Inspection on 13/12/06 for The Lawrence

This inspection was carried out on 13th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Lawrence 23/11/05

The Lawrence 27/09/04

The Lawrence 19/04/04

The Lawrence 30/01/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Snydale Care Home

Whitwood Hall

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

CARE HOME ADULTS 18-65 The Lawrence 316-318 Bradford Road Wrenthorpe Wakefield West Yorks WF2 0QH Lead Inspector Bronwynn Bennett Unannounced Inspection 13th December 2006 09:10 The Lawrence DS0000006195.V321696.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 The Lawrence DS0000006195.V321696.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. The Lawrence DS0000006195.V321696.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Lawrence Address 316-318 Bradford Road Wrenthorpe Wakefield West Yorks WF2 0QH 01924 369164 01924 383811 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) Johnston Care Limited Mrs Elizabeth Richardson Care Home 14 Category(ies) of Learning disability (14), Physical disability (3) registration, with number of places The Lawrence DS0000006195.V321696.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd November 2005 Brief Description of the Service: The Lawrence continues to provide personal care and accommodation for up to 14 people who have a learning disability. Set back in its own grounds these two joined very large period terrace houses provide accommodation on three floors. There are two small gardens to the front one extending around the side and there is parking provided to the rear. The main entrance is also found at the back of the home. There is a large lounge to the rear and a smaller quiet lounge to the front. There is an adjoining dining room to the larger lounge next to the office. All accommodation offered is single, however, there are no en-suite bedrooms and the washing and bathing facilities are shared. The care provided by the home is underpinned by ordinary living principles and there is an expectation that residents do as much for themselves as possible in the pursuit of living an ordinary lifestyle and to maintain their independence. There are only a few local shops nearby including a public house. However, the home is on a main bus route and is only a few minutes journey from the centre of Wakefield and all services and amenities. The home is also close to the M1/M62 link roads. The Lawrence DS0000006195.V321696.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection included an unannounced visit carried out by the inspector. The visit began at 9.10am and finished at 2.45 pm. During this visit the inspector spoke to some service users, some of the staff and the home’s deputy manager. The inspector read records of people’s care, staff records, looked at how medicines are given and looked at the accommodation available in the home. Prior to this visit the Commission for Social Care Inspection sent fourteen questionnaires to service users living at The Lawrence. Nine completed questionnaires were returned. There were thirteen service users living at the home on the day of this visit. Surveys were sent to fourteen service users’ relatives and four responses were received. Other information used as part of this inspection process includes notifications from the home to the Commission for Social Care Inspection about deaths, illnesses, accidents and incidents at the home, and a pre inspection questionnaire was completed by the manager. The inspector would like to thank everyone for their assistance during this inspection process. What the service does well: The service users who responded to the survey said that they had received enough information about the home prior to moving in to The Lawrence. The home provides a warm and friendly environment and the service users appear happy and relaxed with both the staff team and in their environment. Many of the service users have lived at The Lawrence for a number of years and said they liked the home. The service users spoken to said they liked the staff who worked at the home and during this visit were seen being treated in a respectful and dignified manner by the staff team. During this visit the inspector noted there were good relationships shared between the service users and the staff at the home. Service users make decisions about their preferred lifestyle and are supported to be part of the local community. These preferences and choice of lifestyle are recorded in the individuals’ plan of care. The Lawrence DS0000006195.V321696.R01.S.doc Version 5.2 Page 6 The staff at the home have worked well to ensure that service users are confident in raising concerns or making a complaint. It is good practice that the complaints policy and procedure is available in suitable formats for the service users. The surveys received by the CSCI confirmed that service users feel that the staff treat them well and listen and act on what they say. The relatives commented that they were satisfied with the overall care provided at the care home. 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. The Lawrence DS0000006195.V321696.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 The Lawrence DS0000006195.V321696.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 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users’ individual needs and aspirations are assessed prior to admission. EVIDENCE: The admission process for potential service uses was discussed with the deputy manager. No service user is admitted into the home without a full assessment. The respondents to the service user survey said they received sufficient information prior to moving into the care home. The Lawrence DS0000006195.V321696.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Generally the service users know that their assessed and personal needs and goals are recorded in their care plan. Service users are supported to make decisions and take risks in their lives as part of an independent lifestyle. EVIDENCE: The service users spoken to during this visit said they liked the staff at the home and that they had chosen their key worker. All the surveys received by the Commission for Social Care Inspection said the staff treated them well and the carers listened and acted on what they said. The care records for three service users currently living at The Lawrence were audited. Information held in these records gives clear information of individual strengths and needs. The deputy manager said that service users are involved The Lawrence DS0000006195.V321696.R01.S.doc Version 5.2 Page 10 in the formulation and review of their care records. However there was no evidence to show this involvement. A recommendation is made in this report. The care records looked at showed individuals are supported to make decisions in their lives. Information from the surveys confirms that service users are generally supported to make decisions. Service users are supported to manage their own finances should they choose to do so. The care records audited held up-to-date risk assessments relating to any identified risks as part of an individual’s lifestyle. Overall the care records contain detailed, person centred information. The staff are working hard to meet the needs of the service users living at the home. The Lawrence DS0000006195.V321696.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported to be part of the local community and take part in appropriate activities. Service users are supported to maintain relationships with family and friends. The service users’ rights are respected and individuals’ choice and independence is promoted. EVIDENCE: There is currently no one living at the home undertaking paid employment. Some service users do attend a local adult education centre. Service users are supported to be part of the local community and access local facilities such as shops, clubs, pubs and places of interest. The service users spoken with said they enjoy going out with the staff. The Lawrence DS0000006195.V321696.R01.S.doc Version 5.2 Page 12 The relative surveys received by the Commission for Social Care Inspection said that the staff welcome them into the home at any time. The service users spoken to during this visit to the home also confirmed this. Service users are supported to maintain personal relationships and contact with family and friends is recorded in individual care records. Service users’ rights were observed being respected during this visit, and also recorded in the care records. Service users are offered a key to their room. Where there is responsibility for any housekeeping tasks, such as an individual cleaning their own room, is recorded in the care plan. The service users said that the food served at the home is nice and there is plenty to eat and drink. The home offers a four weekly menu and specialist diets are catered for. The deputy manager said that the service users are supported to assist in menu planning and shopping. The Lawrence DS0000006195.V321696.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service users receive personal support in their preferred way. Generally the health care needs of the service users are being met. The home’s medication policy and procedure does not sufficiently protect the service users. EVIDENCE: During this visit the service users were observed being treated in a dignified and respectful manner by the staff. Preferences made by individuals such as, appearance and how to dress were seen recorded in the care records looked at. The records audited showed that service users have contact with health care professionals and access NHS facilities. Where appropriate, individuals are supported to manage their own medical conditions with support from the staff. The medication system was audited and the medication for three service users was checked. One medication was accurate. Two medications audited could The Lawrence DS0000006195.V321696.R01.S.doc Version 5.2 Page 14 not be fully reconciled with the records kept. One medication had a missing signature and one medication had been signed as administered but not given. In addition, this medication had not been carried forward from the previous months records onto the current MAR (Medication Administration Record) sheet. This was discussed with the deputy manager at the time of this visit and a requirement is made in this report. The Lawrence DS0000006195.V321696.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users feel that their views are listened to and acted upon, and they are protected from abuse. EVIDENCE: The home has a policy and procedure for dealing with complaints. In addition there is a complaints procedure displayed in a format suitable for service users living at the home. This is good practice. The service users spoken to said they knew who to speak to should they have a concern or a complaint. The information received by the CSCI from the surveys states that service users knew who to speak with should they have any concerns. And all said they knew how to make a complaint. The staff have worked well to ensure service users feel comfortable in expressing their views. The deputy manager said that all staff working at the home have undertaken protection of vulnerable adults training. The staff spoken with during this visit had a good understanding of adult protection and the required actions that must be taken should there be any allegations of abuse. The Lawrence DS0000006195.V321696.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean and hygienic and the service users live in a homely and generally well maintained environment. EVIDENCE: During this visit the home was generally clean and odour free. However, there was an odour noted in a bedroom and action should be taken to replace the identified floor covering. Bedrooms were seen and had been personalised by the individual. Service users are supported to clean their own room when they are able to do so. The level of support required for the individual to carry out this task is recorded in their plan of care. The surveys asked service users if the home is fresh and clean. Six said “always”, two said “usually” and one said that the home is “sometimes” fresh and clean. The Lawrence DS0000006195.V321696.R01.S.doc Version 5.2 Page 17 The home has had new carpets fitted to the lounge and hall areas in the home and new sofas have been purchased since the last visit by the CSCI. The bathrooms are in need of maintenance and redecoration. The deputy manager said that there are plans to fully refit the bathrooms in early 2007. Good practice in relation to infection control was discussed during this visit. The baths were noted to have anti slip mats that looked clean. However, care needs to be taken to ensure the mats are thoroughly cleaned after each use to prevent the risk of cross infection. The home’s laundry facilities were generally clean and well organised. However this area was not suitably equipped for hand washing. These areas should contain antibacterial hand wash and paper towels. The Lawrence DS0000006195.V321696.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Generally, a competent staff team supports service users. Some improvement is required to the home’s recruitment policy and procedure to ensure it sufficiently protects the service users. EVIDENCE: The service users who responded to the surveys said that the staff always treat them well. The relative surveys said that they were satisfied with the overall care provided at the home. The deputy manager confirmed that 3 staff has achieved NVQ (National Vocational Qualification) level 2 or above in care. The remainder of the staff are ongoing with this training. The deputy manager also confirmed that all the staff currently employed at the home has completed the organisations mandatory training such as Emergency Aid, Infection Control, Food Hygiene, Health and Safety and COSHH (Control of Substances Harmful to Health). The Lawrence DS0000006195.V321696.R01.S.doc Version 5.2 Page 19 In addition there are opportunities provided for staff to undertake further training in relation to the needs of the service users. The staff spoken with said that they had undertaken induction training and mandatory training. The records for two staff working in the home were audited. Both records examined did not contain a full employment history and one of the records did not have the two required references. All staff should have a full employment history and any gaps should be explored. These issues were raised with the deputy manager at the time of this visit. A discussion took place with the deputy manager regarding the safe keeping of satisfactory police checks, Criminal Record Bureau (CRB) checks. The Lawrence DS0000006195.V321696.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well run home that is generally run in their best interests. The health, safety and welfare of the service users, and the staff, is promoted and protected. EVIDENCE: The home has a registered manager Mrs Elizabeth Richardson. The staff spoken with during this visit said the manager is approachable and supportive. She is ongoing with NVQ Level 4 Registered Managers Award. The deputy manager said that there are quality assurance questionnaires sent to service users and their relatives annually. Quality monitoring also takes The Lawrence DS0000006195.V321696.R01.S.doc Version 5.2 Page 21 place through service user meetings and reviews, staff meetings and visits to the home from a representative of the organisation. It would be beneficial for the organisation develop an effective quality monitoring system that incorporates the views of service users, family and friends and relevant professionals. The results of such surveys should be published and made available in suitable formats for service users and any interested parties. The home’s fire alarm system and emergency lighting is tested on a weekly basis. The deputy manager said that staff receive fire training annually and there was evidence to show that there are regular fire drills carried out at the home. It is recommended that fire training be completed twice a year and this is included in this report. A sample of health and safety maintenance records checked was up to date. The Lawrence DS0000006195.V321696.R01.S.doc Version 5.2 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 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 1 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 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 1 X 3 X 2 X X 3 X The Lawrence DS0000006195.V321696.R01.S.doc Version 5.2 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 YA20 Regulation 13.2 Requirement The policy and procedure for medication must be followed to protect the service users. The medication records must be kept up to date. All medication carried forward from the previous month must be transferred onto the current MAR sheet. 2. YA34 19.1(b) 6 The registered person shall not employ a person to work in the care home unless - they have obtained in respect of that person the information and documents specified in schedule 2 of the Care Homes Regulations 2001. There must be a full history of employment, two references and proof of the persons’ identity including a recent photograph. 13/02/07 Timescale for action 13/12/06 The Lawrence DS0000006195.V321696.R01.S.doc Version 5.2 Page 24 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. 2. 3. 4. 5. 6. 7. Refer to Standard YA6 YA24 YA24 YA30 YA30 YA39 YA42 Good Practice Recommendations Service users involvement in their care plan should be recorded in the care records kept. The identified carpet should be replaced. The bathroom facilities should be refurbished. Greater care should be taken to ensure the non slip mats used for bathing meets infection control standards. Suitable facilities for hand washing should be made available in the laundry facilities. The results of quality monitoring carried out by the home should be published and made available in suitable formats for service users and any interested parties. Staff should complete fire training twice a year. The Lawrence DS0000006195.V321696.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND 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 The Lawrence DS0000006195.V321696.R01.S.doc Version 5.2 Page 26 - 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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