Inspection on 04/05/05 for The Limes

This inspection was carried out on 4th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Limes 16/07/07

The Limes 12/12/06

The Limes 06/02/06

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 TF2 8DA Lead Inspector Joy Hoelzel Unannounced 4 May 2005 10:00 th 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 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 Stationary 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 E56 000020568 The Limes V222681 UI 030505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Limes Address 39 Queens Road, Donnington, Telford, TF2 8DA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01952 402295 01952 410779 ProKare Ltd Vacant Care Home 6 Category(ies) of Mental Disorder (6) registration, with number of places The Limes E56 000020568 The Limes V222681 UI 030505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: No Date of last inspection 26/08/04 Brief Description of the Service: The Limes is a care home providing personal care and accommodation to six adults with a mental disorder. It is owned by PrOkare Ltd and was first registered in July 2001. The home is situated in a residential area of Donnington and is within easy walking distance of the local amenities, shops, pubs etc. and close to Telford town centre. The home is a detached two storey property. All six bedrooms are single occupancy, with the three rooms on the ground floor benefiting from en suite facilities including a shower. The communal sitting and dining areas are well furnished and homely. The Limes E56 000020568 The Limes V222681 UI 030505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over four hours on Wednesday 4th May 2005. It is the first of the statutory inspections for 2005/06. Six adults are resident at the home and staffing levels remain at the agreed levels of three staff during the day, to include the acting manager and a recently appointed rehabilitation coordinator. Extra staff are provided to fulfil the one to one needs of service users. At the time of the inspection the home was very busy with planned interviews for the recruitment of waking night staff. The service users were organising their day with shopping trips and community based activities. Staff were observed to be assisting with the organisation of the activities. A tour of the premises took place, discussions were held with two service users and three staff members. Two service users care plans were examined in depth together with supporting documents. What the service does well: The requirements made at the inspection of 26th August and 13th September 2004 have all been complied with, barring the six requirements carried over to this inspection. These are in regard to staff recruitment and the documents that are required to be kept at the home. It was agreed with the acting manager that these would be inspected in depth at the next inspection. The home offers a specialist service to people with acquired brain injuries and makes every effort to provide individuals with a high standard of care to meet the very individual need, following the plan of care. One service user spoke of the support and guidance given to him by all members of the staff and although it was not his family home, he realised that it was the ‘best place’ for him to be. The Limes E56 000020568 The Limes V222681 UI 030505 Stage 4.doc Version 1.30 Page 6 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 Limes E56 000020568 The Limes V222681 UI 030505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Limes E56 000020568 The Limes V222681 UI 030505 Stage 4.doc Version 1.30 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 standard(s) 1,2 The home has a satisfactory admissions procedure ensuring the individuals needs can be fully met. The information currently available is concise and covers all aspects of the service provision. EVIDENCE: The statement of purpose and service user guide has recently been reviewed and now contains all the information required. Both documents have been produced in a clear text and are easy to follow. The acting manager confirms that a copy of each document is available to interested parties and given to each service user at the point of admission to the home. A full assessment of the individuals needs is carried out prior to admission to the home. A copy of the pre admission assessment is kept on file and from which an initial care plan is generated. The Limes E56 000020568 The Limes V222681 UI 030505 Stage 4.doc Version 1.30 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 standard(s) 6,7,9 The revised system and reorganisation of the care planning process ensures that there is a clear and consistent approach to meeting care needs and provide staff with the information they require to deliver a good quality service. EVIDENCE: The care plans for each individual service user are currently being reviewed and re organised to make them more user friendly. There is evidence to suggest that service users are consulted and involved in the care planning process. The acting manager discussed the difficulties with some service users reluctance to sign at each review or when changes are required to be made with the plan. Relatives are involved with the reviews whenever possible and appropriate but again the manager discussed the reluctance of the relatives to sign on behalf of the service user. Service users are fully involved and supported with decision making about every day life. Staff were observed to be advising and supporting one service user who is able to go out alone but sometimes gets distracted and forgets the time. Risk assessments have been carried out for this eventuality with clear instructions for staff to follow in the event of him going temporarily missing. The Limes E56 000020568 The Limes V222681 UI 030505 Stage 4.doc Version 1.30 Page 10 The procedure for dealing with service users personal monies includes two signatures at each transaction with a running total of the credit/debit balance. The Limes E56 000020568 The Limes V222681 UI 030505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,16 The lifestyle of the service users living at this home is wide-ranging and through a framework of activities, independence, personal and social skills, they are encouraged and supported to progress to be as independent as practicably possible. EVIDENCE: One service user discussed going to college four times a week and attends courses for improving life skills, cooking, numeracy and literacy. He stated that he liked living at the home as he is able to have his cd’s and dvd’s in his room for the times he wishes to be alone but also has the opportunity to mix with other service users when he desires. Two service users had been shopping at the local shops with a member of staff; one service user was arranging to join the local library and had already joined the local health and leisure centre. One service user enjoyed going to the local pub for a drink. An individual activity programme and schedule is developed and agreed with service users for daily activities based on the individuals preferences, skills and needs. The Limes E56 000020568 The Limes V222681 UI 030505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,21 The personal and health needs of service users are very well met with evidence of regular review and of good multi disciplinary working taking place on a regular basis EVIDENCE: Care plans indicate that personal support is offered to service users where there is a need to do so. Additional specialist support is accessed when needed and includes visits from occupational therapists, speech and language therapists. Through the care planning process, regular reviews and daily contact with the people living at the home all health care needs are monitored, identified and dealt with at an early stage. Staff commented that they would assist each person at the appropriate level with facilitating and supporting access to healthcare services. Consistency and continuity of support is ensured by the key worker system, service users commented that they are able to choose their key worker if they so wish. The care plans indicate that the subject of dying and death has been discussed with service users with the arrangements and wishes recorded. The acting manager discussed the importance of this information but stated that a sensitive and discreet approach is needed. The Limes E56 000020568 The Limes V222681 UI 030505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 Systems are in place for the protection of people living at the home with concise complaints and adult abuse procedures readily available. EVIDENCE: The complaint procedure is included in the statement of purpose and service user guide and includes all the relevant information. A record is kept of all complaints and concerns with the acting manager auditing the log on a monthly basis. The acting manager and staff demonstrated a good knowledge of the vulnerable adults abuse procedures, the procedures are readily available for all staff, who then sign to say that they have read and understood them. The Limes E56 000020568 The Limes V222681 UI 030505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,27,30 The standard of the environment is good providing service users with a homely and comfortable place to live EVIDENCE: The home is fully suited for the current service user group; the furnishings and fittings are of good quality and domestic in character. The acting manager discussed the plan for relocating the laundry area, redecoration of the dining/sitting room and the installation of a conservatory. Routine decoration and replacement of the fabric continues as and when necessary. The ground floor bathroom is undergoing redecoration with the involvement of service users. The requirements made at the previous inspection in regard to the first floor bathroom have been complied with. The garden is being revamped; a greenhouse has recently been purchased and was seen to be stocked with plants ready for planting out. Staff and service users are involved with this project. The Limes E56 000020568 The Limes V222681 UI 030505 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: These sets of standards were not inspected on this occasion. The requirements made at the last inspection in regard to the recruitment of staff will be examined at the next inspection. The Limes E56 000020568 The Limes V222681 UI 030505 Stage 4.doc Version 1.30 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,42 The premises are run and maintained in a safe manner EVIDENCE: The acting manager has been at the home since July 2004 and has gained the Registered Managers Award, she is currently undertaking further training in care at National Vocational Qualification level 4. It is recommended that the application for the registered manager position be forwarded to the Commission for Social Care Inspection as soon as possible. A deputy manager has recently been recruited (24/04/05) and has completed the induction programme. Systems are in place for the ensuring the health, safety and welfare of all people at the home, including core and specialist topic training, monitoring of equipment and monthly audits by the acting manager. At the time of the inspection all portable electrical appliances were being tested to comply with the Electricity at Work Regulations 1989. The Limes E56 000020568 The Limes V222681 UI 030505 Stage 4.doc Version 1.30 Page 17 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x 3 x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x x 3 x Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Limes Score 3 x x 4 Standard No 37 38 39 40 41 42 43 Score 3 x x x x 3 x E56 000020568 The Limes V222681 UI 030505 Stage 4.doc Version 1.30 Page 18 yes 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. 2. 3. Standard YA34 YA34 YA34 Regulation 19(5) Sched 4.6 19(5) Schedule 4.6 19(5) Schedule 4.6 19(5) Schedule 4.6 19(5) Schedule 4.6 19(5) Schedule 4.6 Requirement Staff files must evident two written references are obtained prior to appointment. Staff files must contain evidence that any gaps in employment history are explored. Staff files must be original documents in order for the validation of authentic references. As part of the inspection process CRB Disclosure records must be available with staff records for inspection Appointment of overseas staff must include evidence of work permits. Declarations of health must contain evidence of immunisation history. Staff files must contain evidence they are aware of their job descriptions and contracts of employment. Timescale for action 28.12.04 28.12.04 28.12.04 4. 5. YA 34 YA 34 28.12.04 28.12.04 6. YA 34 28.12.04 7. The Limes E56 000020568 The Limes V222681 UI 030505 Stage 4.doc Version 1.30 Page 19 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA37 Good Practice Recommendations It is recommended that the application for the registered manager position be forwarded to the Commission for Social Care Inspection as soon as possible The Limes E56 000020568 The Limes V222681 UI 030505 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 2nd Floor St Davids Court Union Street Wolverhampton Wv1 3JE 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 Limes E56 000020568 The Limes V222681 UI 030505 Stage 4.doc Version 1.30 Page 21 - 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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