Inspection on 06/02/07 for The Letchworth Mental Health Project

This inspection was carried out on 6th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Letchworth Mental Health... 14/01/09

The Letchworth Mental Health... 10/02/06

The Letchworth Mental Health... 01/10/05

The Letchworth Mental Health... 09/03/05

The Letchworth Mental Health... 19/05/04

Similar services:

Chesham House

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

Abbey Lodge

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

CARE HOME ADULTS 18-65 The Letchworth Mental Health Project 8-10 Springshott Letchworth Hertfordshire SG6 2HJ Lead Inspector Jeffrey Orange Key Unannounced Inspection 6th February 2007 08:30 The Letchworth Mental Health Project DS0000019577.V329568.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 Letchworth Mental Health Project DS0000019577.V329568.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 Letchworth Mental Health Project DS0000019577.V329568.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Letchworth Mental Health Project Address 8-10 Springshott Letchworth Hertfordshire SG6 2HJ 01462 678122 01462 678122 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) www.grantahousing.org.uk Granta Housing Society Limited Miss Amanda Hoy Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (5) The Letchworth Mental Health Project DS0000019577.V329568.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: There are none Date of last inspection 10th February 2006 Brief Description of the Service: Letchworth Mental Health Project provides accommodation and care to five adults who have a history of mental health problems. The home consists of two terraced houses that have been converted into one house. The accommodation consists of a lounge, kitchen/diner, utility, one bedroom, a staff sleep-in room/office and a toilet on the ground floor, with 4 further bedrooms, two bathrooms and a toilet on the first floor. There is a large garden and patio area with table, chairs and sunshade. There is also an adapted garden shed that provides a sheltered area for those service users who smoke. The property is situated in a quite residential area of Letchworth and is within walking distance of local shopping and public transport facilities. The only parking provision is on road, subject to availability. The home has a Service User’s Guide and Statement of Purpose which contain contact details for the Commission for Social Care Inspection (CSCI) and the most up to date inspection report is also available. Weekly fees are £278.98 (As at February 2007) and are for accommodation and care. Items such as newspapers, personal toiletries, chiropody, dentistry and opticians’ services are paid for by service users. The Letchworth Mental Health Project DS0000019577.V329568.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection visit took place during one morning and provided an opportunity to talk to the five service users present before some of them left for their daytime activities. It was possible to observe staff and service user interaction and to talk to the member of staff present. Later on during the morning it was possible to have a discussion with the manager about the service and issues associated with it. Some key records were checked, including care plans and medication and a brief tour of the premises was carried out. This report also draws on any information received by the CSCI since the previous key inspection in February 2006. This was another very positive inspection visit and the inspector would like to thank the service users for welcoming him into their home and the staff team for their co-operation and assistance. What the service does well: What has improved since the last inspection? What they could do better: There are some relatively minor environmental issues and medication procedures need to be monitored more closely to ensure that what is essentially a satisfactory system for the administration and recording of medication is being adhered to at all times. The Letchworth Mental Health Project DS0000019577.V329568.R01.S.doc Version 5.2 Page 6 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 Letchworth Mental Health Project DS0000019577.V329568.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 Letchworth Mental Health Project DS0000019577.V329568.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): Standard 2 3 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessment and admission procedure in place is comprehensive and robust and should ensure that only those whose needs can be appropriately met are admitted into the home. EVIDENCE: Whilst there have not been any recent admissions to the home, it has previously been established that the process of assessment before admission involves not only the prospective service user but also a range of social care and health professionals. This makes sure that the prospective service user’s needs are fully understood and can be satisfactorily met by the home. The assessment process includes a series of visits to the home, including stays of various lengths. There is also a six-week trial period and review before service users and the home make a decision about permanent residence. The Letchworth Mental Health Project DS0000019577.V329568.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): Standards 6 7 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of person centred care planning is high and reflects service user’s individual needs and how they are being met. There is a comprehensive system of review and risk assessment in place to ensure that care plans reflect the ongoing and current needs of service users and are adapted as and when these change. EVIDENCE: Care plan documentation was seen which included evidence of service user involvement and a robust system of review. Risk assessments are in place but are not used as an excuse to unnecessarily restrict service user’s independence. “I am going to college, I get the mini-bus myself up the road” one service user told the inspector. A review of one service user’s care plan was being planned with them during this inspection visit. The Letchworth Mental Health Project DS0000019577.V329568.R01.S.doc Version 5.2 Page 10 Service users were being supported and fully involved in decisions about their day throughout this visit e.g. what they wanted to do and how much money they wanted to take with them. “I am going into town, to go to my club and see my boyfriend – I have a very full day” The Letchworth Mental Health Project DS0000019577.V329568.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): Standards 12 13 15 16 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are encouraged and enabled to maintain and wherever possible increase independent living skills and to make use of community facilities in order to follow and develop their personal interests and relationships. EVIDENCE: There is a house rota for cooking, cleaning, shopping etc and service users personal care plans incorporate commitment to this by both the home and service users. Speaking to service users it became evident that they enjoy full and varied lifestyles including clubs, resource centres, churches and other social outlets and are able to access these with a high degree of independence and personal choice. The Letchworth Mental Health Project DS0000019577.V329568.R01.S.doc Version 5.2 Page 12 The degree of autonomy and independence seen was impressive and one service user is currently being assisted and encouraged to take steps towards moving from the home into a more independent supported housing option. “I am quite excited about this” was the comment she made about this possibility. The Letchworth Mental Health Project DS0000019577.V329568.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): Standards 18 19 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are encouraged to attend to their own personal care needs with discreet monitoring and encouragement from staff, this helps service users maintain independence and motivation. Service users benefit from access to a range of services to monitor and maintain their physical and emotional health needs. The medication practice in the home, whilst essentially sound, requires closer monitoring to ensure that it remains consistent. EVIDENCE: Support continues to be offered in a very individual way, based upon clear care plan strategies agreed with service users. Care plans contain evidence of appropriate access to health care services, facilitated where necessary by staff. The Letchworth Mental Health Project DS0000019577.V329568.R01.S.doc Version 5.2 Page 14 The basic standard of medication practice found was adequate, however there were some errors in recording which need to be addressed, and the storage of some medication was not in accordance with the manufacturer’s instructions. The Letchworth Mental Health Project DS0000019577.V329568.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): Standards 22 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are formal and informal communication opportunities in the home, which provide service users and staff with opportunities to listen to each other and to ensure, wherever possible that the home’s routine meets their needs in a way that they find acceptable. The process of staff training, record keeping and communication in the home should ensure that service users can feel confident that they will not be subject to any form of abuse. EVIDENCE: A copy of the Hertfordshire Protection of Vulnerable Adults Procedure is available to all staff and the staff team have received training in how to recognise abuse and what to do if it is suspected. Service user meetings are held regularly to discuss the way the house is run and to air any issues service users or staff may have. The Letchworth Mental Health Project DS0000019577.V329568.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): Standards 24 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and safe environment for those who live and work there with only some minor repair work needed to the kitchen floor. The service users and staff work together to keep the home clean and hygienic. EVIDENCE: Service users have an agreed rota for assisting with cleaning their own rooms and communal areas and the environment was acceptably clean and tidy on the day of the inspection given that it is the service user’s home and not an institution. The Letchworth Mental Health Project DS0000019577.V329568.R01.S.doc Version 5.2 Page 17 The kitchen floor has a tear near to the door that needs attention before it becomes a potential trip hazard. Following requirements made in previous inspections an external smoking area has been provided and the registered manager confirmed that those first floor windows, previously identified as needing opening restrictors have had them fitted. The Letchworth Mental Health Project DS0000019577.V329568.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): Standards 32 34 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are provided with the necessary training and support to enable them to meet service user’s assessed needs appropriately. The recruitment process is sufficiently robust, to ensure that service users are protected by the employment in the home only of those who are assessed as being suitable and qualified to provide them care and support. EVIDENCE: The registered manager confirmed that there is a training schedule to ensure that routine training is undertaken and regularly updated. The member of staff on duty confirmed that she is provided with training and support to enable her to provide the care service users require. All of the care staff have now achieved NVQ level 2 in care. The Letchworth Mental Health Project DS0000019577.V329568.R01.S.doc Version 5.2 Page 19 No new staff have been employed since the previous inspection, it was however established at that time that records relating to recruitment were satisfactory. The Letchworth Mental Health Project DS0000019577.V329568.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): Standards 37 39 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This is a well run home, which has the service user at the centre of its operations and involves them fully in the decision making process. The person centred care planning format provides for the identification and assessment of risks to the health and safety of service users and promotes and protects their health and safety with appropriate action. EVIDENCE: Service users expressed a high degree of satisfaction with the home and the staff and the way that it is managed. The Letchworth Mental Health Project DS0000019577.V329568.R01.S.doc Version 5.2 Page 21 Care plans include a comprehensive range of risk assessments and the home has comprehensive health and safety policies and procedures. There is good evidence of the involvement of service users in the decision making process of the home. The Letchworth Mental Health Project DS0000019577.V329568.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 3 4 3 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 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 2 X 3 X 3 X X 3 X The Letchworth Mental Health Project DS0000019577.V329568.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 All medication must be stored in accordance with the manufacturer’s instructions including those relating to the temperature of storage. The temperature of the home’s medication storage must be monitored and recorded in order to ensure it remains within the appropriate range for the medication stored in it. The registered person must ensure that the instructions for the administration of each medicine are consistent and that where variable doses are prescribed, the exact dose administered in each case is recorded. The registered person must review the monitoring of medication administration to ensure that practice is consistently in line with the home’s policy and that any errors are identified and rectified at the earliest possible opportunity. Timescale for action 06/02/07 2 YA20 13(2) 06/02/07 3 YA20 13(2) 06/02/07 4 YA20 13(2) 06/02/07 The Letchworth Mental Health Project DS0000019577.V329568.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 Refer to Standard YA24 Good Practice Recommendations The kitchen floor should be repaired where it has become worn or torn, in order to prevent it deteriorating and becoming a hazard to service users or staff. 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