Inspection on 04/06/05 for The Laurels - Fontwell

This inspection was carried out on 4th 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 - Fontwell 26/06/06

The Laurels - Fontwell 27/10/05

The Laurels - Fontwell 12/01/05

The Laurels - Fontwell 16/08/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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 Turner Unannounced 4th June 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 V229883 260505 Stage 4.doc Version 1.30 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 Rual Enterprises Ltd) Mr Paul Christopher Clausen CRH – Care Home 6 Category(ies) of LD Learning Disability - 6 registration, with number of places The Laurels - Fontwell H60-H11 S14781 The Laurels-Fontwell V229883 260505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12 January 2005 Brief Description of the Service: The Laurels is a care home registered to accommodate up to six service users aged between eighteen and sixty-five years in the category learning disability (LD). 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 that is accessed by a flight of stairs. Every bedroom has a wash hand basin. There are two bathrooms with separate toilets 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 V229883 260505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place during a Saturday morning. The six service users were at home and time was spent with all of them. There was one member of staff on duty. A second member of staff had been called away to provide cover in another establishment. The service users agreed to delay their shopping trip until after lunch so that the inspection could take place. The service users sat with the inspector and the member of staff to discuss the questions on the pictorial comment cards produced by the Commission to help people who have communication difficulties. Two service users helped with a tour of the home. There was a discussion with the member of staff and some case records were seen. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The Laurels - Fontwell H60-H11 S14781 The Laurels-Fontwell V229883 260505 Stage 4.doc Version 1.30 Page 6 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 V229883 260505 Stage 4.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 - Fontwell H60-H11 S14781 The Laurels-Fontwell V229883 260505 Stage 4.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) 1, 2 and 4 Service users are provided with the information they need to feel confident about moving to the Laurels. The information about the services provided is in a suitable format for people to understand. The pre-assessment process is thorough to make sure people’s needs could be met and that they would get on with other people living in the home. The planned introduction and trial visits ensure that people make an informed choice. EVIDENCE: Information about the home is provided in symbol format to help people who have communication difficulties. There is a pre-assessment process that includes all aspects of service users’ needs and aspirations. Information is gathered from other professionals who know the service user and are involved in their care. The pre-assessment form is detailed and includes all aspects of the person’s needs in order for them to have a good quality of life. There is a policy that service users should have a planned introduction to the Laurels. One person said that he had been told about the home before he moved and that he had visited several times to make sure that he liked it. It is through this process that people can find out whether they will get on with the staff and other people who live at The Laurels. The Laurels - Fontwell H60-H11 S14781 The Laurels-Fontwell V229883 260505 Stage 4.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, 7 and 9 There is a thorough care planning process and a person centred care planning approach is being introduced. In house reviews take place every six months and placing authorities hold annual reviews. It was not clear how the care plan is reviewed for people who have increasing needs and how future plans are decided. The risk assessments show that people’s safety is taken into account however it was not clear how learning programmes are planned in order to develop individual independence skills. EVIDENCE: Case records are kept in several different files. Person centred care planning is being introduced by the organisation and some paperwork is in the process of being completed. Service users said they know what is in their care plan and that they attend their annual reviews. There was evidence to show that six monthly in house reviews are held. Where someone’s needs were changing significantly the reviewing and future care planning process was not clear. Aspects of risk to individual service users had been assessed and there was some evidence to show that these are being reviewed. There was evidence to show that some work has been done with two people to support them in being home alone for short periods of time. Several people said they would like to travel by bus; it was not clearly documented that work is continuing to help people learn this skill. Behavioural issues and risks are being recorded. It was The Laurels - Fontwell H60-H11 S14781 The Laurels-Fontwell V229883 260505 Stage 4.doc Version 1.30 Page 10 not clear that there is written guidance for staff taking six people out where some risks have been identified. The Laurels - Fontwell H60-H11 S14781 The Laurels-Fontwell V229883 260505 Stage 4.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) 11, 12, 13, 14, 15 and 17 Service users are provided with a full and varied programme during the week. Activities are limited at weekends if there is only one member of staff on duty. Everyone is supported to pursue their leisure interests. Service users are supported to be independent in some areas of their lives; however learning programmes should be clearly documented to show the progress people are making towards independence or the reasons for restricting independence for their safety. Service users have a healthy and nutritious diet and are supported to be involved in menu planning and meal preparation. EVIDENCE: Records showed that service users receive specialist advice and support when they need it. Everyone was enthusiastic about the activities they take part in. Those who are able to have supported work placements and attend college courses. There were certificates in people’s rooms to show their achievements. Everyone was excited about their planned holidays to Ireland, Holland and other destinations. CARE pays a proportion of the cost of holidays. Staff support service users to budget their money to make sure that they can take part in leisure activities of their choice. It was evident that The Laurels - Fontwell H60-H11 S14781 The Laurels-Fontwell V229883 260505 Stage 4.doc Version 1.30 Page 12 service users are supported to take part in community activities such as swimming, shopping and theatre trips; however some people who wanted to go swimming were unable to at the time because there was only one member of staff on duty. People said that their friends and relatives sometimes visit them at home or come to special events. There is a policy regarding intimate relationships and people are provided with specialist support in this area of their life. Service users choose the menu and go shopping for food with staff. People take turns to cook and are supported to be independent in preparing meals. The Laurels - Fontwell H60-H11 S14781 The Laurels-Fontwell V229883 260505 Stage 4.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 and 19 Service users are supported to maintain their independence with personal hygiene as far as they are able to. Service users have access to the healthcare services that they need. Changing health care needs of individuals should be clearly documented. EVIDENCE: Service users’ personal and healthcare needs were noted on their case records and their wishes taken into account. Staff are provided with the policies and guidance to ensure that they understand how to support service users and protect their privacy and dignity. Medical appointments and correspondence were on file. People said that they are able to see their GP or dentist when they need to. It was clear from discussion that the health of service users is monitored and specialist advice and guidance is sought as required. The reviewing and future care planning for people whose health may be deteriorating was not clearly documented. The Laurels - Fontwell H60-H11 S14781 The Laurels-Fontwell V229883 260505 Stage 4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Service users’ views are listened to and they are encouraged to raise any concerns. The complaints procedure is provided in a format people can understand. Staff have the policies and training in order to protect service users from abuse, neglect or self harm. EVIDENCE: Everyone said that care staff listen to them. Service users have a copy of the complaints policy in symbol format so they can more easily understand their rights. There is a system for recording complaints and none have been documented. It was evident that people are encouraged to raise concerns at the regular house meetings. An agenda is put up on the notice board so that staff can support them to add any issues or concerns. Two people attend an advocacy group and there is a strong commitment within the organisation to ensure that service users’ views are listened to and acted on. Staff are provided with policies and training regarding protecting service users from abuse. Service users said they feel safe at The Laurels. The Laurels - Fontwell H60-H11 S14781 The Laurels-Fontwell V229883 260505 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29 and 30 Service users are provided with a homely, comfortable and safe environment. Everyone was very happy with their rooms and the communal areas meet their needs. The home was clean and everyone was relaxed in the home. The ongoing programme of redecoration ensures that the high standards of safety are maintained. EVIDENCE: Two service users helped with a tour of the building and the gardens. Everyone said that they like their rooms and those that were seen reflected the interests of the individual and included everything that they need. Some of the communal areas have recently been redecorated. Service users are involved in making choices about their environment. Everyone takes a turn with some of the cleaning duties with staff support and it was clear that people take a pride in their home. There are sufficient bathrooms and toilets and a domestic laundry room where service users are supported to do their own laundry where they are able. There is a toilet on the ground floor for people who use a wheelchair. There are no other facilities for people who have mobility difficulties. The Laurels - Fontwell H60-H11 S14781 The Laurels-Fontwell V229883 260505 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 and 33 The member of staff on duty had undertaken the training required in order to provide support and care for service users. The staffing rota showed that there are usually two members of staff on duty during the day at weekends however on this occasion the options for service users was limited because there was only one person on duty. EVIDENCE: At the time of the inspection there was only one person on duty because a second member of staff had been called away to cover staff absence elsewhere. There is an on call system for emergencies. The member of staff had been on sleeping in duty and was due to be working all weekend. A second member of staff was due to work during the day on Sunday. The staffing cover during the week takes into account the activity programmes of the service users. Additional staffing hours had been agreed to support one person, it was unclear how this time was to be used; additional staff were on the rota for two periods of time during the week. The member of staff on duty said that she is encouraged to take part in training that is provided and she has just achieved the NVQ level three award. The Laurels - Fontwell H60-H11 S14781 The Laurels-Fontwell V229883 260505 Stage 4.doc Version 1.30 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) 39 There is an emphasis on ensuring that the views of service users are listened to and acted on, this is reflected in the confidence of service users to openly discuss issues that concern them EVIDENCE: CARE provides a format for seeking feedback from service users about the care that they receive; some of these forms were on case records. One service user had attended a national conference to represent the views of other people living at The Laurels. It was clear that service users are encouraged to express their views through the house meetings and in individual discussion with staff. The Laurels - Fontwell H60-H11 S14781 The Laurels-Fontwell V229883 260505 Stage 4.doc Version 1.30 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score x 3 2 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Laurels - Fontwell Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x 3 x x x x H60-H11 S14781 The Laurels-Fontwell V229883 260505 Stage 4.doc Version 1.30 Page 19 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 33 Regulation Reg 18 (1) (a) Requirement At all times suitably qualified, competent and experienced persons are working in the care home in such numbers as are appropriate for the health and welfare of service users. Timescale for action 30/06/05 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 - Fontwell H60-H11 S14781 The Laurels-Fontwell V229883 260505 Stage 4.doc Version 1.30 Page 20 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. Extracts may not be used or reproduced without the express permission of CSCI The Laurels - Fontwell H60-H11 S14781 The Laurels-Fontwell V229883 260505 Stage 4.doc Version 1.30 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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