Inspection on 24/11/05 for The Limes (Northampton)

This inspection was carried out on 24th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Limes (Northampton) 15/12/08

The Limes (Northampton) 04/08/05

The Limes (Northampton) 02/09/04

The Limes (Northampton) 13/04/04

Similar services:

Trevayler Residential Care Home

Thornham Grove

Thistle Hill Hall

Conifer Lodge

Westwood Lodge

Egerton Lodge Care Home

Alfred Minto House Care Home

St Matthews Unit

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

CARE HOME ADULTS 18-65 The Limes (Northampton) 193 Weedon Road Northampton Northants NN5 5DA Lead Inspector Mrs Sara Morrison Unannounced Inspection 24th November 2005 10:30 The Limes (Northampton) DS0000012844.V265833.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 Limes (Northampton) DS0000012844.V265833.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 Limes (Northampton) DS0000012844.V265833.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Limes (Northampton) Address 193 Weedon Road Northampton Northants NN5 5DA 01604 751948 01604 751948 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) Mrs Maureen Elaine Keet Mr Philip Henry Keet Mrs Joan Fay Samuel Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (8) of places The Limes (Northampton) DS0000012844.V265833.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. No person falling within the category mental disorder (MD) can be admitted where there are already 8 persons of category mental disorder (MD) in the home. Two people whose primary need is mental disorder (MD) but who also have a physical disability (PD) may be accommodated. Total number of service users in the home must not exceed 8. 2. 3. Date of last inspection Brief Description of the Service: The Limes is a care home providing personal care for a maximum of 8 people aged between 18 and 65 years who have mental health problems. Two people who also have a physical disability can be accommodated. Mr and Mrs Keet who run the Msaada goup of services own the home. The house, which is a large semi-detached property, is located in a suburb of Northampton within easy walking distance of a local shopping centre and approximately 2 miles for the town centre. Public transport is close by. The accommodation consists of 4 single and 2 double bedrooms. The two double rooms are currently occupied as singles and this will only change where there is a special request by two people to share. There are two large lounge areas and a kitchen/diner. There is a rear garden and off road parking at the front of the house. The Limes (Northampton) DS0000012844.V265833.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over three and a half hours during the morning and afternoon, was carried out as part of the regular inspection visits required by law and was unannounced. Prior to the inspection time was taken to review the information gathered since the last inspection and plan this inspection visit. The inspection included a tour of the communal areas, inspection of certain records, discussion with three of the staff and the manager, discussion with service users and observation of the routines of the home. The method of inspection was to track the lives of several service users. This was achieved by speaking to them about the service they receive, observing them with staff, talking to staff and reviewing the records. The two requirements made in this report relate to the oversight of the home by the owners and a system for assuring the quality of the service. The requirements both have a short timescale as they have also been made in the reports of the inspections carried out in September and October this year in the two other homes run by the group. What the service does well: The findings of this inspection lead to the same conclusion as the last visit that the service provides good outcomes for service users. Service users confirmed that there are good relationships between them and staff. One service user said that the best thing about the home is the staff who are kind and helpful and always ready to listen if they are upset or anxious. Another person felt that staff would encourage and advise but would not tell them what to do. Staff are knowledgeable about the needs of the service users and there are good systems in place, for example medication that allow the service users to take control of their lives. The recording of information about service users and plans for how their needs are to be met by staff is good. Where they choose to do so service users are involved in the plans for their care and are able to read the information written about them. The Limes (Northampton) DS0000012844.V265833.R01.S.doc Version 5.0 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 (Northampton) DS0000012844.V265833.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 Limes (Northampton) DS0000012844.V265833.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): Standards in this section were not reviewed at this inspection. EVIDENCE: The Limes (Northampton) DS0000012844.V265833.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): 6&7 The care plans are good; they are well set out, comprehensive and give clear guidance to staff on the needs and support required by service users. EVIDENCE: The care plans were very thorough. Individual headings ensure that all aspects of a person are considered and problems identified. The information on the care plan is taken from an assessment carried out prior to a service user moving in. The documents gave ‘at a glance’ information to staff on the particular areas of need and where there were particular problems made reference to more detailed information in risk assessments. There was good guidance for staff on the triggers for problems/behaviours and information about what to do to de-escalate or manage these. A daily contact sheet is written by care staff and a two –weekly summary written by the person’s key worker is presented to regular staff meetings. In addition the deputy manager uses this information to write the monthly review. The Limes (Northampton) DS0000012844.V265833.R01.S.doc Version 5.0 Page 10 One service user said that he was involved in the writing of his care plan and is fully aware of all that is written about him. He said that a member of staff was supporting him at his Care Programme approach meeting later that day. This person also said that he is able to make decisions about his life, he said staff encourage and advise him but do not tell him what to do. The Limes (Northampton) DS0000012844.V265833.R01.S.doc Version 5.0 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 the following standard(s): 12 & 16 Service users are encouraged to take part in daily activities and take responsibility for their lives. EVIDENCE: One service user said that he is involved in a number of community activities and is working towards future employment. Another person said that she does not like to go out much however does go into town at least once a week. This person said that staff help her to write letters which is an activity she enjoys. The home has introduced a budget for those service users who are able to shop and cook for themselves. One person said that he enjoys shopping and cooking; another person said that she would not be able to cope with this task and is happy for staff to provide her meals for her. This service user was observed to be happy to make drinks and snacks for herself and other people. The Limes (Northampton) DS0000012844.V265833.R01.S.doc Version 5.0 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 the following standard(s): 18, 19 & 20 Physical and emotional health needs are well met by staff, there is a holistic approach to meeting needs that supports service users to take control of their lives. EVIDENCE: Through discussion with service users and information on file it was evident that all aspects of a service users’ health and emotional needs are considered and action taken by staff to ensure the needs are met. Service users confirmed that they are encouraged to be as independent as possible and make their own choices about what they would like to do. There is support to attend NHS healthcare treatment such as G.P, dentist and optician. There is a key worker system and service users spoke about their key worker and what they did for them. There is a willingness within the home to work with other professionals and advocates to ensure the well being of the service users. The medication system was checked and found to meet the required standard. There was good recording and staff were able to competently explain how the The Limes (Northampton) DS0000012844.V265833.R01.S.doc Version 5.0 Page 13 system works. It is encouraging that the home view medication administration from the point of all service users being able to self –medicate. Risk assessments are carried out to enable service users to take as much control as possible. Where people require more support they are encouraged with staff supervision to dispense their medication. One service user said that although he usually self-medicates he had asked staff to manage his medication on a temporary basis to ensure he remained well, he said that he was confident that staff would help him to regain control of his medication. The Limes (Northampton) DS0000012844.V265833.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): Standards in this section were not reviewed at this inspection. EVIDENCE: The Limes (Northampton) DS0000012844.V265833.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 & 30 The standard of the environment is good and provides a comfortable home for service users. EVIDENCE: All communal areas were well maintained clean and comfortable. There was a good standard of cleanliness. Service users said that they liked their rooms and spent time in them. One service user who is very tall said that a new double bed was being purchased for him, he said that this would be better for him than his current single one. Service users were using both lounges, the kitchen and their own rooms during the inspection. The Limes (Northampton) DS0000012844.V265833.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): 33 There is an effective staff team who are knowledgeable about the needs of the service users and provide continuity of care. EVIDENCE: The staff roster has been reviewed and revised. The manager explained that this was done in consultation with staff and although new appears to be working well. In general staff now work longer shifts with more days off in between. From the service users perspective this now means that activities can take place over a whole day rather than breaking in the afternoon because of a change of shift. Staff said they are happy with the changes, they said they are working well and suit their work/life balance. The Limes (Northampton) DS0000012844.V265833.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 Service users live in a home that is run by a competent person however there is a lack of oversight and quality assurance by the owners that may lead to a poorer outcome for service users. EVIDENCE: The manager said that different people from the Msaada Group (but not the Registered people) had carried out two visits in line with regulation 26 of the Care Homes Regulations 2001, one recently and the other some time ago. Two proformas have been provided by the Commission for Social Care Inspection to the organisation for this purpose however the template used for the recent visit did not reflect either of these. The information recorded did not demonstrate that the visit had been carried out in line with the regulation, as there was no evidence of staff or service user involvement. See requirements. The Limes (Northampton) DS0000012844.V265833.R01.S.doc Version 5.0 Page 18 The manager said she had purchased a specialized quality assurance system before she became the manager of the home during the time she worked at the head office. The Msaada Group has not implemented this. It is disappointing that although the owner informed the inspector in July this year that a person had been appointed to carry out quality assurance for the group this has not happened. See requirements. The Limes (Northampton) DS0000012844.V265833.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X X 3 X X X CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Limes (Northampton) Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score X X 1 X X X X DS0000012844.V265833.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 2 Standard YA39 YA39 Regulation 24 26 Requirement There must be a system to review the quality of care. The Registered Provider must visit the home and provide detailed visit reports in line with Care Homes Regulations 2001 Timescale for action 31/12/05 31/12/05 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 (Northampton) DS0000012844.V265833.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 (Northampton) DS0000012844.V265833.R01.S.doc Version 5.0 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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