Inspection on 20/07/05 for The Old Hall Care Home

This inspection was carried out on 20th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Old Hall Care Home 17/04/07

The Old Hall Care Home 27/04/06

The Old Hall Care Home 18/01/06

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 The Old Hall Chapel Road Fiskerton Lincoln, Lincs LN3 4HT Lead Inspector Mick Walklin Unannounced 20 July 2005 09:30 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 Old Hall C53-C04 S63061 TheOldHall V238224 200705 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service The Old Hall Address Chapel Road Fiskerton Lincoln Lincs LN3 4HT 01522 595395 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) Home From Home Care Ltd Ms Amanda Jayne Swallow Care home only 7 Category(ies) of LD Learning disability (7) registration, with number of places The Old Hall C53-C04 S63061 TheOldHall V238224 200705 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1) The home is registered to provide personal care for service users aged 1865, of both sexes whose primary needs fall within the following category: Learning Disabilities (LD) - 7 places Date of last inspection First Inspection. Brief Description of the Service: The Old Hall is a former children’s home, which has been completely renovated and now has the facilities to accommodate up to 7 people from 18-65 with learning disabilities. The home is one of two owned by Home from Home Care Limited. The home has been refurbished to a very high standard. All bedrooms are spacious, with en-suite facilities. Three of the rooms are suitable for accommodating wheelchair users. The home is in the village of Fiskerton which has limited facilities, but it is situated close to Lincoln with public transport links. The home also has its own people carrier. The gardens are enclosed, with a patio area, and there is car parking to the front of the house. The Old Hall C53-C04 S63061 TheOldHall V238224 200705 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was over a period of 8 hours. A tour of the premises was conducted with a team leader. The main method of inspection used was called case tracking which involved tracking the care the three residents receive, through the checking of their records, discussion with them, the care staff and observation of care practices. The manager completed a pre-inspection questionnaire. Documentation within the home was inspected. 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Old Hall C53-C04 S63061 TheOldHall V238224 200705 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection The Old Hall C53-C04 S63061 TheOldHall V238224 200705 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 & 4. There are thorough procedures for the introduction and assessment of people to the home, ensuring that their care needs can be catered for. EVIDENCE: The home produces a ‘Statement of Purpose’ and a ‘Service User Guide’, which provide useful information for prospective residents, their relatives and social workers, although the Service User Guide is not available in alternative communication formats as yet. All three residents came to the home with large amounts of information from their placing authorities, and senior staff from the home had conducted a detailed assessment of their needs prior to admission. There are clear admission criteria set out in the Statement of Purpose, which also sets out the admission process to the home. One resident was admitted as an emergency admission, and there was adequate pre-admission information to support this process. Trial visits are usually encouraged, but the best way to introduce a resident to the home is assessed on an individual basis, and may not always involve a trial visit. The Old Hall C53-C04 S63061 TheOldHall V238224 200705 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9 & 10. Care plans are under review, but the current care plans do not cover a sufficiently wide range of needs. These shortfalls have the potential to place residents and staff at risk. EVIDENCE: All three residents have been admitted during the past few weeks, and it is acknowledged that care plans are in the early stages of development. The care planning format is currently being updated and revised, and will be inspected in more detail during the next inspection. The current care plans give staff clear instructions, but are not wide ranging enough to cover important care needs. For example, one resident, who has mobility difficulties, requires assistance with transfers and mobility. Staff were observed to be assisting him walking by standing behind him and supporting him. Some staff were also observed to be carrying him on their own. There was no moving and handling plan or risk assessment, and no record of his weight. Another resident who had been exhibiting seriously challenging behaviour over the past two days, did not have a care plan relating to his specific behaviours, which staff stated that they were having difficulty in coping with. A behavioural intervention plan was on another file, but this was not the working file. The Old Hall C53-C04 S63061 TheOldHall V238224 200705 Stage 4.doc Version 1.20 Page 9 Some care plans had not been reviewed by their review date, and the need to demonstrate the involvement of the resident or their representative was discussed with the person in charge. Staff were observed to be offering residents choice at every opportunity, and a residents meeting was held recently. It is planned to hold these meetings every month, to consult residents and discuss household issues. A range of risk assessments are in place, which identify the activity, hazard and control measures, and enable residents to develop independence within a safe framework. Care plans were stored in an unlocked drawer in the kitchen, and these were moved to a lockable drawer by the person in charge to maintain the confidentiality of residents. The Old Hall C53-C04 S63061 TheOldHall V238224 200705 Stage 4.doc Version 1.20 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) 11, 12, 13, 14, 15 & 17. An activity timetable is being developed, which will give residents a variety of educational, occupational and leisure opportunities, enabling them to develop their skills, and enjoy stimulating activities. EVIDENCE: A range of activities are currently available, with the support of 1-1 staffing. Although the individual activity timetables lack detail, there was evidence that staff were putting a lot of work into identifying suitable opportunities, and this will be assessed in more detail at the next inspection. Two residents have attended ‘taster’ sessions at Lincoln College to do horticulture, with a view to commencing in September. Opportunities for residents to work at a conservation project are also being explored. One resident said that he was looking forward to going horse riding the following day. Another resident said that he was able to pursue his interests at the home, although he was unwell on the day of the inspection. There are a range of art materials and games available, and the garden is equipped with a swimming pool and trampoline. A gardener is employed one day per week, and residents have been helping with The Old Hall C53-C04 S63061 TheOldHall V238224 200705 Stage 4.doc Version 1.20 Page 11 the vegetable garden. A people carrier is available for outings, and the village is served by public transport links, which one resident said he enjoyed using. The home has an open visiting policy, and they will also facilitate home visits. There is an arrangement with a local bed and breakfast if relatives wish to stop overnight. A cordless telephone is available for private calls. Staff were actively encouraging residents to participate in household tasks, and residents said that they help with cleaning, cooking, shopping and gardening amongst other things. Staff were observed to be encouraging independence with one resident by using hand-over-hand teaching methods. Catering arrangements are of a domestic nature, and residents said that the meals were good, with personal choice being catered for. The kitchen was well organised, and menus were varied. A record of food served is not kept, and this needs to be in sufficient detail to determine whether an individuals diet is satisfactory. The Old Hall C53-C04 S63061 TheOldHall V238224 200705 Stage 4.doc Version 1.20 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) 19 & 20. There are good arrangements with local health services to ensure that residents health needs are met. EVIDENCE: All residents are registered with the local GP practice, and have had a full health check recently. The person in charge said that the home has an excellent relationship with the surgery. However, there are currently problems with referrals to specialist services such as Psychology, Psychiatry and Speech and Language Therapy, which the manager is currently trying to resolve. All staff receive first aid training as part of their induction. Medication storage and administration is satisfactory, and there are policies and procedures, which include guidelines on the administration of homely remedies. Senior staff attend a Safe Handling of Medication course, to ensure that medication is administered safely. The Old Hall C53-C04 S63061 TheOldHall V238224 200705 Stage 4.doc Version 1.20 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. There are good procedures for dealing with complaints and allegations of abuse, which ensure that residents are protected and able to raise concerns. EVIDENCE: The complaints policy gives timescales for dealing with complaints, and contact details for the Commission. However, this is not available in symbols format as yet. Staff confirmed that they had received training relating to adult protection, or were due to attend next week. All gave satisfactory answers to a scenario presented to them. The Adult Protection policy gives staff clear guidelines about reporting suspected abuse. The Old Hall C53-C04 S63061 TheOldHall V238224 200705 Stage 4.doc Version 1.20 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 The home is decorated and furnished to an exceptionally high standard, providing a homely, comfortable and spacious environment for residents to live in. EVIDENCE: The home was completely re-furbished prior to registration, and this has been completed to a very high standard. There is ample communal space, comprising a kitchen/diner with a conservatory attached, a lounge and a quiet room. All bedrooms are en-suite, and residents commented that they liked the home. The gardens are enclosed, and have a patio with garden furniture. A vegetable garden is situated to the side of the house. The Old Hall C53-C04 S63061 TheOldHall V238224 200705 Stage 4.doc Version 1.20 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) 31, 33, 34 & 35. There are adequate staffing arrangements to ensure that the needs of residents are met, and induction procedures are good. EVIDENCE: Staff were able to clearly describe their role and confirmed that they had been given job descriptions. Staffing is on a 1-1 basis, and the staffing situation has improved since new staff have been recruited, although staff said they were “struggling” prior to this. Agency staff are still used to cover nights, pending the recruitment of a night team. Staff said that they went through a formal recruitment and selection procedure, and residents are invited to meet candidates. Staff attend a two-week induction, and the Learning Disabilities Awards Framework is in place. They said that their induction had been good, and some were carrying on NVQ studies from their previous employment. Staff have been asked for details of training undertaken in previous employment so that a training plan can be formulated. All staff receive accredited training in the prevention of challenging behaviours, and physical intervention techniques. The Old Hall C53-C04 S63061 TheOldHall V238224 200705 Stage 4.doc Version 1.20 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, 38, 41 & 42. The home is generally well managed and organised, but staff files were incomplete, and some health and safety issues were identified which could potentially put residents at risk. EVIDENCE: The Registered Manager is a Registered Nurse (Learning Disabilities) and also a qualified Social Worker. She has 10 years experience in this field. There is also an acting manager responsible for the day-to-day running of the home, who is applying to become registered manager. Staff said that they feel very well supported and valued, and the manager is accessible and relaxed. Documentation is well organised. The Commission has received one Regulation 26 report so far. There are satisfactory procedures for the storage and recording of residents finances. No furniture has been brought into the home, but it is recommended that inventories of possessions are completed. Some staff files did not contain the documentation necessary, and there was no The Old Hall C53-C04 S63061 TheOldHall V238224 200705 Stage 4.doc Version 1.20 Page 17 evidence on some files that rigorous pre-employment checks had been carried out for the protection of residents. The following health and safety issues were identified: • • • • • • There is no fire risk assessment. There is no general risk assessment for the building and grounds. COSHH data sheets were not available for all hazardous substances. A paper towel dispenser should be fitted in the kitchen, and the Environmental Health Officer should be consulted regarding the existing arrangements for disposal of paper towels. It is recommended that hot water temperature checks are conducted in residents accommodation on a periodic basis. It is recommended that the deputy manager, who has responsibility for health and safety issues, be allocated time to set up and organise health and safety documentation and systems. The Old Hall C53-C04 S63061 TheOldHall V238224 200705 Stage 4.doc Version 1.20 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 x x x x x x Standard No 11 12 13 14 15 16 17 3 3 3 3 3 x 2 Standard No 31 32 33 34 35 36 Score 3 x 3 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Old Hall Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x 1 2 x C53-C04 S63061 TheOldHall V238224 200705 Stage 4.doc Version 1.20 Page 19 N/A 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 6 Regulation 15 Requirement The registered person must ensure that care plans and risk assessments cover service users care needs in sufficient detail to enable these needs to be met. Current moving and handling techniques used must be reviewed as a matter of urgency, with the involvement of a Physiotherapist if necessary, and detailed moving and handling plans be formulated for residents if required. The registered person must ensure that a record of food served is kept. The registered person must ensure that the documents outlined in Schedule 2 of the Care Homes Regulations 2001 are obtained prior to the commencement of employment. The registered must ensure that copies of the documents outlined in Schedule 4(6) are kept in the care home. The registered person must ensure that the health and safety issues identified are remidied. Timescale for action 29/7/05 2. 3. 17 41 17(2) Schedule 4(13). 19 30/11/05 Immediate 4. 41 17(2) 5/8/05 5. 6. 42 13(4) 30/8/05 The Old Hall C53-C04 S63061 TheOldHall V238224 200705 Stage 4.doc Version 1.20 Page 20 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. 3. 4. Refer to Standard 1 6 22 41 Good Practice Recommendations It is recommended that the Service User Guide be made available in alternative formats so it is accessible to all service users. It is recommended that service users weights are monitored on a periodic basis. It is recommended that the complaints procedure be made availablein alternative formats so it is accessible to all service users. It is recommended that an inventory of service users possessions is kept. The Old Hall C53-C04 S63061 TheOldHall V238224 200705 Stage 4.doc Version 1.20 Page 21 Commission for Social Care Inspection Unity House, The Point Weaver Road off Whisby Road Lincoln, LN6 3QN 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 Old Hall C53-C04 S63061 TheOldHall V238224 200705 Stage 4.doc Version 1.20 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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