Inspection on 06/05/05 for Upper Lattimore Road (2)

This inspection was carried out on 6th May 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Upper Lattimore Road (2) 10/11/06

Upper Lattimore Road (2) 21/01/06

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 Kyros House 2 Upper Lattimore Road St Albans AL1 3TU Lead Inspector Hazel Wynn Unannounced 06.05.05 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. Upper Lattimore Road I52 s19599 Upper Lattimore v224206 060505 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Upper Lattimore Road Address Kyros House 2 Upper Lattimore Road St Albans Hertfordshire AL1 3TU 01727 858783 01727 858783 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) Walsingham Mrs Meline Charles Care Home 6 Category(ies) of LD LD Learning - 6 registration, with number LD (E) LD (E) Learning disability - over 65 6 of places Upper Lattimore Road I52 s19599 Upper Lattimore v224206 060505 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: There are no additional conditions of registration. Date of last inspection 05.10.05 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 particpate 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 I52 s19599 Upper Lattimore v224206 060505 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on the 6th May 2005 and it found that the majority of the Standards had been met. The registered manager who had been in post has now retired and a new registered manager must be appointed, (the newly apponted manager commenced the application process by applying to the Commission for Social Care Inspection immediately following this inspection). Medication was generally well managed; however, one medication, in use, had not been dated on opening and a recommendation was made in this respect. The individual Service User progress logs were stored on the side in the kitchen and a requirement was made for the secure storage of all personal data. The home was generally well run and the Service Users were very satisfied with their service. What the service does well: What has improved since the last inspection? A new manager is now in post and is actively promoting stability in the team following the disruption of the retirement of both the registered manager and the deputy. Upper Lattimore Road I52 s19599 Upper Lattimore v224206 060505 stage 4.doc Version 1.30 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. Upper Lattimore Road I52 s19599 Upper Lattimore v224206 060505 stage 4.doc Version 1.30 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 Upper Lattimore Road I52 s19599 Upper Lattimore v224206 060505 stage 4.doc Version 1.30 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, 2, 3, 4 and 5 The service supports prospective service users to make a choice of home and to consider the views of current service users with regard to the filling of a vacancy. Needs are fully assessed and the home does not accept prospective Service Users if it does not have the capacity to meet those needs. EVIDENCE: Prospective Service Users make several visits to the home prior to making a choice. Each Service User is given a user friendly formatted agreement that is signed by both the Service User and the organisation. A Service User who has moved into the home more recently was able to recall how he made the transition to his new home and still visits, with staff support, friends he made in his previous home. The home has a procedure for admissions and lengthy transitions are always supported to ensure that the prospective Service User is provided with an informed choice and that the current Service Users views and feelings are valued and taken into consideration. Upper Lattimore Road I52 s19599 Upper Lattimore v224206 060505 stage 4.doc Version 1.30 Page 9 A comprehensive initial assessment is maintained on each Service Users file; this provides the base for the production of the care plan. Reviews of the Care Plan are held at regular intervals with the fullest possible involvement of the Service User. A copy of the Service Users Agreement was on the Service Users individual files and this was signed by both the Service User and the organisation; the agreement is a précis of the contract with the appropriate local authority. Upper Lattimore Road I52 s19599 Upper Lattimore v224206 060505 stage 4.doc Version 1.30 Page 10 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 Service Users are involved in formulating and reviewing their care plans. Service Users are empowered to make decisions and to influence how the home is run. Risks are managed within a risk management framework to enable Service Users to lead full and meaningful lives with as greater independence as is possible. A tighter reign is needed regarding the storage of all personal data. EVIDENCE: Service Users stated they attend all meeting regarding their care planning/reviews and that everything they need is written down in their care plan. The care plans we saw were comprehensive and progress notes are maintained and these 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 care plans for individual Service Users contain risk assessments and risk management plans to support risk taking. Service Users stated that at the moment they are looking to choose what holiday venues they would like to travel to this year but hadn’t all made up their own minds yet as to where to take their holiday. Upper Lattimore Road I52 s19599 Upper Lattimore v224206 060505 stage 4.doc Version 1.30 Page 11 The Service Users hold ‘Residents Meetings’ and the minutes reflect how they influence the running of the home. The home has policies and procedures in place regarding data protection but progress notes were found stored on the side in the kitchen in breach of the policies. A requirement was made to ensure that in future all personal data is securely stored. Upper Lattimore Road I52 s19599 Upper Lattimore v224206 060505 stage 4.doc Version 1.30 Page 12 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, 14,15,16 and 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 is supported where relevant and appropriate. Service User rights and responsibilities are respected. A healthy diet is enjoyed in a congenial setting. EVIDENCE: The care plans and progress notes provided evidence of how Service Users are supported to develop themselves in all aspects of daily living skills. There were records of Service Users having participated in meaningful activities that were age, peer and culturally appropriate. Service Users spoken with various activities and leisure pursuits that they had recently enjoyed, both in the local community and further afield. Service users disclosed that they keep contact with their families and friends and are supported to do so where support is needed. Upper Lattimore Road I52 s19599 Upper Lattimore v224206 060505 stage 4.doc Version 1.30 Page 13 Self advocacy is promoted by the home and one of the Service Users discussed with us that she belongs to and attends a Advocacy Group. Other Service Users stated that they know their rights and that staff also know about Service User rights and respect them. The community dietician provides advice to the home to support healthy meal planning and Service Users stated how they take this advice when planning their own menu. The menu reflected healthy eating choices and the Service Users confirmed that the menu choices were their own and that they have a variety of choice with eating times being flexible. The setting observed at the evening meal was very sociable with Service Users engaging in conversation with one another about their day and their plans. Ownership and empowerment was very evident. Upper Lattimore Road I52 s19599 Upper Lattimore v224206 060505 stage 4.doc Version 1.30 Page 14 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) 18,19,20 and 21 Personal care is provided to Service Users with an approach and method acceptable to them. The meeting of personal and emotional needs is very satisfactory. Medication is generally well managed. Ageing, illness and death would be handled with respect and in a manner acceptable to the Service Users. EVIDENCE: Service Users 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; service users discussed how well they are supported by staff when they are upset about something. One of the Service Users told us that staff took her to the hospital because her sight was failing and she had an operation to improve it (cataract removal) and that she was going to have the other eye improved when the Doctor felt the time was right. All medical appointments were highlighted in the diary and a note is maintained of outcomes of all medical appointments to provide for consitent handover within the team. Two Service Users have electric recliner chairs that they were assessed for and they went to the provider to ensure that the chair they would order was right for them. Upper Lattimore Road I52 s19599 Upper Lattimore v224206 060505 stage 4.doc Version 1.30 Page 15 Service Users wishes were documented in the care plan. 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. One medication bottle had not been dated on opening and a recommendation was made that all medication be dated on opening. Upper Lattimore Road I52 s19599 Upper Lattimore v224206 060505 stage 4.doc Version 1.30 Page 16 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 and 23 Service users views are listened to and responded to positively. Service Users are protected from all forms of abuse by good policies, procedures and staff training and also by having empowered Service Users to air their views and whistle blow. EVIDENCE: One of the Service Users told us she attends an advocacy group, which the home staff introduced her to a long time ago and that if she has a personal grumble staff listen and try to put it right. Three Service Users told us about their Service User meetings and how they help to change things in the home so that things are the way they want them to be. 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 I52 s19599 Upper Lattimore v224206 060505 stage 4.doc Version 1.30 Page 17 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) 24,25, 26, 27, 28, 29 and 30 The environment is homely, comfortable and protocols are in place to maintain safety. Personal rooms are very individual and there are sufficient well equipped bathroom and toilet facilities. The home is domestic in size but provides enough communal space and adequate personal space. The home is well maintained and kept clean. EVIDENCE: We observed the home to be fresh and clean. A check of records showed that health and safety audits had been carried out and the outcomes of self audits had been actioned, for example: were Portable Appliance tests are due, dates were planned in. Weekly fire safety checks and water and fridge/freezer temperature checks were recorded and signed by the person conducting the check. Two Service Users have electric recliner chairs that they were assessed for and these aid their comfort and aid their independent rising from a seated to standing position. Upper Lattimore Road I52 s19599 Upper Lattimore v224206 060505 stage 4.doc Version 1.30 Page 18 Control of substances hazardous to health was being managed according to guidance and the policies and procedures in place in the home; hazardous substances were in a locked cupboard and the substance data and guidance in the event of an accident with any substance stored in the home was available. Upper Lattimore Road I52 s19599 Upper Lattimore v224206 060505 stage 4.doc Version 1.30 Page 19 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, 32, 33, 35 and 36 Staff understand their role and responsibilities and are competent and trained to carry out their duties effectively and professionally. The care staff team are formally supervised and supported by management. EVIDENCE: Staff handbooks are issued to all new members of staff and these contain their job description outlining their role and responsibilities; staff stated that they had received these when they commenced employment. Staff stated that they had completed the Learning Disability Award Framework to achieve competence for their role. The staff also stated that they had been required to provide references and that a CRB/POVA check had been carried out before they could commence work. Access to the recruitment files was not possible on this occasion because the manager was off duty and has the key to keeping the documents secure. Staff stated that they receive regular formal supervision and were well supported by management to discharge their duties. Upper Lattimore Road I52 s19599 Upper Lattimore v224206 060505 stage 4.doc Version 1.30 Page 20 The rota provided evidence the home is adequately staffed at all times; two vacancies are advertised and in the meantime any gaps are covered by the home’s care team and bank staff. 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 most of the team had just attended a course in Values III training, which equips staff with valuable insight into the values of the five accomplishments a philosophy/ethos encouraged by John O’Brien; the two staff who had not been able to attend this month would attend next month. Upper Lattimore Road I52 s19599 Upper Lattimore v224206 060505 stage 4.doc Version 1.30 Page 21 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, 39, 40, 21, 42 and 43. The home is run with the backing of strong leadership and the competent, accountable management approach and a solid ethos. Service Users views influence how the home is run and how it develops. The rights and interests of the Service Users are respected and safeguarded (with the exception of Standard 10 confidentiality of records). The health, safety and welfare of both Service users and staff are protected. EVIDENCE: Service Users stated that their new manager makes sure that everything is done well. Staff stated that they receive regular supervision and are well supported and that staff meetings are well attended and take place on a regular basis. Service Users stated that they hold ‘Residents Meetings’ and if they have a matter arising the manager will look at this and try to resolve it for them. The Service Users further stated that they are very involved in the way things are done in the home and are supported to create the agenda for positive changes. Upper Lattimore Road I52 s19599 Upper Lattimore v224206 060505 stage 4.doc Version 1.30 Page 22 In the standards covering the environment (Standards 31-36) we have highlighted the records covering health and safety that we looked at during this inspection, and these had been well maintained. In standards 16, 22 and 23 we have discussed the policies, procedures and practice in place to protect the best interests and rights of the Service Users. Standards 18, 19 and 24 – 30 contain statements regarding the positive outcomes of this inspection regarding the health, safety and welfare of both Staff and Service Users. The homes policy and procedure regarding data protection had not been adhered to in respect of the Service Users Individual progress logs, these were found stored on the kitchen side and a requirement was made for all personal data to be stored securely. Service Users hold their own finances and understand their cash flow, they stated that they store their small amounts of cash securely in their own rooms and check and record with a member of staff their transactions and balances. Policies and procedures are also in place to safeguard the service users in the financial area; the organisation sends a representative to the home each month who carries out an audit and reports to the Commission for Social Care Inspection. The Service Users questioned why we would want to check their finances and stated that this was personal and the Service Manager comes and checks; we respected their wishes and declined this part of the inspection checks. The relief manager (registered manager of another Walsingham Community Home) has succeeded to post in this home and has been appointed. A requirement was made for him to apply for registration with the Commission for Social Care Inspection. (The process was commenced the day after this inspection took place). Upper Lattimore Road I52 s19599 Upper Lattimore v224206 060505 stage 4.doc Version 1.30 Page 23 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 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 1 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Upper Lattimore Road Score 3 3 2 3 Standard No 37 38 39 40 41 42 43 Score 1 3 3 3 3 3 3 I52 s19599 Upper Lattimore v224206 060505 stage 4.doc Version 1.30 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA37 Regulation 17 Requirement All personal data must be securely stored and data protection must be safegaurded at all times. The newly appointed manager must apply to be registered by the Commision for Social Care Inspection. (It is noted that an application form was requested for the manager appointed by the home, following this inspection). Timescale for action 07.07.05 2. YA37 8 06.05.05 immediate requiremen t 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 20 Good Practice Recommendations As part of best practice all medication should be dated on opening.(Refers to one bottle of medication that was in use but not dated on the day of opening). Upper Lattimore Road I52 s19599 Upper Lattimore v224206 060505 stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection 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 I52 s19599 Upper Lattimore v224206 060505 stage 4.doc Version 1.30 Page 26 - 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!