laurels V231112 030605.doc Version 1.30 Page 24 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton, Hants 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. Extracts may not be used or reproduced without the express permission of CSCI The Laurels H54 S28542 The Laurels V231112 030605.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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