Inspection on 24/04/06 for The Sycamores

This inspection was carried out on 24th April 2006.

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 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 Sycamores 19/10/05

The Sycamores 27/06/05

The Sycamores 12/01/05

The Sycamores 23/08/04

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 Sycamores 45 South Street Alford Lincs LN13 9AN Lead Inspector Wendy Taylor Key Unannounced Inspection 24th April 2006 08:45 The Sycamores DS0000002571.V289494.R01.S.doc Version 5.1 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 Sycamores DS0000002571.V289494.R01.S.doc Version 5.1 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 Sycamores DS0000002571.V289494.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Sycamores Address 45 South Street Alford Lincs LN13 9AN 01507 462971 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) Linkage Community Trust Mrs Diane Johnson Care Home 8 Category(ies) of Learning disability (8) registration, with number of places The Sycamores DS0000002571.V289494.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th October 2005 Brief Description of the Service: The Sycamores is a large converted private house with gardens to the front and rear of the building. Situated in Alford it is conveniently placed for access to local facilities and shops. The home is registered for 8 service users with learning disabilities, all accommodated in single rooms. Employment and training opportunities are offered in the local community, and in Mablethorpe at a bowling green with a hire shop, café and amenity area, which has been developed by the Linkage Community Trust. This provides occupational options for the service users in addition to other work experience projects and/or parttime attendance at the Trust’s day centre resource at Scremby. The home is owned and operated by Linkage Community Trust, which is a registered charity. The Sycamores DS0000002571.V289494.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 5 ¼ hours. A service user took the inspector to look around the house and gardens. The support received by three service users was looked at in detail. One service user was available to speak to. Individual service user records and general house records were looked at, staff and managers were spoken to and an observation of the support provision was made. Feedback from other service users was gained from surveys carried out prior to the visit. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Sycamores DS0000002571.V289494.R01.S.doc Version 5.1 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Sycamores DS0000002571.V289494.R01.S.doc Version 5.1 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 the following standard(s): 1,2,4,5 Service users benefit from the range of information available to them and know that the home can meet their needs. EVIDENCE: Discussions with, and feedback from service users demonstrates that they are provided with contracts and are helped to understand them. Copies of the homes’ statement of purpose and service user guide were available on individual files. Terms and conditions were also available on files together with placing authority assessments and care plans. Individual assessments carried out by the home were available and a service user said that they had visited the home before moving in. The Sycamores DS0000002571.V289494.R01.S.doc Version 5.1 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 the following standard(s): 6,7,8,9 Care plans focus on assessed needs and support is delivered in a respectful manner. Service users benefit from being able to make informed choices and are consulted about all aspects of their lives. EVIDENCE: Three service user files were looked at and all contained comprehensive care plans relating to issues such as behavioural management, medical need, personal hygiene and motivation. Care plans are cross-referenced with risk assessments, which address needs such as medication, road safety, fire safety and general emergencies. Person centred plans and health action plans are also in individual files. Choice and decision-making are evident throughout the care plans and feedback from service users indicated that they are involved in developing the plans, and they have signed the plans to indicate this. Service users have access to policies and procedures on DVD such as complaints, fire, community support and communications. There is evidence that care plans and risk assessments are reviewed regularly by both the home and the placing authority and again service users say that they are involved in the reviews. The Sycamores DS0000002571.V289494.R01.S.doc Version 5.1 Page 9 There was evidence of service user meetings and a service user said that they talk about what they want to do and what they want to eat. Staff were observed to present information in a way that helped the service user to make an informed choice. The Sycamores DS0000002571.V289494.R01.S.doc Version 5.1 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 the following standard(s): 12,13,14,15,16,17 Service users are fully supported to maintain control of their everyday lives and develop their independence. EVIDENCE: There was information on the use of advocacy services within individual files and also evidence that each person has registered for a postal vote. Contact sheets were available to demonstrate that service users are encouraged to maintain relationships with family and friends. A service user said that he had recently been to stay with family at their home. Several service users were on holiday in Spain at the time of the visit. The home has a weekly activity plan, which is displayed in the office area. Service users said that there is enough activity offered and they choose what they want to do. During the visit a service user was being supported to go shopping. There was evidence of activity such as gardening, going to shops and cafes and going to the pub. A service user said that they go to football matches. There was evidence that service users are supported to engage in work placements and staff said that employment services within Linkage are The Sycamores DS0000002571.V289494.R01.S.doc Version 5.1 Page 11 being extended to help with issues such as filling in application forms and attending interviews. Two service users have pets and a one of them described the responsibilities of looking after the pets. There is also a computer available in the home and all service users have their own e-mail addresses. Menus were seen and service users said that they enjoyed their food and chose what they wanted to eat. A service user prepared a lunchtime meal with support from staff. The meal demonstrated an awareness of healthy options, and the mealtime was relaxed. Nutritional care plans were available in individual files where necessary. The Sycamores DS0000002571.V289494.R01.S.doc Version 5.1 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 Personal and healthcare support is delivered in a way that reflects the development of independence and an attention to the health and safety needs of service users. EVIDENCE: Care plans reflect individual personal care, medical and emotional needs. Records also reflect attendance at well-women/man clinics. A service user said that they have a key worker who helps them to do whatever they need, and feedback from other service users indicates that they get the medical support that they require. Storage and record keeping relating to medication was satisfactory and risk assessments were available for general medicine issues and individual selfmedication processes. The home has a medicines policy that includes selfmedication information. Consent forms were seen for those who opted to selfmedicate. Lockable storage was seen in service users bedrooms and staff were able to describe the self-medication processes in detail. A service user was able to describe where medicines are dispensed from and how they are given out. A report of the last pharmacy inspection, dated December 2005 indicated that there were no problems at the time. The Sycamores DS0000002571.V289494.R01.S.doc Version 5.1 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 the following standard(s): 22,23 Service users are protected by robust and accessible policies and procedures, and they benefit from an environment that encourages them to express their views. EVIDENCE: Local authority adult protection guidelines and the complaints policy are available on individual files and service users said that if they were not happy with anything they knew who to speak to. Feedback also indicates that they feel staff will listen to their views. The complaints policy is available on DVD and in picture format. Staff demonstrated a good awareness of adult protection issues and what to do if a situation arose. Records demonstrate that staff have attended adult protection training. There have been no reports of adult protection issues since the previous inspection. There has been one complaint recorded since the last inspection. Records demonstrated that the home had followed the complaints procedure and outcomes were clearly recorded. The Sycamores DS0000002571.V289494.R01.S.doc Version 5.1 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 the following standard(s): 24,25,28,30 Service users benefit from comfortable and personalised private rooms and well maintained communal areas. EVIDENCE: On the day of the visit the home was very clean and tidy. Décor, furniture and flooring were in very good order and the outside space was in a pleasant and well-maintained state. Service user bedrooms were very well personalised and reflected the likes and interests of the individual. A service user said that they liked their room and they keep it clean and tidy themselves. Communal areas such as the lounge and music room were comfortably furnished and spacious. Cleaning equipment and substances were stored appropriately. A shower is currently out of order but maintenance records indicate that that the problem is being managed appropriately. Linkage maintenance staff were at the home during the visit attending to repairs. The Sycamores DS0000002571.V289494.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36 Service users are protected by a robust recruitment procedure and by a welltrained and knowledgeable staff team. EVIDENCE: Three staff files were looked at and all information required under Schedule 2 of the National Minimum Standards was available. Training records demonstrated that staff receive a robust induction and foundation programme including issues such as health and safety, fire safety, medicine administration, challenging behaviours, epilepsy and disability discrimination. Staff said that they also receive specific training for individual needs from Linkage psychology service. Staff said that there is good access to training and the managers will support applications. There was also evidence on files to show that staff receive supervision on a monthly basis. Staff demonstrated a good knowledge of individual service user needs and feedback from service users indicates that there is always enough staff around to help them. Staff said that there is very good levels of communication within the team and throughout the wider Linkage service. They also said that support is very good from colleagues and managers. They confirmed that they receive regular supervision and have monthly staff meetings. Minutes of the meetings were The Sycamores DS0000002571.V289494.R01.S.doc Version 5.1 Page 16 seen and they demonstrated are well-organised and informative sessions for staff. The Sycamores DS0000002571.V289494.R01.S.doc Version 5.1 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): 37,39,42 The home ensures that the health, safety and welfare needs of service users are protected and they maintain robust records. A robust quality assurance programme enables service users to participate in the development of the home. EVIDENCE: Information regarding personal finances is recorded in individual files and the money held in the home matched the records. A service user described how he receives his money and service users sign record books to say that they have received it. There was evidence that the home carries out regular surveys. Copies of Investors In People questionnaires, relative’s satisfaction surveys, staff surveys, and service user satisfaction surveys were seen, and a service user said that they have completed one. Feedback on survey forms was positive and had been analysed by the home. The Sycamores DS0000002571.V289494.R01.S.doc Version 5.1 Page 18 Records demonstrate that portable appliance testing is carried out regularly as well as hot water temperature testing, fire system checks and fridge/freezer temperature recording. Gas and electrical safety certificates were also seen and were in date. The Sycamores DS0000002571.V289494.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 3 29 X 30 4 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 4 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 4 15 4 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X The Sycamores DS0000002571.V289494.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Sycamores DS0000002571.V289494.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Lincoln Area Office 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 Sycamores DS0000002571.V289494.R01.S.doc Version 5.1 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. 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!