Inspection on 21/01/06 for Upper Lattimore Road (2)

This inspection was carried out on 21st January 2006.

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.

Other inspections for this house

Upper Lattimore Road (2) 10/11/06

Upper Lattimore Road (2) 06/05/05

Upper Lattimore Road (2) 05/10/04

Upper Lattimore Road (2) 22/06/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Upper Lattimore Road (2) Kyros House 2 Upper Lattimore Road St Albans Hertfordshire AL1 3TU Lead Inspector Hazel Wynn Unannounced Inspection 21st January 2006 12.40 Upper Lattimore Road (2) DS0000019599.V280221.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 Upper Lattimore Road (2) DS0000019599.V280221.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. Upper Lattimore Road (2) DS0000019599.V280221.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Upper Lattimore Road (2) Address Kyros House 2 Upper Lattimore Road St Albans Hertfordshire AL1 3TU 01727 858 783 01727 858 783 kyroshse@walsingham.com 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) Walsingham Mr Jose Arlindo Vasconcelos Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (6) of places Upper Lattimore Road (2) DS0000019599.V280221.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th May 2005 Brief Description of the Service: Kyros House is a home for six people aged 18 - 65 years who have a learning disability and associated mental health problems. The homes purpose is to support Service Users towards greater independence, to be part of and participate in community life, to promote rights and accountability, to support achievement of goals and aspirations within a supported environment and to provide for the health, social and personal care needs. Kyros House operates activities within a risk management framework. The accommodation comprises a six bed roomed detached house with front and rear gardens. The front garden is given over to parking the service users vehicle and up to three other cars. There is limited other parking close by. The home is situated close to local shops and the main town of St Albans is a short car journey away. The town centre is popular to tourists world wide, being an old Roman town, and offers many restaurants and other amenities. Upper Lattimore Road (2) DS0000019599.V280221.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place during the day on 21st January 2006. The inspection process found that the National Minimum Standards assessed were met and that requirements/recommendations made during the last inspection had also been met. This inspection process provided a snapshot of the service on the day of the inspection. The CSCI met with staff and service users who provided positive feedback of their experiences of the service. The home was well managed and the service users were leading meaningful lives with maximised independence. 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. Upper Lattimore Road (2) DS0000019599.V280221.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 Upper Lattimore Road (2) DS0000019599.V280221.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): 2 Prospective Service Users individual aspirations and needs are assessed. EVIDENCE: A rigorous process of assessment is undertaken for all prospective service users and copies of the original assessments had been maintained on the files perused at this inspection. The assessments involve the input of all significant others and the service user is the centre point of the assessment process; being fully involved in the process. As part of the assessment process the service user is also very involved with considering risks, assessing risks and agreement to the risk management strategies, which are to be included in the care plan, to minimise risks. The outcomes for the remaining standards in this section appear in the previous report, dated 6th May 2005. Upper Lattimore Road (2) DS0000019599.V280221.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 - 10 Service users know that their assessed and changing needs and personal goals are reflected in their individual plan and they make decisions about their lives with support were required. Service users are consulted and play an active part in the management and developments by the home. The service users are supported to take risks as part of an independent lifestyle. Information about service users is securely stored and their confidences kept. EVIDENCE: Samples of individual plans were examined at this inspection and these contained comprehensive assessments of need, aspirations and goals, which had been regularly reviewed. Individual plans are currently being reviewed and information transferred to a preferable format. The individual service users progress notes had been maintained; they provided information about how the service users are empowered to make their own decisions and how their current and changing needs will continue to be met. The Service Users informed the inspector that they had just held a meeting and that an advocate from POWHER had been invited to attend and had supported them at their meeting. They said that they have regular meetings Upper Lattimore Road (2) DS0000019599.V280221.R01.S.doc Version 5.1 Page 9 and that any issues arising do get actioned. One of the service users said that each service user attends all meeting regarding their care planning/reviews and that everything they need is written down in their care plan. The proprietor’s agent conducts a review/audit of the service each month and meets with service users and hears their views; a report is provided to the CSCI of these visits. The company carries out a service users feedback survey and the results of this influence any developments. Service users stated they had chosen their own holiday venues and enjoyed the holidays that they had taken in the last six months. The care plans for individual Service Users contained risk assessments; supporting them to increase their independence within a risk management framework. There are policies and procedures in place regarding data protection. A requirement made at the last inspection regarding security of information had been actioned and information was securely stored at this inspection. Staff training supports assurance that confidentiality is part of the home’s ethos; the induction programme and rolling training programme contained confidentiality training on its agenda. Upper Lattimore Road (2) DS0000019599.V280221.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): 11 - 17 Service users are supported to develop to their fullest potential and to take part in age, peer and culturally appropriate activities. The service users are very much part of their community; using local facilities and resources. A variety of leisure activities are enjoyed. Relationships with family and friends are supported where relevant and appropriate. Service user rights and responsibilities are respected. A healthy diet is enjoyed in a congenial setting. EVIDENCE: The sample of individual plans and progress notes examined at this inspection provided evidence of how service users are supported to develop themselves in all aspects of daily living skills; the service users spoken with also confirmed this fact. There were records of service users having participated in meaningful activities that were age, peer and culturally appropriate. Service users spoken with shared information about various activities and leisure pursuits that they had recently enjoyed, both in the local community and further afield. They reported that they keep contact with their families and friends and are supported to do so where support is needed. Self-advocacy is promoted by the home and one of the Service Users discussed with us that a member of the advocacy group, POWHER, had attended the Upper Lattimore Road (2) DS0000019599.V280221.R01.S.doc Version 5.1 Page 11 residents meeting on the previous day. Other residents stated that they know their rights and that staff also know about residents’ rights and respect them. The community dietician provides advice to the home to support healthy meal planning. One of the residents stated that this advice is taken when planning their own menu. The menu reflected healthy eating choices and three residents confirmed that the menu choices were their own and that they have a variety of choice with eating times being flexible. The dining setting is comfortable, well lit and looks out onto the garden. During fair weather the service users sometimes take a meal in the garden and there is good quality garden furniture provided to enable this. Upper Lattimore Road (2) DS0000019599.V280221.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 -21 Personal care is provided to residents with an approach and method acceptable to them. The meeting of personal and emotional needs was very satisfactory. Medication was generally well managed. Ageing, illness and death would be handled with respect and in a manner acceptable to the service users. EVIDENCE: Three residents stated that the care staff team know their needs and follow their care plans. Personal care needs and guidance are documented in the individual care plans. Physical and emotional care needs are also documented in the individual care plans with guidance for staff; residents spoken with at this inspection, stated that they are well supported by staff when they are upset about something or need advice or assistance. All medical appointments were highlighted in the diary and a comprehensive note is maintained of outcomes of medical appointments to provide for consistency. There is a comprehensive and formal handover process. There were no gaps in the Medication Administration Record and medication was appropriately stored and easily reconciled. Receipts were maintained for the return to pharmacy of any unused/discontinued medication. Medication had been dated on opening. Upper Lattimore Road (2) DS0000019599.V280221.R01.S.doc Version 5.1 Page 13 There is a policy and procedure in place in respect of ageing, deteriorating in health and dying and staff training is provided. Loss and bereavement training is provided and part of the company’s/homes ethos is the support of residents through all stages of life and in all circumstances. Upper Lattimore Road (2) DS0000019599.V280221.R01.S.doc Version 5.1 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): 22 and 23 Residents know their views are important and are listened to and acted on. The residents are protected from all forms of abuse. EVIDENCE: Three service users spoke about their residents’ meetings and how they help to change things in the home so that things are the way they want them to be. There had been a residents’ meeting on the day previous to this inspection date and one of the residents said that an advocate from POWHER had attended the meeting to provide support. Policies and procedures are in place regarding protection of vulnerable adults and both staff and service users attend training in abuse awareness. Upper Lattimore Road (2) DS0000019599.V280221.R01.S.doc Version 5.1 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 - 28 & 30 The environment is homely, comfortable and protocols are in place to maintain safety. Personal rooms are very individual and there are sufficient wellequipped bathroom and toilet facilities. The home is domestic in size providing sufficient communal space and adequate personal space. The home is well maintained and kept clean. EVIDENCE: The home was comfortable, pleasant, bright and homely and protocols were in place to maintain a safe environment. Fire safety records were maintained showing regular checks, tests, drills and servicing and the proprietors agent visits monthly and samples systems in place. Environment risk assessments have been conducted and are reviewed. Individual risk assessments were on the files examined at this inspection. One service user allowed the CSCI to see his room; this had been very well decorated in accordance with his choice and was nicely furnished and personalised; the service user had chosen to replace the furniture provided with items of his own choice, which had also contributed towards his independence. Upper Lattimore Road (2) DS0000019599.V280221.R01.S.doc Version 5.1 Page 16 The toilets, bathroom and shower room are designed to provide for privacy and independence but also allow for assistance where required and are well furbished. The lounge is tight for space for all of the service users to be seated together, especially if accompanied by staff; however the dining area also provides space for activities and the service users own rooms provide adequate space for their comfort and relaxation. In fair weather the garden is well used for leisure and sometimes for meals outdoors. During this inspection, the home was seen to be clean, tidy and fresh. Upper Lattimore Road (2) DS0000019599.V280221.R01.S.doc Version 5.1 Page 17 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): 31 - 35 There is clarity of staff roles and responsibilities. A recognised induction programme is utilised and staff are appropriately trained to support the residents. Satisfactory recruitment practices are to be assured by the CSCI Provider Relationship Manager. Staff receive the training they need to meet the individual and collective needs of the residents. Supervision is in place for the support of staff. EVIDENCE: Staff handbooks are issued to all new members of staff and these contain their job description outlining their role and responsibilities; at the last inspection, staff stated that they had received these when they commenced employment. There had been no new recruits since the last inspection when staff stated that they had completed the Learning Disability Award Framework to achieve competence for their role. The CSCI Provider Relationship Manager has undertaken the responsibility of ensuring requirement that recruitment practices must be robust; the CSCI lead inspector for this home has not received the outcomes of such audit from the Provider Relationship Manager in time for the writing of this report. Recruitment policies and procedures are in place. Upper Lattimore Road (2) DS0000019599.V280221.R01.S.doc Version 5.1 Page 18 The training planner was seen at this inspection and provided a very satisfactory profile of training for staff. Staff confirmed that they receive regular supervision and support. Although there are vacancies within the staff team, agency staff, who are familiar with the service, are engaged to ensure staffing levels are maintained at previously agreed levels. The rota provided evidence the home is adequately staffed at all times. One and a half staff vacancies are advertised and in the meantime any gaps are covered satisfactorily. There was a rolling training programme in place and all mandatory training in addition to other training had taken place with updates planned. Staff stated that they receive regular formal supervision and were well supported by the manager to discharge their duties. One staff member spoke highly of the newly registered manager. Upper Lattimore Road (2) DS0000019599.V280221.R01.S.doc Version 5.1 Page 19 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 and 42 The residents are benefiting from a well run home and they are confident that their views underpin all self-monitoring, review and development of the home. The health, safety and welfare of the residents are promoted and protected. EVIDENCE: In the relevant sections of this report evidence has been provided to substantiate that the home is well run and the service users views are obtained and help in decision making when developments are being considered or where change is needed. Advocates from POWHER support service users to put their views forward and the organisation formally obtains the service users views in by way of a regular questionnaire and also less formally during the proprietor’s agent’s monthly visit when she meets with the service users and reports outcomes to the CSCI. Individual plans and progress notes, and discussion with residents provided evidence that the health, safety and welfare of residents is in place. Individual Upper Lattimore Road (2) DS0000019599.V280221.R01.S.doc Version 5.1 Page 20 and generic risk assessments were examined at this inspection and these provided evidence that the health, safety and welfare of staff and residents is promoted and protected. Upper Lattimore Road (2) DS0000019599.V280221.R01.S.doc Version 5.1 Page 21 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 X X 3 X Upper Lattimore Road (2) DS0000019599.V280221.R01.S.doc Version 5.1 Page 22 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. 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 YA34 Good Practice Recommendations The agreement reached between Walsingham Community Homes Ltd and the CSCI Provider Relationship manager, for the purpose of auditing recruitment practices, does not allow the lead CSCI Inspector to carry out the duty of ensuring robust recruitment practices are in place. A system needs to be put in place so that the CSCI inspector can make a judgement. The onus is on the provider to ensure that the lead inspector can be assured that the requirement has been fully met. Upper Lattimore Road (2) DS0000019599.V280221.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Upper Lattimore Road (2) DS0000019599.V280221.R01.S.doc Version 5.1 Page 24 - 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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