Inspection on 16/03/06 for The Legard

This inspection was carried out on 16th March 2006.

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 no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Legard 10/02/09

The Legard 09/01/08

The Legard 16/01/07

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

Muston Road (70)

Grayling

The Cornerstone

John Street Nursing Home

Pennine Camphill

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

CARE HOME ADULTS 18-65 The Legard Wivern Road Holderness Road Kingston upon Hull East Yorkshire HU9 4HU Lead Inspector Simon Morley Announced Inspection 16th March 2006 09:00 The Legard DS0000065035.V263686.R01.S.doc Version 5.1 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 Legard DS0000065035.V263686.R01.S.doc Version 5.1 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 Legard DS0000065035.V263686.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Legard Address Wivern Road Holderness Road Kingston upon Hull East Yorkshire HU9 4HU 01482 781039 01482 781008 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) Milbury Care Services Kerry Ann Shepherd Care Home 8 Category(ies) of Learning disability (8), Physical disability (8) registration, with number of places The Legard DS0000065035.V263686.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection This was the first inspection of the service. Brief Description of the Service: Milbury Care own and manage The Legard. The home is registered to provide care and accommodation for up to 8 adults between the ages of 18-65 who have a learning disability and may also have physical disabilities. The home is located to the east of Hull city centre and is purpose built. The home has eight single bedrooms four upstairs and four downstairs. Bedrooms are paired together, each pair separated by a fully equipped disabled bathroom, each bedroom having individual access. The upstairs bedrooms are set in two ‘apartment’ style living arrangements, each with a lounge and kitchen to promote independence living. There is an office, large hallway, kitchen/dining room, laundry, sensory room and shower room downstairs. Upstairs is an activity room and staff sleep-in room. There is wheelchair access throughout and a platform lift providing access to the upstairs accommodation. The home has a large garden to the side and rear. Building work was underway to develop two smaller buildings in the grounds to provide additional living accommodation. There is a car park area to the side with additional street parking. The Legard DS0000065035.V263686.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection lasted for seven hours. The inspector talked to two residents, four staff and the manager, about the home. He had a look around the home to check the quality of the accommodation, looked at some care records and other documentation in relation to running a home. There were five residents living at the home at the time of inspection. The inspector spoke to two of these. Some of the residents’ verbal communication skills were limited and time was spent observing how staff interacted with them. Residents and their relatives had the opportunity to complete a satisfaction survey about the home. This was the home’s first inspection since opening last September. The inspection covered all the key national minimum standards. What the service does well: What has improved since the last inspection? What they could do better: Information available about the service must not make false or misleading statements about what is offered. Information about the home for prospective residents must be accurate to help them choose to live there. A written contract/statement of terms and conditions must be agreed with residents and/or their representatives at the time of admission. This is so that The Legard DS0000065035.V263686.R01.S.doc Version 5.1 Page 6 residents know what they can expect to get from the home in return for the money spent to live there. Improvements need to be made to medication procedures to help safeguard the health of service users. Formal application must be made to the Commission to register the new buildings being built in the grounds. This is to make sure they are safe and meet minimum standards before they are used. 50 of care staff must have achieved the NVQ level 2, care qualification, to help ensure residents are supported by competent staff. Thorough checks must be made about independent people visiting the home that have unsupervised access to residents, to help keep them safe from harm. Staff new to working in learning disability services must receive the required induction training within 6 weeks of starting work. This will help new staff be more competent when starting to work at the home. 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 Legard DS0000065035.V263686.R01.S.doc Version 5.1 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 Legard DS0000065035.V263686.R01.S.doc Version 5.1 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 the following standard(s): 1, 2, 3, 4 and 5. The admissions procedure was generally good; two improvements were needed to meet the minimum standards. EVIDENCE: There was a good range of information for prospective service users and their relatives to help them decide if this is the home for them. Some of this information was false and misleading for example, ‘Person centre planning is the foundation of the service.’ There was no person centred planning at the home at all. The manager acknowledged this and has started to take action to put this right. People have their care needs assessed before moving into the home. Two sets of care records looked at had good evidence of assessments. Two residents had been supported by a local advocacy scheme to help them choose to move into The Legard. Staff had the skills and experience to provide a service that met peoples’ needs. Staff reported they got good training. There were good records of staff training that showed staff got specific training to meet peoples specific care needs. Services were provided in line with current good practice. Support and advice from community health services about individual conditions was always asked for when necessary. The Legard DS0000065035.V263686.R01.S.doc Version 5.1 Page 9 There was a guide for residents about the home and what they could expect for the fees that are paid. For two residents this had still not been agreed with them or their relatives despite having been at the home for 3 months. This must be done at the time of admission. The Legard DS0000065035.V263686.R01.S.doc Version 5.1 Page 10 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 the following standard(s): 6, 7 and 9. There were good arrangements for providing care to meet people’s needs and giving them opportunities to make choices. EVIDENCE: Peoples care needs were set out in an individual plan of care. Staff spoken to said they read these care plans so they know what to do to look after people. Residents spoken to were happy with their care and relatives’ comments were also positive. It was recommended that implementing ‘person centred planning’ would improve the care planning process. Residents were able to make their own decisions for example about their appearance, clothing, when they got up, went to bed, what they ate and how they spent their time in the home. Some of these choices were recorded in daily notes. Residents were also supported to make use of local community amenities according to their wishes. Staff were seen to support residents throughout the day to do what they wanted. The Legard DS0000065035.V263686.R01.S.doc Version 5.1 Page 11 A range of potential risks to residents was considered as part of the care planning process. These are recorded as risk assessments and include the measures needed to reduce any danger whilst still allowing residents to take risks to promote their independence. The Legard DS0000065035.V263686.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17. There were good arrangements for providing residents with positive lifestyle outcomes. EVIDENCE: There was good support for residents to engage in meaningful activities, become part of, participate in the local community, and have access to and choice of a range of appropriate leisure facilities. Care plans describe how the service will meet these needs and there are enough staff to support residents to use local community facilities. Daily records refer to people going out and using local community amenities, social clubs, leisure facilities and shops. The manager plans to make this more structured based on what residents like to do and their care needs. Contact with and involvement of relatives in the home is actively supported. There was good evidence in daily records of residents keeping in touch with their relatives. Residents were seen to come and go freely from their rooms and make use of communal rooms. The Legard DS0000065035.V263686.R01.S.doc Version 5.1 Page 13 Staff were seen to be spending time in the home interacting with residents. Residents spoken to said they liked the food and could choose what they ate. Staff said they plan menus/meals with residents and they shop together. Staff spoken to said they promote healthy eating and were aware of any special dietary needs of the residents. Peoples’ dietary intake and weight are monitored and significant changes or concerns are referred to appropriate community health services for support. The Legard DS0000065035.V263686.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 18, 19 and 20. The arrangements of personal and healthcare support were good; some improvements were needed to the medication procedures. EVIDENCE: Satisfaction surveys completed by residents and their relatives Staff spoken to were aware of residents individual needs and preferences and were able to respond accordingly. There were detailed care plans and records that indicated residents received good help and support with their personal and health care needs. Residents were registered with a GP and received regular health checks including dental visits, hearing and eyesight tests. Referrals to local community health services are made to help support people with specific needs. There was good practice in administering and storing medication for residents. Written directions for administering some medicines had not been checked by two staff to ensure they were accurate. This must be done to reduce the risks of medication being wrongly administered. The Legard DS0000065035.V263686.R01.S.doc Version 5.1 Page 15 There must also be signed receipts/records of medication returned to the pharmacy. The Legard DS0000065035.V263686.R01.S.doc Version 5.1 Page 16 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 the following standard(s): Staff respond well to resident views and there are good arrangements for protecting residents from harm. EVIDENCE: Residents were able to tell staff their views and concerns on a daily basis. Staff were seen to respond well to this. There were no formal complaints recorded in the complaints book. But there were two nice compliments about staff being friendly and helpful. There were procedures in place for dealing with suspicions or allegations of abuse. Staff were trained in what to do should they witness any abuse to help keep residents free from harm. The Legard DS0000065035.V263686.R01.S.doc Version 5.1 Page 17 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 the following standard(s): 24 and 30. The Legard is homely, comfortable, clean and tidy. EVIDENCE: The Legard is purpose built, spacious, accessible and safe. Residents all have a single room with ensuite facilities, including a bath. Four of the bedrooms are in two separate apartments, each with a kitchen and lounge for two to share. These are aimed at promoting more independent living. There is a communal lounge, kitchen/dining room, activity room, sensory room and laundry. Furnishings were homely and of good quality. The home was well decorated, clean and tidy. Building work was underway to develop two smaller buildings in the grounds to provide additional living accommodation. These cannot be used until they are formally registered with the Commission. The Legard DS0000065035.V263686.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35. Some of the staffing arrangements were good some needed to improve. EVIDENCE: There are 3 staff on duty during the day, two overnight (one who sleeps). The manager is available for support and works a small number of shifts looking after the residents. Care staff also do the cooking and cleaning, where possible with the involvement of residents. This amounts to 344 care hours per week, which meets the recommended guidance. Only 4 out of 11 staff ( ) have achieved the required care qualification. 50 should have done so by now. There was one other training issue. Although staff new to learning disability training were receiving the proper induction training, this was not being done within 6 weeks of them starting as it must. Otherwise training records showed that staff had received basic training and further specialist training to meet specific care needs of the residents. Staff also confirmed this. The Legard DS0000065035.V263686.R01.S.doc Version 5.1 Page 19 Recruitment records were looked at for 3 staff. The required checks were made before staff started to work. This is to make sure they are suitable for the job. There must also be evidence of suitable checks of all people who visit the home and have unsupervised access to residents. This was not the case at the time of inspection. The Legard DS0000065035.V263686.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 There were good management arrangements in the home. EVIDENCE: The manager of the home has the required management qualification and is working towards the required care qualification. The home is well run with the interests of residents at heart. There is a friendly and welcoming atmosphere. There are arrangements for monitoring the quality of the service. Senior managers visit and complete audits. Asking relatives and residents their views is planned as part of monitoring the quality of care. The home was safe and well maintained. Regular safety checks are made and records of these kept. The Legard DS0000065035.V263686.R01.S.doc Version 5.1 Page 21 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 2 2 3 3 3 4 3 5 2 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 2 33 3 34 2 35 2 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 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X The Legard DS0000065035.V263686.R01.S.doc Version 5.1 Page 22 N/A 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 YA1 Regulation 4 and 15 Requirement Timescale for action 30/06/06 2 YA5 3 4 5 YA20 YA20 YA24 6 7 YA32 YA34 The statement of purpose must not make false statements about using person centred planning unless person centre planning is a central part of the service. 5 A written contract/statement of terms and conditions must be agreed with residents and/or their representatives at the time of admission. 13 Handwritten instructions on MAR charts must be witnessed and signed by two staff. 13 There must be a signed receipt for medication that is returned to the pharmacist. Section 11 Formal application must be made to the Commission to register the new buildings being built in the grounds. 18 50 of care staff must have achieved NVQ 2. 19 The manager must obtain enhanced level CRB disclosures for all people who visit the home and have unsupervised access to residents. 30/06/06 30/06/06 30/06/06 31/05/06 31/12/06 30/06/06 The Legard DS0000065035.V263686.R01.S.doc Version 5.1 Page 23 8 YA35 18 Staff new to working in learning disability services must receive Learning Disability Award Framework (LDAF) induction training within 6 weeks of starting work. 30/06/06 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 YA6 Good Practice Recommendations The process of ‘person centred planning’ should be used to develop individual care plans. The Legard DS0000065035.V263686.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Legard DS0000065035.V263686.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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