Inspection on 07/06/07 for The Laurels

This inspection was carried out on 7th June 2007.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Laurels 25/09/05

The Laurels 03/05/05

The Laurels 18/11/04

The Laurels 15/04/04

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 Laurels, The Highfield Road Shanklin Isle Of Wight PO37 6PR Lead Inspector Neil Kingman Unannounced Inspection 7 June 2007 14:00 Laurels, The DS0000012506.V338732.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 Laurels, The DS0000012506.V338732.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. Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Laurels, The Address Highfield Road Shanklin Isle Of Wight PO37 6PR 01983 867297 01983 865777 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) Islecare `97 Limited Mrs Linda Janet Sims Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25 September 2005 Brief Description of the Service: The Laurels is a registered residential home providing care and accommodation for up to six younger adults with learning disabilities. Mrs Linda Sims manages the home on behalf of the owners Islecare 97 who provide a number of homes for people with learning disabilities on the Isle of Wight. The manager is responsible for both The Laurels and Highmead, a similar home on the first floor of the same building and has experienced deputy managers to assist her in each home. The Laurels occupies the lower ground floor of a larger building, which, in addition to Highmead, houses Islecare management and training rooms on the ground floor. All rooms are for single occupancy and are equipped with wash hand basins. Communal space comprises a lounge and kitchen/diner and there is a bathroom with shower/wet room and separate toilet facilities. Outside there are private gardens with some seating and limited parking spaces can be found at the front and side of the main building. Weekly fees are determined by the social services funding arrangements and currently range between £353.22 and £875.23. The manager states that a copy of the home’s service user’s guide, together with the terms and conditions of residency are provided to all prospective residents, or their representatives where applicable Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report details the results of an evaluation of the quality of the service provided by The Laurels and brings together accumulated evidence of activity in the home since the last key inspection on 25 September 2005. Part of the process has been to consult with people who use the service; including a Social Services Care Manager who regularly visits the home. There were four responses to the visitors/relatives survey. Included in the inspection was an unannounced site visit to the home by an inspector on 7 June 2007. The registered manager Mrs Sims was not available on the day so a return visit was made the following day to complete the examination of records. At the visit we had an opportunity to tour the building, speak with staff on duty and all the people who use the service. We also looked at a selection of records. Prior to the site visit the manager sent to the Commission a range of information about the service including an Annual Quality Assurance Assessment (referred to as the ‘assessment’ during the report). However, the assessment lacked essential detail in all areas, especially the key areas of what the service does well and what they could do better. What the service does well: A social services care manager who represents several people in the home was very complimentary about the service provided, confirming that staff have the right skills and are very good at responding to individual’s needs. Special mention was made of their ability to network for advice and problem solve. Comments from visiting relatives include, “The staff are very caring to those living there and my admiration goes out to them.” “The care home is amazingly supportive at all times.” “The home chooses and trains truly caring people.” “A very happy home – staff show great patience, kindness, understanding and care towards the residents.” From conversations with people before and during the site visit and from observations in the home it was evident that staff are given the skills and support to meet peoples’ changing needs Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 6 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 summary of this inspection report can be made available in other formats on request. Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 – People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager ensures that the care support needs of the people who use the service will be met by undertaking a proper assessment prior to them moving into the home. EVIDENCE: Pre-admission assessment The Laurels provides care and support for up to six younger adults with learning disabilities and people who live there tend to be long term. At the time of the inspection there was full occupancy. Currently all those who use the service have been referred through Social Services Care Management, the most recent having moved into the home in November 2004, before the current manager took over the post. The manager confirmed that while she had not been involved with the admission of anybody new to this home she had previous experience of the process and showed a good understanding of the importance of a professional assessment in which the prospective resident/representative is fully involved, with appropriate support. Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 - People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are involved in decisions about their lives, which are determined by assessment and recorded in individual personal plans. However, plans lack a ‘person centred’ approach and need to reflect best practice in this area. People are encouraged to be as independent as possible and to take sensible risks, which enhance their enjoyment of life. EVIDENCE: Personal plans – Each person who uses the service has an individual personal plan. A sample of three plans was viewed during the site visit. The intention was to look at the outcomes for people in general by assessing the information and support, which helps them to express their views and lead the lives that they choose. The sample (two males and a female) included the newest admission to the home, a person with good verbal communication and a person with relatively high support needs who has no verbal communication. Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 10 It was noted that information in personals plans is not ‘person centred’, and is very much ‘care’ orientated. Several documents used for recording information are date stamped to indicate that Islecare introduced them in 1998, e.g., ‘customer information’ and ‘summary of initial assessment’. The summary of initial assessment in particular is not person centred but rather clinical in its format. In addition, a ‘care needs sheet’ is used to identify the care need, aim and expected outcome and the care/nursing treatment to be given and when. This style of documentation is considered more suitable to an older persons service and does not reflect good practice in services for younger adults. Peoples’ files do contain a Health Action Plan, which is used to assist the National Health Service at times when individuals may need hospital treatment. The information in these plans is set out in a person centred way. In discussions with the manager it was clear that she is fully aware of the need for a person centred approach to recording individual’s needs, wishes and aspirations. There was evidence to show that she had begun the process of updating personal plans in the other Islecare home that she manages. It is important that this process takes place in The Laurels for the standard to be fully met. Decision making In discussions with the manager and staff on duty it was clear that they respect peoples’ rights to make their own decisions. Discussions with one individual who has good verbal communication supported this. This person had made a decision not to continue with day services because it was not what they wanted anymore, preferring instead to go out with staff on a one to one basis, or stay in the home painting, colouring or watching TV. Another resident on their return from a day centre wanted to talk about their plans for the following week. There was every indication that it was their decision to attend the various activities that were outlined on a weekly activities planner. It was understood in discussions with the manager that all but one has someone independent of the home to represent them. One individual has an independent advocate. People who use the service do not have the cognitive ability to manage their own finances and need staff to assist them. During the site visit we looked at the system in place to safeguard peoples’ monies and support them to meet the various expenses incurred during the week. Records of expenditures are well maintained and receipts are kept to evidence purchases. Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 11 Risk taking – Specific risk assessments were noted on the sample of personal plans viewed. Risks are identified, and to what degree. Guidance is given for staff on what to do to reduce the risk. There are comprehensive guidelines in place, which have been drawn up with the support of external healthcare professionals, e.g., Psychologist, Community Psychiatric Nurse and in one case an Occupational Therapist. Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 - People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are encouraged and supported to make choices about their lifestyle and develop life skills. A range of activities meets individual’s likes, dislikes and expectations. People are supported to maintain regular contact with families, friends and the local community and routines help to promote their independence. They are offered meals they enjoy, which are varied and healthy. EVIDENCE: Education and occupation The manager and staff said the home works hard at exploring different activities to stimulate and challenge the residents as their assessed needs are such that seeking jobs for them is not appropriate. Physical and cognitive impairments limit their opportunities for education and training to that which is offered through the day services they attend throughout the week. In Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 13 discussions with the manager about the administration of residents’ finances it was clear that any problems they have with finances or benefits are referred appropriately. This was confirmed with the care manager spoken with. Community links, social inclusion and relationshipsEach person has an individual weekly programme of activities that includes a range of day services and leisure activities, intended to help develop and maintain life skills and provides opportunities for socialisation away from the home. These activities include: shopping trips, several day services, picnics, walks, trips to places of interest, and aromatherapy. The home has the benefit of two specially adapted people carriers, capable of accommodating people with wheelchairs. People are given the opportunity to go on holiday each year and this year the home was making plans for several to visit the West Country, accompanied by staff. One person spoken with was very clear that they were not interested in organised activities, preferring instead to spend time in the home doing arts and crafts based activities, watching TV and accompanying staff when they go out in the home’s transport. Five of the six people who use the service maintain contact with their families. The manager supports them to visit family away from the home if required. All four responses to the relatives/visitors survey indicated the home always or usually help the resident to keep in touch with them. Daily routines Bedrooms were seen to be well personalised and reflected residents’ different interests and preferences. Staff respect their privacy and were seen to knock before entering their rooms. We noted communication between staff and the people who use the service to very good; even those with no or limited verbal communication are understood through non-verbal signs and the experience of the staff. The manager said that while not all people want to, or have the cognitive ability to assist with housekeeping tasks one in particular can, with encouragement help in some small way with some of the domestic tasks like cleaning, laying tables and making the bed etc. Meals – During the site visit the senior care support worker on duty was preparing the cooked evening meal. In discussions it was understood that staff take turns to cook the meals, an arrangement that works well in the domestic scale environment. She said that staff work well as a team. Residents who were able to give an informed view about the food were very complimentary. Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 14 All staff spoken with considered the meals were well received by the residents. They said they knew through several years experience what they liked and needed in their diet. Menus were seen as varied and nutritious, with plenty of fresh food, including vegetables. It was noted that fresh fruit was available and offered as an alternative to other sweets. Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 15 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 - People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff provide flexible but consistent support for people and are responsive to their changing needs. They encourage them to make choices, which reflect their individual personalities. Healthcare needs are assessed and key workers enable and support people to receive healthcare checks at appropriate intervals. Medication is securely held and appropriate records maintained. EVIDENCE: Personal support – On the afternoon of the site visit there were four residents in the home. The other two returned from their respective day services around teatime. The home operates a key worker system and people are supported to make decisions and choices in respect of clothing and personal appearance. It was noted that they were dressed differently, as one would expect, according to their ages and preferred tastes. Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 16 Daily recording on personal plans showed there is flexibility around times for getting up and going to bed and it was noted that respect for dignity was an important issue. On the morning of the second visit it was noted one person had wanted to rise later than normal and staff accommodated this. There is a mix of males and females amongst the people who use the service and similarly the home has a mixed gender staff group. Staff showed a good understanding of the issue of respect for peoples’ dignity in describing the daily routines of personal care and support. They were seen to knock before entering rooms and addressed them in friendly and respectful way. Risk assessments in respect of safe moving and handling have been completed for all those who use the service and were seen in care plans during the inspection. With adequate aids and equipment and two vehicles available staff are able to fully support residents to go out for appointments, shopping, day services and leisure activities. The home has four height adjustable beds to meet the assessed needs of those who require support with personal care in their rooms. Healthcare – Records showed that peoples’ health care needs are regularly addressed. They receive checks from the GP, dentist, optician and specialist health care professionals. All health care needs of the residents are identified in their personal plans and each has a person centred Health Action Plan. The manager said that all residents are registered with local health clinics where there are several GPs. The care manager confirmed in discussions that staff had a good understanding of residents’ healthcare needs, and kept them informed of important events affecting their wellbeing. Medication Medication is dispensed by means of a monitored dosage (blister pack) system by staff who have completed the appropriate training and deemed competent by the manager. At the time of the site visit medication for residents was securely held in appropriate facilities, and records relating to its safekeeping and administration were found to be in good order. Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 17 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 - People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be sure their complaints are treated seriously and given an appropriate response. The home’s policies, procedures and practices ensure that residents are safeguarded from abuse. EVIDENCE: Complaints The home has a formal complaints policy and procedure, which is included in the Service User’s Guide. In a general sense people who use the service have cognitive impairments, which made it difficult to gauge their understanding of what to do if they had a concern. Two of the four responses to the visiting relatives survey indicated they knew how to complain; one could not remember and one did not know but had never needed to make a complaint. The pre-inspection information about the home, which was forwarded to the Commission prior to the site visit, confirmed that there had been no complaints since the last inspection. In discussions with the staff group it was clear that support workers know how to recognise the non-verbal signs that would point to a resident being unhappy. Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 18 Safeguarding adults The home has an adult protection policy and procedure in place, which was reviewed in 2006 and updated to link with the local authority guidance. Islecare has produced a one-page adult protection summary guidance as a reminder for staff on the reporting procedures. This document is prominently displayed on the wall in the hall. In discussions with care support workers it was clear they were confident about reporting issues of concern without delay. Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 19 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 and 30 - People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home’s premises do not fully meet the individual needs of all those who use the service. While generally homely, comfortable and safe they are not well maintained and cannot be said to be in keeping with the local community. On the day of the site visit the home was clean, hygienic and free from unpleasant odours. EVIDENCE: Premises The home provides a physical environment that is appropriate to the specific needs of some but not all the people who live there. A tour of the building and grounds was undertaken during the site visit. The Laurels occupies the lower ground floor at the rear of a large building shared with another home for people with learning disabilities and Islecare Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 20 management, training and administration offices. The home is approached through a gate, near to which are the rubbish collection and clinical waste bins. An attempt has been made to make a section of the grounds more pleasing to the eye by creating a patio and gravelled area with a nautical theme titled ‘The Laurels harbour’. The side and rear of the building are, according to one of the support workers, not generally used and are not subject to regular maintenance. Window frames have peeling paintwork and sills show signs of rot. The outside windowsill to one resident’s room has almost completely rotted away. Inside, all residents’ rooms are for single occupancy and are generally well personalised and reasonable decorated. To meet the physical needs of some people modern height adjustable beds have been introduced. One person who uses the service is a wheelchair user. The opening width to this person’s room is 100mm less than the minimum 800mm recommended for new build, extensions and first time registrations. The outcome is that there is potential for the wheelchair user to catch their knuckles on the doorframe on their way in and out of the room. The same applies to the entrances to the lounge and the kitchen/diner both of which measure 760mm. Since the last key inspection work has been carried out to upgrade the bathroom, which is bright, spacious and now includes a shower/wet room. Next to the bathroom is a separate toilet, which although clean is old fashioned and shabby with a paper freeze, which is peeling off the wall. The lounge used by those who live in the home is comfortable and reasonably decorated. Furniture is designed to meet the individual needs of those who have a physical disability. The kitchen/diner like the toilet is in need of modernisation. The only negative comments in the Social Services Care Manager and visiting relatives’ surveys relate to the home’s environment: “The actual building is looking in poor shape.” “The Laurels is a very small home. A bigger custom-built home would be beneficial for them.” “A new purpose-built home with en-suite for all would be ideal.” “It’s an old Victorian building in need of some work – needs money spent on it.” Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 21 Three people who use the service who were able to make comment said they liked their individual rooms. The manager recognised that improvements are needed but explained that the building is owned by the local authority, and despite several formal requests having been made there has been no response. Cleanliness It was noted during the site visit that all areas of the home were clean, hygienic and free from unpleasant odours. A laundry is located away from areas where food is stored, cooked and eaten, and houses machines capable of washing soiled articles at appropriate temperature. Infection control procedures are in place to manage the handling and disposal of clinical waste. Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 22 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 and 35 - People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home have the necessary skills, experience and qualifications to meet the needs of the people who live there. A robust recruitment procedure ensures residents are protected. EVIDENCE: Staff recruitment The manager confirmed that five new care support workers had been recruited since this standard was last assessed. Individual staff recruitment files were available for inspection and showed that the home’s recruitment procedure includes: • • • • • • An application form A job description A contract of employment Proof of identification Two written references Police and Protection of Vulnerable Adults (POVA) checks on all staff. DS0000012506.V338732.R01.S.doc Version 5.2 Page 23 Laurels, The The recruitment records of all five new recruits were checked and found to be in good order. Staff training, development and competencies The manager said that Islecare on the Isle of Wight had recently recruited a training administrator who is developing a computerised system to identify and co-ordinate the training needs of care support staff in their services across the Island. At this site visit there was evidence to show that Islcare provides their staff with a good training package. This was supported with comments from staff spoken with. There was an opportunity to speak with the Company’s Island training co-ordinator who described a progressive approach in plans for future staff training. The manager and staff confirmed the content of the training programme, which includes: Health and safety Health and hygiene Appointed persons Downs syndrome Autistic spectrum disorder Person centred planning Manual handling Food hygiene Health and care matters Safeguarding adults Medicines administration and control Refresher training is ongoing. The manager said that all staff were undertaking Learning Disabilities Award Framework (LDAF) training and one had completed it. 69 of the thirteen care support workers employed in the home have achieved the NVQ at levels 2 or above and the Company’s training programme ensures that the standard continues to be met. Individual staff training files with achievement certificates were available for inspection. All four responses to the visiting relatives survey indicated the staff employed in the home usually have the right skills and experience to look after people properly. The care manager who visits the home considered staff to be well trained and competent. Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 24 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 - People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service live in a home where the registered manager is fit to be in charge, has experience and is fully qualified to run the home and meet its stated purpose, aims and objectives. Quality assurance measures are in place to ensure the home is run in peoples’ best interests, and the home’s policies, procedures and staff training ensure as far as is reasonably practicable, peoples’ health and safety. EVIDENCE: Management – The manager has many years experience of managing a service for people with learning disabilities. She was appointed to the post at The Laurels in March 2005 and is fully qualified, having achieved the NVQ at level 4 in care and also the Registered Managers Award (RMA). Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 25 Staff spoken with regarded the home as being well run and morale was generally good. They confirmed that the manager was approachable and supportive and that regular staff meetings and formal supervision sessions take place. Quality assurance At the site visit the manager produced the Company’s strategic plan for 2007 – 2012. The document covers the whole range of services run by the company and is not specific to The Laurels. However, the manager highlighted her own quality audit for the home, which incorporates key performance indicators, objectives and an action plan. This has yet to be updated with results. The home is relatively small and domestic in scale. In discussions with the manager she outlined the steps taken to monitor the quality of service at The Laurels: • • • • • • • Key worker system Annual service audits by a representative of the Company. Annual care/support reviews involving residents, families, advocates and social services. Regular one-to-one contact with families/representatives. Staff meetings and supervisions. Monthly statutory visits to monitor the conduct of the home. Investors in People Award. The responses from the visiting relatives and care manager survey were quite positive, the only negative issue being the state of the environment. Health and safety All support staff undertake statutory training, which includes health and safety awareness, manual handling, fire training, appointed persons, food hygiene and infection control. The home’s pre-inspection information confirmed that policies and procedures were in place to ensure safe working practices in the home. During the site visit a sample of records was viewed including fire alarm tests, risk assessments, public liability insurance, and gas and electrical certificates, all of which were in good order. Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 26 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 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 1 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 x LIFESTYLES Standard No Score 11 x 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 3 x 3 x x 3 x Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 27 Yes 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 1 YA6 Regulation 15 Requirement Timescale for action 31/08/07 2 YA24 23 To review the personal planning process, to ensure that each plan is appropriate to the age and needs of the individual. 20/07/07 To forward to the Commission a plan with timescales for addressing the environmental shortfalls identified in the report: • Poor maintenance of window frames and sills and the residents’ toilet gives the building a neglected and ‘run down’ look. (The requirement relating to the toilet remains outstanding from the last inspection) • Narrow door openings to bedrooms and communal living areas can cause pain and discomfort for wheelchair users. Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 28 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 Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Laurels, The DS0000012506.V338732.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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