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Inspection on 04/08/05 for The Limes (Northampton)

Also see our care home review for The Limes (Northampton) for more information

This inspection was carried out on 4th August 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service provides good outcomes for service users and there were 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. Although the premises weren`t inspected the standard of the environment in the lounges and communal areas is good. These areas have recently been redecorated and provide a comfortable and homely place to live. New service users are able to visit the home and stay for short periods in order to see if they like the home. There is a relaxed and friendly atmosphere. Service users said they are satisfied with the service they receive.

What has improved since the last inspection?

Since the last inspection the Statement of Purpose that sets out what the home does, has been developed along with the written plans for how service users` care needs are to be met, and written assessments of the possible risks they could face as they go about their daily lives. The management of the home has changed and there is clear leadership and direction for staff on what they should do and how they are to behave. Staff said they are now working well together as a team everyone knows what they have to do and this is improving the lives of the service users.

CARE HOME ADULTS 18-65 The Limes 193 Weedon Road Northampton Northants NN5 5DA Lead Inspector Sara Morrison Unannounced 04 August 2005 09:00 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 C51 C08 S12844 The Limes V240781 040805 Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Limes Address 193 Weedon Road Northampton Northants Nn5 5DA 01604 751948 01604 751948 NA Mrs ME Keet 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) Mrs ME Keet Care Home 8 Category(ies) of MD Mental Disorder (8) registration, with number of places The Limes C51 C08 S12844 The Limes V240781 040805 Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: To include 2 people with an additional Physical Disability (PD) Date of last inspection 02/09/04 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. The home is owned by Mr and Mrs Keet who run the Msaada goup of services. 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 C51 C08 S12844 The Limes V240781 040805 Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 4 hours during the middle of the day and was carried out as part of the regular inspection visits required by law. Prior to the inspection time was taken to review the information on file and plan the inspection visit. The method of inspection was to track the lives of several service users. This was achieved by speaking to them and the staff on duty, speaking with the manager and observing the relationships and routines. No requirements or recommendations were made at this inspection What the service does well: What has improved since the last inspection? Since the last inspection the Statement of Purpose that sets out what the home does, has been developed along with the written plans for how service users’ care needs are to be met, and written assessments of the possible risks they could face as they go about their daily lives. The management of the home has changed and there is clear leadership and direction for staff on what they should do and how they are to behave. Staff said they are now working well together as a team everyone knows what they have to do and this is improving the lives of the service users. The Limes C51 C08 S12844 The Limes V240781 040805 Stage4.doc Version 1.40 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 Limes C51 C08 S12844 The Limes V240781 040805 Stage4.doc Version 1.40 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 C51 C08 S12844 The Limes V240781 040805 Stage4.doc Version 1.40 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 - 4 The home has developed its written information and has a good admission process that ensures service users who come to live at the home know their needs will be met. EVIDENCE: Since the last inspection the manager has developed the Statement of Purpose in line with the requirements of the Care Homes Regulations 2001. A copy will be sent to The Commission for Social Care Inspection. At the time of the inspection a prospective service users was visiting the home. Staff explained that he is currently staying at the home from Monday to Friday in order for him to be introduced to the staff and other service users and undergo a more detailed assessment. Through discussion with staff it was evident that staff are familiar with this service user’s particular problems and understand his needs. Other service users were satisfied that staff understand them and are always available to assist and support them. The Limes C51 C08 S12844 The Limes V240781 040805 Stage4.doc Version 1.40 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 & 9 There is a good system that identifies needs and plans how these are to be met. This process enables service users to make decisions about their lives and take risks. EVIDENCE: Service users knew that there are plans for their care and said that staff had gone through these with them and they are happy with the content. Staff were knowledgeable about the content of the care plans and the guidance for staff on how to meet needs and understood the need for a consistent approach to service users’ care. There is a key worker system and each key worker has a co-worker. Service users knew their key workers and explained their role. All service users are subject to Care Programme Approach (CPA) oversight. Staff explained how this works and outlined their part in the screening. Service users said they are able to make decisions about their lives and are able to choose what they would like to do and when. They said staff are available to support them if necessary. The Limes C51 C08 S12844 The Limes V240781 040805 Stage4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13,15,& 17 Service users are encouraged to take part in local activities in order to be part of the local community. EVIDENCE: Service users said that they often walk to the local shops to buy toiletries or visit the bank, and sometimes visit the pub. One person says he does this on his own and another person said that staff assist him. Service users said that they are happy with the level of involvement in the local community; one person said that he does find it difficult to be in a crowded place and so chooses the time that he goes to do his shopping. Staff said that it is difficult to motivate some of the service users to participate in activities, however depending on personalities and gender a member of staff may get a different response from a service user. These relationships are used to encourage service users to go out. For example one service user recently went to the cinema with a male member of staff however would not go with a female. Staff are aware of this and ensure male staff offer support to this person. The Limes C51 C08 S12844 The Limes V240781 040805 Stage4.doc Version 1.40 Page 11 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) These standards were not inspected at this inspection. EVIDENCE: The Limes C51 C08 S12844 The Limes V240781 040805 Stage4.doc Version 1.40 Page 12 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 Staff understood the process for complaints and the protection of vulnerable adults. Staff ensure that service users are listened to and are protected from harm. EVIDENCE: Service users were clear about what they would do and whom they would speak to if they were not happy with anything. Service users said that staff listen to them and resolve any problems promptly. The manager discussed an issue that has been raised by a service user and is being dealt with in line with the complaints procedure. It appears that the owner and manager have done all they can to ensure that matters are addressed and have sought external professional input to review the issues raised. Through discussion with staff it was clear they knew what to do if they had any suspicions that a service users was being abused. Staff knew about the Protection of Vulnerable Adults (POVA) and understood how they should handle any money or valuable belonging to service users. The Limes C51 C08 S12844 The Limes V240781 040805 Stage4.doc Version 1.40 Page 13 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) These standards were not inspected at this inspection. EVIDENCE: The Limes C51 C08 S12844 The Limes V240781 040805 Stage4.doc Version 1.40 Page 14 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) 32, 33, 35 & 36 The staffing arrangements have improved since the last inspection. Staff morale has improved and an effective staff team supports service users. EVIDENCE: Staff said that all aspects of staffing has improved since the current manager took up her post. They said that everyone is now working together as a team and there is clarity in each person’s role and responsibilities. There is a good handover process between shifts and at the start of each shift the shift leader decides on who will do what and when. Staff said they feel well supported by the manager and her deputy, there are regular staff meetings and individual supervision sessions. Staff are encouraged to undertake National Vocational qualifications (NVQ) Two staff spoken to had just completed NVQ training and were looking at going on to the next level. Staff were very knowledgeable about the needs of the service users and the content of the care plans. The deputy had a good knowledge of the Mental Health Act and how it applies to the service users. The Limes C51 C08 S12844 The Limes V240781 040805 Stage4.doc Version 1.40 Page 15 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 & 38 The manager provides good leadership and direction to staff and ensures that service users benefit from a well run home. EVIDENCE: The manager took over the running of the home at the end of 2004. Both staff and service users spoke highly of the manager saying that she is open and approachable and is clear about her expectations. It was evident that the manager is clear about the boundaries of care that can be provided and understands the needs of the service users. Systems and procedures have been reviewed and changes made as necessary. There was a calm, relaxed atmosphere during the inspection that it is concluded is a direct result of the management style and attitude. The Limes C51 C08 S12844 The Limes V240781 040805 Stage4.doc Version 1.40 Page 16 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 3 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x x 3 x 3 x 3 Standard No 31 32 33 34 35 36 Score x 3 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Limes Score x x x x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x x x C51 C08 S12844 The Limes V240781 040805 Stage4.doc Version 1.40 Page 17 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 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. 1. Refer to Standard Good Practice Recommendations The Limes C51 C08 S12844 The Limes V240781 040805 Stage4.doc Version 1.40 Page 18 Commission for Social Care Inspection 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 C51 C08 S12844 The Limes V240781 040805 Stage4.doc Version 1.40 Page 19 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!