Inspection on 12/12/06 for The Limes

This inspection was carried out on 12th December 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Limes 16/07/07

The Limes 06/02/06

The Limes 04/05/05

The Limes 26/08/04

The Limes 16/04/04

Similar services:

The Lodge Nursing Home

Bracken House

Sunnycroft

Field Farm House

Edgeview Nursing Home

Church Terrace Nursing & Residential Home

The Forbury

The Maples

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

CARE HOME ADULTS 18-65 The Limes 39 Queens Road Donnington Telford Shropshire TF2 8DA Lead Inspector Keith Salmon Announced Inspection 12th December 2006 09:30 The Limes DS0000020568.V307961.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 Limes DS0000020568.V307961.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 Limes DS0000020568.V307961.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Limes Address 39 Queens Road Donnington Telford Shropshire TF2 8DA 01952 402295 01952 410779 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) prOKare Ltd. Mrs Kim Scott Webster Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places The Limes DS0000020568.V307961.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th February 2006 Brief Description of the Service: The Limes Care Home provides personal care and accommodation to six adults with a mental disorder. It is owned by PrOKare Ltd and was first registered in July 2001. Situated in a residential area of Donnington the Home is within easy walking distance of local amenities, i.e. shops, public houses, transport, and in close proximity to Telford Town Centre. The Home is a detached two-storey property with communal sitting and dining areas, six bedrooms offering single occupancy, including three bedrooms on the ground floor benefiting from en-suite facilities. The property is well maintained, with décor and furnishings providing a warm, homely and comfortable ambience. The Limes DS0000020568.V307961.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This ‘Key’ Announced Inspection commenced at 9.30pm, concluded at 12.30pm (a duration of 3.0 hours), and was conducted by Mr Keith Salmon. The main objective of this Inspection was to review all of the ‘Key’ Standards, as set out on the National Minimum Standards for Care Homes for Adults (18 – 65). Present throughout the Inspection, was Ms. Kim Scott-Webster, Registered Manager. This Report is a product of observations made during a tour of the Home, a review of care related documentation, staff duty rotas and staff files, plus a range of documents/records reflecting the general operation of the Home. The Inspector also held discussions with the Manager and Residents. No Relatives/Representatives were present at the time of the Inspection. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The 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 Limes DS0000020568.V307961.R01.S.doc Version 5.2 Page 6 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 Limes DS0000020568.V307961.R01.S.doc Version 5.2 Page 7 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. Processes to ensure appropriate and thorough care needs assessment, prior to admission, are effectively applied. The findings are applied to ensure appropriate placement. EVIDENCE: Documentation and Care Plans for three Residents were reviewed, and examples of pre-admission assessment were found in each set of documentation. Care Plans demonstrated assessed needs had been addressed and fully implemented, together with regular review by the Manager. Areas covered by Care Plans included health care needs, communication, food and drink, leisure interests, personal appearance, the environment and risk assessment. The Limes DS0000020568.V307961.R01.S.doc Version 5.2 Page 8 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 & 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents participate, and develop, in most areas of life within the Home supported by assessments of risk, and conduct their day/life in ways only restricted by their individual limits of capability. EVIDENCE: Documentation and Care Plans for three Residents were reviewed and demonstrated personal goals are developed using the ‘Bereweeke’ Assessment/Planning system. Whilst quite a complex process it produces clearly stated personal goals, which are restated in more ‘user-friendly’ form within the Home’s ‘Goal Planning’ book. This sets out an ‘Activity Schedule’ which comprises a closely structured, and monitored, daily programme for each Resident, as well as recording daily events. Evidence was also seen of the 3-4 monthly multi-agency case review of progress for each Resident. Residents in discussion with the Inspector indicated they are very happy with care provided at the Home. The Limes DS0000020568.V307961.R01.S.doc Version 5.2 Page 9 Individual care plans, together with discussions with the Manager, and other Staff, reflect Residents have opportunities to take (fully assessed) risks to maximise lifestyle potential. The Limes DS0000020568.V307961.R01.S.doc Version 5.2 Page 10 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 & 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Leisure opportunities are provided, which are individually tailored so as to be stimulating and consistent with Residents’ capabilities. The Home facilitates achievement of desired lifestyle through Residents’ conducting the pattern of their day, where possible, as they wish, including continuation of religious practices. There is a daily choice of attractive and nutritious meals. EVIDENCE: Reviewed case tracked care plans, and discussions with Residents and Staff, provided evidence that Residents have access to activities appropriate to their age/culture and with their peer group. There is involvement in the local community through arranged activities e.g. Residents enjoy activities which reflect personal preferences – including; drama, movement and music at the local college; horse riding at a local stables; golf at a local golf course; joining a Healthy Lifestyle Group at the local General Practice. In addition, as part of The Limes DS0000020568.V307961.R01.S.doc Version 5.2 Page 11 their individual programmes, Residents undertake supported trips, i.e. being seen off at the beginning of the journey and then met at the other end, which may be to Telford Town Centre or to other, quite far-flung parts of the Country. The Inspector was also informed by the Manager and a Resident, about ‘cross-visiting’ between Residents from the Limes and Residents from the nearby ‘sister’ Home, ‘West View’. This occurs on a regular informal/ unescorted basis and is much enjoyed by Residents. The menu, based on a four-week cycle, incorporates a choice at each mealtime, plus further options. Residents, in discussion with the Inspector stated they really enjoyed the meals. Much of the Home’s bread and cakes are baked within the Home. The Limes DS0000020568.V307961.R01.S.doc Version 5.2 Page 12 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 & 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a clear and consistent care planning system in place, which ensures Staff possess the information required to provide care effective in meeting Resident’s assessed care needs. A safe and effective system for the administration of medication is employed, which is in accordance with accepted good practice. EVIDENCE: Daily notes seen in the care plans of ‘case tracked’ Residents provided evidence of well thought through strategies to enable Staff to assist in helping to meet Resident’s individual care needs. At the time of the Inspection none of the Residents were ‘self-medicating’. However, it is planned that one Resident, who had previously self-medicated, but had ceased to do so, will probably recommence in the near future. A Review of medicines administration policies/procedures; records relating to, supply, storage, administration, disposal, and management of medicines was undertaken and all related practices were found to be satisfactory. The Limes DS0000020568.V307961.R01.S.doc Version 5.2 Page 13 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 & 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home has a satisfactory complaints system in place. Communication with Residents and Relatives is excellent. Arrangements for the protection of Residents from abuse are satisfactory. EVIDENCE: A review of relevant documentation demonstrated Complaints Procedure details are included in the Service User Guide and are displayed prominently for the benefit of all interested parties. Records were reviewed of Residents’/Staff monthly meetings, i.e. agenda, minutes, action and outcome. Residents and Staff described these meetings as being active and enjoyable. There are policies and procedures in place intended to provide protection for vulnerable people. Staff receive ‘Adult Protection’ training at induction, and through on-going staff training, confirmation of which was forthcoming through 1:1 discussions with Staff, and from Staff Records. There have been no complaints received by the Commission for Social Care Inspection during the past twelve months. The Limes DS0000020568.V307961.R01.S.doc Version 5.2 Page 14 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): 24,25,26,28,29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home continues to provide an environment, which is of very high quality, with spacious and comfortable lounge/sitting and dining areas. Residents’ bedrooms are furnished with good quality furnishings with personal taste much in evidence. EVIDENCE: The Home is spacious, well designed and continues to provide high quality accommodation for Residents. Communal accommodation comprises a good size lounge area, dining area and kitchen. Since the previous Inspection the upstairs bathroom has been totally refurbished and redecorated to provide a generously sized bath and shower enclosure. All bedrooms are pleasantly decorated, well furnished with evidence of ‘personalisation’ by Residents. The Home was clean and well maintained throughout. Review of related documentation confirmed all necessary maintenance contracts are in place, with all areas clearly benefiting from regular refurbishment/redecoration as required. The garden provides a safe environment, is easily accessible to Service Users at all times of year, and provides opportunity for Residents to be involved in its maintenance. The Limes DS0000020568.V307961.R01.S.doc Version 5.2 Page 15 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, & 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff numbers on duty, and skill-mix were sufficient to meet the assessed care needs of current Residents. Recruitment and employment practices are consistent with the safeguarding of Residents. The commitment of the Home to providing training for Care Staff, and to continuing supervision and support, is excellent with much of it conducted inhouse and, whilst including the basic range of foundation and development topics, is focussed on the needs of Staff in meeting the assessed care needs of the current client group. There is an effective and well-supported staff group with the skills and knowledge to enable Service Users to enjoy a quality of life that meets their individual requirements and aspirations. The Limes DS0000020568.V307961.R01.S.doc Version 5.2 Page 16 EVIDENCE: The current staffing rota, and those from the immediately preceding weeks, were examined. Staff numbers, and skill-mix, enable a service provision, which meets the care needs of Service Users. Staff Personal Files demonstrated evidence of full compliance with the ‘Standard’ relating to employment practices aimed at ensuring safety of Residents e.g. full employment history, references, ‘POVA’ clearance and satisfactory CRB disclosure. Staff are subject to a thorough and relevant orientation/induction programme with evidence of on-going training. The provision of time to enable Staff to undertake training is well thought through, in that all Staff, whilst being contracted to work 37 hours (if full-time) are rostered to work two hours less, with the ‘spare’ two hours providing an accumulation of paid hours, which staff use to attend training. This is seen as very good practice. The training includes; Lifting & Handling; Infection Control; Challenging Behaviour; Principles of Care; and Health and Safety. Health and safety and fire safety training is also provided for Staff. Training received by Staff is exemplary in that much of it is conducted in-house and, whilst including the basic range of foundation and development topics, is focussed on the needs of Staff in meeting the assessed care needs of the current client group. The Limes DS0000020568.V307961.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 & 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Operationally, the Home is very well organised, with the central purpose being ‘the best interests of Residents’. Staff are subject to effective support with regular supervision by the Manager. Staff appeared involved and happy in their work. The systems for Resident consultation are good with evidence suggesting their views are sought and acted upon. The management team are developing and maintaining a well-supported Staff group in the Home’s quest to constantly improve the service in order to meet Residents’ needs and aspirations. The Limes DS0000020568.V307961.R01.S.doc Version 5.2 Page 18 EVIDENCE: Observation, and a review of relevant documentation, suggests the Manager, who has been in post since January 2006, provides good strategic, and day-today, management. The views of Residents, relating to the quality of care provided by the Home, are actively sought and influence the operation of the Home. The Home’s management actively pursues the establishment of a ‘Quality Assurance’ culture – this includes the recent introduction of a new Health and Safety Policy’, incorporating a tool which provides a quantative score. Health and Safety Policies/Procedures/Practices were satisfactory. The Limes DS0000020568.V307961.R01.S.doc Version 5.2 Page 19 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 3 25 3 26 3 27 X 28 3 29 3 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 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X The Limes DS0000020568.V307961.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Limes DS0000020568.V307961.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 Limes DS0000020568.V307961.R01.S.doc Version 5.2 Page 22 - 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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