Inspection on 27/10/05 for The Laurels - Fontwell

This inspection was carried out on 27th October 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 - Fontwell 26/06/06

The Laurels - Fontwell 04/06/05

The Laurels - Fontwell 12/01/05

The Laurels - Fontwell 16/08/04

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

CARE HOME ADULTS 18-65 The Laurels-Fontwell Arundel Road Fontwell Arundel, West Sussex BN18 0SB Lead Inspector Annette Campbell-Currie Announced 27 October 2005 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-Fontwell H60-H11 S14781 The Laurels-Fontwell V248351 271005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Laurels - Fontwell Address Arundel Road, Fontwell, Arundel, West Sussex, BN18 0SB 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) 01243 544514 CARE (Cottage and Rural Enterprises Limited) Mr Paul Christopher Clausen Care Home 6 Category(ies) of LD Learning Disability - 6 registration, with number of places The Laurels-Fontwell H60-H11 S14781 The Laurels-Fontwell V248351 271005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 04 June 2005 Brief Description of the Service: The Laurels is a care home registered to accommodate up to six service users who have a learning disability (LD) and are aged between eighteen and sixtyfive years. The Laurels is a purpose built care home that was opened in 1996; it is situated in the rural village of Fontwell near Chichester. Service users are accommodated in single rooms on the first floor which is accessed by a flight of stairs. Every bedroom has a wash hand basin. There are two bathrooms with separate toilet facilities on the first floor. On the ground floor there is a communal lounge and an open plan kitchen and dining room. There is a large enclosed garden and patio area. Cottage and Rural Enterprises (CARE) own the Laurels. Mr Michael Keighley is the responsible individual for the organisation and Mr Paul Clausen is the registered manager responsible for the day-to-day running of the home. The Laurels-Fontwell H60-H11 S14781 The Laurels-Fontwell V248351 271005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over an afternoon and early evening. Information and comments from service users and their relatives were sought to assist with the planning of the inspection. The five service users currently living at The Laurels returned comment cards completed with the help of staff. Four relatives returned comment cards. All the comments received were very positive about the care provided at The Laurels. The registered manager was on leave at the time of the inspection so the deputy manager and Mr Clausen’s line manager assisted with the inspection. Time was spent reading documents and case records and also in discussion with staff and service users. The service users extended an invitation for the inspector to join them for the evening meal. This provided an excellent opportunity to spend time with service users in a relaxed atmosphere discussing how they feel about their life at The Laurels. One of the service users had prepared and cooked the meal with the help of the member of staff on duty in the evening. What the service does well: What has improved since the last inspection? The staffing structure has changed and a new post has been created. A senior member of staff has been appointed as deputy manager. Two new members of staff have been appointed to increase the staffing levels. The staffing situation at weekends has improved, shift patterns have been altered to ensure The Laurels-Fontwell H60-H11 S14781 The Laurels-Fontwell V248351 271005 Stage 4.doc Version 1.40 Page 6 that people do not work over long shifts at weekends. Regular bank staff are employed to supplement staffing numbers, especially at weekends. One person whose needs had changed has moved to a home that can better meet his needs. All service users have enjoyed a holiday to the destination of their choice. The system of person centred care planning is beginning to be implemented. 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-Fontwell H60-H11 S14781 The Laurels-Fontwell V248351 271005 Stage 4.doc Version 1.40 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-Fontwell H60-H11 S14781 The Laurels-Fontwell V248351 271005 Stage 4.doc Version 1.40 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) 1, 3 and 5 Service users are provided with up to date information about The Laurels so that they can make an informed choice about where they live. Service users can be confident that their needs will be met at The Laurels. Each person is provided with a statement about the terms and conditions of the home. EVIDENCE: The Statement of Purpose has been reviewed and updated to ensure that it reflects current circumstances and staffing details. Information about the home is provided in symbol format for people who use this form of communication. It was evident from training information and discussion that staff are provided with the specialist skills that they need to meet the needs of people living at The Laurels. Service users have access to additional support from the local Community Learning Disability Team. Service users are provided with written information in a suitable format regarding the terms and conditions of their stay at The Laurels. The Laurels-Fontwell H60-H11 S14781 The Laurels-Fontwell V248351 271005 Stage 4.doc Version 1.40 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, 9 and 10 Service users know that their assessed and changing needs are reflected in their individual care plan. Service users are supported to take risks as part of an independent lifestyle. Service users can be confident that information about them is handled appropriately. EVIDENCE: The new format for using a person centred approach to care planning and review is beginning to be implemented. Samples of case records were seen and some of the new documentation had been used. Staff have received training in using the person centred approach. The deputy manager said that the person centred approach was very useful in helping to clearly identify individual goals. The documentation also provides a detailed risk assessment for some independent living skills. There was evidence that risk assessments have been carried out in some aspects of people’s lives and that these have been reviewed. Some work has been carried out with three service users in assessing and supporting them with bus travel. There is a confidentiality policy that is made clear to staff during induction. There are lockable facilities for the safe storage of confidential information. The Laurels-Fontwell H60-H11 S14781 The Laurels-Fontwell V248351 271005 Stage 4.doc Version 1.40 Page 10 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) 14, 16 and 17 Service users are supported to take part in leisure activities of their choice. People’s rights are respected and responsibilities recognised in their daily lives. Service users have a healthy and nutritious diet and are involved in menu planning and meal preparation. EVIDENCE: Service users are supported to take part in a range of leisure activities of their choice including discos, swimming, Tai Chi, music for health, horse-riding and sports activities. Theatre and cinema outings are also arranged. Staff support service users in choosing their holiday destinations and then support them to save towards their trip. This year everyone had a holiday at the destination of their choice including Ireland and Holland. All the service users have expressed an interest in travelling to New York for a holiday next year and were very excited about this opportunity. CARE pays a proportion of the cost of holidays and staff help service users save towards the balance. Service users have unrestricted access to the house and grounds and can choose whether to spend time alone or in company. The privacy of individuals is respected and people have a key to their room. Daily routines promote choice and people are actively encouraged to make decisions and share responsibility The Laurels-Fontwell H60-H11 S14781 The Laurels-Fontwell V248351 271005 Stage 4.doc Version 1.40 Page 11 for keeping their home in good order. Service users take a great pride in their home and enjoy sharing housework tasks. Service users are supported to plan their weekly menu and to do the food shopping. A sample of menus were seen and showed that service users have a balanced diet. People are encouraged to try new recipes to ensure that there is a variety of food on the menu. People take turns to prepare and cook meals with staff support. The evening meal was very tasty and the mealtime was a relaxed and social occasion when everyone shared their experiences of the day. Mealtimes provide a good opportunity for service users and staff to share information on a daily basis. The Laurels-Fontwell H60-H11 S14781 The Laurels-Fontwell V248351 271005 Stage 4.doc Version 1.40 Page 12 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) 20 and 21 There are policies and procedures in place to protect service users in dealing with medication. There are policies to ensure that ageing, illness and death of service users would be handled with respect. EVIDENCE: There were risk assessments regarding the ability of service users to safely administer their own medication. It was clear that where a risk had recently been identified that the situation is being addressed and monitored. The policies and procedures in place make it clear to staff what guidance they need to follow. There is secure storage of medication. There are policies and guidance in place regarding supporting people who are ill or may be dying. The organisation provides some opportunity for staff in training for dealing with loss and bereavement. The layout of the building is not suitable to provide accommodation for people who have mobility difficulties. The Laurels-Fontwell H60-H11 S14781 The Laurels-Fontwell V248351 271005 Stage 4.doc Version 1.40 Page 13 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 Service users feel that their views are listened to and acted on. EVIDENCE: There is a complaints policy and procedure that is also provided in symbol format for people who use this form of communication. There is a system for recording complaints; none have been recorded in the past twelve months. The Laurels-Fontwell H60-H11 S14781 The Laurels-Fontwell V248351 271005 Stage 4.doc Version 1.40 Page 14 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, 26 and 28 The Laurels provides a homely, comfortable and safe environment. Service users have bedrooms that suit their needs and promote their independence. Shared spaces complement and supplement service users’ individual rooms. EVIDENCE: The home was purpose built with a large enclosed garden. The building is maintained by CARE and all the required safety checks are carried out to protect service users. Service users have single rooms that provide ample space for their belongings. Each room has a wash hand basin and lockable facilities. Service users said that they are very happy with their rooms. Everyone has a key to their room subject to a risk assessment. There is a large shared lounge that is very comfortable and homely. The kitchen and dining area is open plan and provides a separate area for people to use for relaxation and leisure activities. New kitchen units are due to be fitted soon. The Laurels-Fontwell H60-H11 S14781 The Laurels-Fontwell V248351 271005 Stage 4.doc Version 1.40 Page 15 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) 31, 32, 33, 34, 35 and 36 Staff are provided with job descriptions to clarify their roles and responsibilities. Staffing levels have increased to ensure that service users are supported by an effective staff team. There are training opportunities to ensure that staff have the knowledge and skills to carry out their tasks. Service users are protected by the home’s recruitment policy and practice. Service users benefit from a well supported and supervised staff group. EVIDENCE: The organisation has provided job descriptions for all staff. The staff who were spoken with were clear about their roles and responsibilities. The deputy manager has achieved the NVQ level three award. The staffing structure has been reviewed and changed; there is now a registered manager, a deputy manager and two full time care staff. There are three people who are bank staff who understand the needs of service users and cover shifts on a regular basis. The staffing rotas were seen and showed that there are now sufficient staff to provide care at weekends and that shift patterns have changed to ensure that people have breaks when working at the weekend. The recruitment policy and process is robust. Service users are involved in an internal interview and their views are taken into account in decision-making. The records of recent appointments were seen and showed that the recruitment policy had been followed. There is an induction and training The Laurels-Fontwell H60-H11 S14781 The Laurels-Fontwell V248351 271005 Stage 4.doc Version 1.40 Page 16 programme in place and staff have annual appraisal meetings to identify their training needs. The staff spoken with said that they are supported to take up opportunities for training. There is a supervision system in place. The deputy manager is due to undertake supervision training because his role will involve supervising other care staff. The Laurels-Fontwell H60-H11 S14781 The Laurels-Fontwell V248351 271005 Stage 4.doc Version 1.40 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 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) 37, 38, 40, 41, 42 and 43 Service users benefit from a well run home. The ethos and leadership in the home encourages people to feel included in decisions made about their lives. The records, policies and procedures protect the rights and best interests of service users. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. EVIDENCE: Mr Clausen is experienced and qualified to manage the home. Mr Clausen has recently achieved the NVQ level four award in management. The manager and staff have established an open and inclusive atmosphere in the home so that service users are encouraged to contribute to the development of the home. It is clear from discussion and feedback from service users that they feel their contributions are welcomed and listened to. There is a comprehensive set of policies and procedures that are followed and understood by staff. There are some local policies that apply to The Laurels. Service users have the The Laurels-Fontwell H60-H11 S14781 The Laurels-Fontwell V248351 271005 Stage 4.doc Version 1.40 Page 18 opportunity to contribute to the review of policies at house meetings and the forum meetings of CARE Walberton. The records that were seen were up to date and in good order. There are policies in place regarding health and safety issues. Staff are provided with mandatory training to ensure that they understand how to protect the safety of service users. Three of the staff who provide care have a first aid certificate. The COSSH records have been reviewed and updated to ensure the relevant information is available to staff. There is adequate insurance cover in place. The accounts of CARE are audited annually. The annual development plan is currently being reviewed with new objectives being set for next year. The Laurels-Fontwell H60-H11 S14781 The Laurels-Fontwell V248351 271005 Stage 4.doc Version 1.40 Page 19 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 3 x 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x 3 x x Standard No 11 12 13 14 15 16 17 x x x 4 x 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Laurels-Fontwell Score x x 3 3 Standard No 37 38 39 40 41 42 43 Score 3 4 x 3 3 3 3 H60-H11 S14781 The Laurels-Fontwell V248351 271005 Stage 4.doc Version 1.40 Page 20 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 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 Good Practice Recommendations The Laurels-Fontwell H60-H11 S14781 The Laurels-Fontwell V248351 271005 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 2nd Floor, Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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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