CARE HOME ADULTS 18-65
The Leys Park Lane Sharnbrook Bedfordshire MK44 1LX Lead Inspector
Katrina Derbyshire Unannounced Inspection 14th October 2005 02:10 The Leys DS0000014926.V258731.R01.S.doc Version 5.0 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 Leys DS0000014926.V258731.R01.S.doc Version 5.0 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 Leys DS0000014926.V258731.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service The Leys Address Park Lane Sharnbrook Bedfordshire MK44 1LX 01234 781982 01234 350606 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) Lansdowne Care Services Mr D A Diemer Care Home 8 Category(ies) of Learning disability (8), Physical disability (8) registration, with number of places The Leys DS0000014926.V258731.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 9th May 2005 Brief Description of the Service: The Leys is a large six-bedded bungalow and self contained two-bedroom flat set in countryside on the outskirts of Sharnbrook. The home can provide residential care to eight adults with learning disabilities including those with physical disabilities. The home is staffed over a twenty-four hour period and is adjacent to a day care facility. All accommodation is on one level and there is ramped access to the buildings. Sharnbrook is about fifteen minutes drive from both Rushden and Bedford and there is a bus service to both towns. The service has its own transport, which assists service users in accessing facilities in both the village and nearby towns. The Leys DS0000014926.V258731.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 14th October 2005. The Registered Manager, Mr David Diemer was present for part of the visit. During the inspection several areas of the home were visited and the inspectors spent time with many of the residents in one lounge, garden area and their own individual rooms. The care of three residents was examined in depth by looking at their records and interviewing the residents and staff who look after them. What the service does well: What has improved since the last inspection?
The home has changed the way the staff receive training to give a special type of medication and this has improved safety for both the residents and staff. They have also changed the way they record when they have carried out a special check on staff so that when an inspection takes place, they can prove that this check to protect vulnerable people has been carried out. Also meetings between individual staff and their manager where they discuss the care that the member of staff offers are happening more often. This is good as it means the standard of care will get better all the time as staff will receive feedback on what they are good at and on areas that they need to improve upon. The Leys DS0000014926.V258731.R01.S.doc Version 5.0 Page 6 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 Leys DS0000014926.V258731.R01.S.doc Version 5.0 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 Leys DS0000014926.V258731.R01.S.doc Version 5.0 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): EVIDENCE: These standards were not assessed at this inspection. The Leys DS0000014926.V258731.R01.S.doc Version 5.0 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 the following standard(s): 7 & 10. Residents are continually supported by staff to make decisions about their lives; this results in increasing their independence and receiving care to a standard acceptable to the resident. EVIDENCE: Care records seen contained numerous entries to describe the individual decisions and choices that residents made on a daily basis. Entries included daily choice of clothing to individual decisions concerning the resident’s personal life and relationships. All residents spoke of their freedom of choice, one resident said, “ yes of course l make decisions about me and what l want, who else would”. Evidence was also seen to demonstrate the varying methods of communication staff used with the residents so that they could communicate the needs, wants and desires. All staff for example had been trained in the use of makaton; pictorials were in use alongside continual use of non-verbal communication. Care records and personal documents were seen to be kept in a secure area of the home. Staff confirmed that this designated area was kept locked and individual keys to gain access were supplied.
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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): 15 & 16 The systems and support to residents in maintaining personal relationships is good, and enhances the resident’s standard of life. EVIDENCE: All residents spoke of their individual contact with friends and family, many went to stay once a week or month with relatives. Entries within the care records showed the assistance given in maintaining telephone contact and the personal aims of each resident included the continued contact with people close to them living outside of the home. In addition the home had a system in place so that a reminder was given if needed to remember close friends and families birthdays. The relative of one resident was seen and he expressed his satisfaction with the home and the care given. Further evidence from monthly reviews and formal reviews showed that full encouragement is offered by the home as continuing relationships for residents is seen as a priority. The use of advocacy services was seen to be utilised through documentation in place. The views and rights of the residents are maintained through involving the residents in all aspects of their care planning. One resident said, “ this is my home l feel safe for the first time, yes the staff treat me very well”.
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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 & 20. The relationships between staff and residents are good and create a supportive and caring atmosphere to receive personal care. EVIDENCE: The receipt, storage and administration of medication was inspected fully in May 2005. At that time a requirement was made relating to training on the administration of rectal diazepam, documentary evidence was seen and staff confirmed that this had been undertaken therefore this standard is now met. Observations were made of the support offered to residents throughout the inspection. Staff were at all times courteous to all residents providing verbal and non verbal reassurance. Staff were also seen to knock on a door before entering thus maintaining the privacy of the resident. Care plans were very clear on the level and type of support that staff should provide and through staff interviews it was evident that the guidance within the residents care records was carried out by the staff team on a daily basis. The Leys DS0000014926.V258731.R01.S.doc Version 5.0 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 the following standard(s): 23. Staff have a good knowledge and understanding of Adult protection issues which protects resident’s from abuse. EVIDENCE: The home has in place the local policy for the protection of vulnerable adults, this included the reporting of any alleged abuse and the responsibilities for co coordinating any referral made under this scheme. Staff when questioned were able to give an accurate description of the protocols within the homes policy, and all staff interviewed knew how to report an incident of abuse and to whom they could report the matter to. The Leys DS0000014926.V258731.R01.S.doc Version 5.0 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 the following standard(s): 24. The overall quality of the furnishings and fittings is good and provides a spacious and homely environment for the residents to live in. EVIDENCE: All accommodation is provided on the ground floor with easy access to all buildings for the residents. The home is situated just outside of the village of Sharnbrook in a rural setting. There is a large amount of outdoor space available to the residents and this is well kept. Six residents share a lounge and dining room in the main building; two other residents share a two-bedded bungalow providing its own self-contained accommodation. Photographs of resident’s on the walls assists in creating a homely atmosphere alongside having domestic style furnishings in place. Residents stated that they were “very happy” with their accommodation. All areas of the home seen were clean and tidy. The Leys DS0000014926.V258731.R01.S.doc Version 5.0 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 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): 34, 35 & 36. Staff morale is high resulting in an enthusiastic workforce that works positively with residents to improve their whole quality of life. EVIDENCE: The training records of staff showed that statutory training had been undertaken, including fire safety, food hygiene and manual handling. In addition the home was seen to use the induction recommended by the General Social Care Council and staff had attended additional training relating specifically to the individual needs of the residents at the home for example epilepsy. Staff also confirmed that training was always available and that this had been the case throughout their employment with the home. At the inspection in May 2005 it was raised that changes were needed relating to how the home recorded its safety checks on staff and staff supervision, both these areas were now noted to be in place therefore these standards are met. Private conversations between staff could be heard in one area of the home and staff need to be careful so that residents cannot overhear something that may not be suitable, this was discussed with the manager at the time of the inspection. The Leys DS0000014926.V258731.R01.S.doc Version 5.0 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 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): 39. The systems in place for resident consultation require further development, as they do not fully act upon the resident’s views. EVIDENCE: The home carries out consultation with the residents in different forms. Staff confirmed that on a day-to-day basis residents are asked for their views and these decisions are then integrated into the care plans of the resident, examples included a certain type of diet. More formal methods such as residents meetings had taken place in the past and minutes were available for inspection, but the home recognised that the views of all residents could not be sought in this way. Therefore the homes management attended recent training in resident’s consultation and hope to introduce new ways of communicating through the use of photographs and then receiving the individual views of all the residents. The manager stated that the home then hope to use the views of the residents to change policies and the running of the home.
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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 X X X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 4 X X 3 Standard No 24 25 26 27 28 29 30
STAFFING Score 3 X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 4 17 Standard No 31 32 33 34 35 36 Score X X X 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
The Leys Score 3 X 3 X Standard No 37 38 39 40 41 42 43 Score X X 2 X X X X DS0000014926.V258731.R01.S.doc Version 5.0 Page 20 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 YA39 Regulation Requirement Timescale for action 31/03/06 24(1)(2)(3) The home must show the results of resident’s views and how they have been used to influence the running of the home. 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 YA36 Good Practice Recommendations Staff should ensure that personal conversations between themselves cannot be overheard by the residents in the home. The Leys DS0000014926.V258731.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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