CARE HOME ADULTS 18-65
Warrington Community Living - Lucklaw Lucklaw Burtonwood Road Great Sankey Warrington Cheshire WA5 3AN Lead Inspector
David Jones Key Unannounced Inspection 23 August and the 7 September 2006 12:00
rd th Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 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 Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 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. Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Warrington Community Living - Lucklaw Address 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) Lucklaw Burtonwood Road Great Sankey Warrington Cheshire WA5 3AN 01925 230474 Warrington Community Living Leslie Andrew Whittle Care Home 4 Category(ies) of Physical disability (4) registration, with number of places Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The home is registered for a maximum of 4 accommodated in the category physical disability (PD) service users The registered provider must ensure that Mr Leslie Whittle achieves the Registered Manager’s Award by 1st November 2006 7th December 2005 Date of last inspection Brief Description of the Service: Lucklaw is a care home registered with the Commission for Social Care Inspection to provide personal care and accommodation for four adults with physical disabilities. The establishment is a domestic four-bedroom bungalow set within a residential area of Warrington and blends in with neighbouring properties. The premises have been adapted to accommodate the needs of people with a disability. There is level access throughout the bungalow with low gradient ramps to the front door and gardens. Preparations were being made at the time of the inspection to provide additional bathroom and toilet facilities. Residents have specially adapted transport enabling them to access the local community. Information about Lucklaw including copies of the most recent inspection report is made available to each resident and their representatives and can be acquired by contacting Warrington Community Living on 01925 246870. Fees range according to the needs of the individual. Contact Warrington Community Living on 01925 246870 for further information. There are no additional charges other than transport costs shared between the four residents. Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The Key unannounced inspection of Lucklaw included a site visit to the home. This was completed on two days over 6 and half hours in total. This key inspection, takes into consideration the developments in the home since the last inspection. It is focused on the experiences of residents and the people who support them. The views of residents’ representatives including family members health and social care professionals were gathered by survey questionnaires before the site visit. In addition two family members were spoken with on the day of the visit. Three of the four residents were also spoken with but discussion was limited due to communication difficulties. Time was spent with the residents observing their interactions with staff. The manager and some staff were spoken with and the inspector looked around the building to assess its suitability to provide a comfortable, safe and homely environment. What the service does well:
Lucklaw is the established home of four younger adults. It is valued by them and their representatives. The accommodation is spacious, comfortable and well equipped. It has been adapted to meet the needs of people with a physical disability and is decorated and furnished in accordance with residents’ personal needs and characters. The atmosphere in the home is relaxed, welcoming and sociable. Residents are at ease and confident in the home’s environment. They take part in the day to day domestic routines associated with running the home by observing staff cleaning and tidying the house and accompanying them on shopping trips to the local community. Residents greet all visitors at the front door. The home’s assessment and care planning processes involve family members and health and social care professionals. They focus on the diverse needs of each individual, putting them first and make sure their needs are met. Residents explore and take advantage of new opportunities for activities and social interaction. One of the residents recently visited a Disco in Manchester a new experience that they enjoyed. Staff support residents to maintain family links and help them to correspond with relatives who receive post cards and letters from holidays and are informed of significant events in the home. Visiting relatives indicate satisfaction with the standard of care, facilities and services provided. They feel welcome when they visit and express confidence in the staff teams’ abilities and attitude to care and support. Two visiting relatives said standards are excellent and staff are skilled and caring.
Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 6 There is a dedicated and well-managed team of staff who conduct their work with care, good humour and affection for the residents. Visiting health care professionals speak highly of the staff team. Staff are said to work in partnership, demonstrate a clear understanding of the care needs of each resident and communicate effectively. What has improved since the last inspection?
Much has been achieved since the last inspection. New management initiatives have required support staff to take responsibility for various aspects of service delivery. The staff group presents as a skilled and well-organised team. The manager and senior support worker are focused on developing and maintaining effective arrangements for the care and support of residents. Each resident and their representatives are at the centre of decision-making regarding the care of the individual. Assessment and care planning systems are progressive, accurate and up to date. Essential life style plan assessments have been simplified and developed on behalf of each resident. These address each person’s social and emotional needs from their own perspective. Likes, dislikes and personal preferences are recorded to help develop individual personal plans tailored to the precise needs of each resident. Individual personal plan meetings (IPPs) have been arranged for all four of the residents and two had been completed at the time of the visit. Risk assessment is central to the home’s assessment processes. Residents have been referred to health care professionals where specialist advice is required. Risk assessments are up to date, written in plain language and confirm control measures in the appropriate detail. Care practice is monitored and there is evidence of staff working closely with health care professionals including general practitioners, nurses, speech therapists and occupational therapists. This helps care staff to make sure that each residents needs are met in a consistent and safe manner. Discussion with relatives and staff confirms that residents are benefiting from this increased level of planning and dialogue with their representatives. They are getting out more and are engaging in activities that are suitable to their particular needs and personal preferences. Arrangements for the safe storage and administration and recording of medication meet the requirements of the National Minimum Standards and regulations and staff have access to a supportive pharmacist for advice and guidance when required. Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 7 Robust procedures for responding to suspicion or evidence of abuse or neglect are in place and the vast majority of staff have received appropriate training in adult protection. Staff are employed in numbers appropriate for the well being of residents. Minimum staffing levels are adhered to at all times and there are times when staff are employed in threes, fours and fives. This provides residents with opportunities to go out and engage in social events and activities. What they could do better:
The manager must finalise his work on the statement of purpose and service users guide and make these documents available to residents. Without this information residents are disadvantaged when making decisions about the home. The registered persons should explore ways and means of developing the service users guide and statement of purpose to make them more accessible to current and potential residents. Audio and visual methods of communication my prove useful including audiotapes, compact disc, and digital videodiscs. Residents’ and their representatives’ views should feature in the home’s service users guide, where appropriate. There have been vast improvements in the home’s assessment and care planning systems. Staff should build on this work by sharing assessments and care plans with relatives and visiting health care professionals. This will help staff to develop arrangements for care, which reflect the individual’s needs, aspirations and personal preferences. Residents show affection for staff and staff respond with affection for residents as is appropriate. Residents’ needs for affection should be detailed in the care plans with guidelines for staff as to appropriate responses. Appropriate bathing and toilet facilities must be provided in accordance with residents’ assessed needs. Warrington Community Living staff recruitment procedures must be followed to ensure that residents are appropriately protected. The staff induction-training programme should be developed to reflect “Skills for care” criteria. This will help to ensure that all staff are trained to an appropriate level and have the skills they need to do their work and meet residents’ needs. Quality assurance systems require further development to ensure that residents, aided by their representatives, are consulted on quality issues and action is taken to address matters raised. Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 8 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. Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 9 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 Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 10 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, 3 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a site visit to the service. The home’s assessment procedures are efficient and effective. Residents’ needs and aspirations are identified and acted upon. EVIDENCE: Warrington Community Living has established procedures for introducing new residents to the home. These are designed to enable the individual and their representatives to make an informed choice. The home provides a Statement of Purpose that is specific to the individual home. It sets out the objectives and philosophy of the service and is supported by a Service user Guide. However the service users guide must be further developed to ensure it incorporates a standard form of contract. This will ensure that resident and their representatives have written information confirming their rights and responsibilities. Visiting relatives advised that they had not seen the statement of purpose or service users guide and although one of the visitors was the named advocate for one of the residents they had not seen or received a copy of terms and conditions. The statement of purpose, service users guide and statement of terms and conditions should be made available to residents and their representatives this will ensure they have the information they need when making decisions about the home. Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 11 Neither the statement of purpose or service users guide are available in a format suitable for the current or possible future residents of the home. The registered persons should explore ways and means of developing this information to make it more interesting and accessible to current and potential residents. Audio and visual methods of communication my prove useful including audiotapes, compact disc, and digital videodiscs. Residents’ and their representatives’ views should feature in the home’s service users guide, where appropriate. Reading of case records and discussion with staff and visiting relatives confirms that the home’s assessment procedures are efficient and effective. Residents’ needs and subsequent arrangements for care are identified and developed with the involvement of residents; their representatives including relatives and appropriate health and social care professionals. Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 12 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 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a site visit to the service. Residents’ needs, expectations and personal preferences are identified and met in a consistent and appropriate manner. EVIDENCE: A new simplified but more effective assessment and care-planning system has been introduced. This has benefited residents who are enjoying new and improved opportunities for a fulfilled life style. Visiting health care professionals speak highly of the staff team. Staff are said to work in partnership, demonstrate a clear understanding of the care needs of each resident and communicate effectively. Assessments and care plans are up-to-date, accurate and clear. Care practice is monitored and there is evidence of staff working closely with health care professionals including general practitioners, nurses, speech therapists and occupational therapists. This helps care staff to make sure that each residents needs are met in a consistent and safe manner.
Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 13 Risk assessment is central to the home’s assessment processes. Where appropriate residents have been referred to health care professionals where specialist advice is required. Risk assessments are written in plain language and confirm control measures in the appropriate detail. Only one of the care plans seen needed further development. The speech therapist had given precise instructions regarding how staff should assist the resident to eat their meals to avoid ingestion of food or chocking associated with swallowing problems. The care plan detailed some of the advice given by the speech therapist but not all. Important guidance to ensure that the individual is sitting upright when eating and drinking their head not tilted forward or back had been omitted. This should be recorded in the care plan for the immediate reference of staff to ensure the safety of the resident and consistency in approach to the task. Discussion with the senior support worker confirmed that residents’ representatives are consulted on all aspects of care and services provided. However, they are not routinely asked to read and sign care plans to confirm their agreement. The registered persons should share assessments and care plans with each of the resident’s representatives. This will help staff to develop arrangements for care, which reflect the individual’s needs, aspirations and personal preferences. Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 14 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, 12, 13, 14 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a site visit to the service. Residents are supported to maintain family links and daily routines promote individual choice and freedom of movement. EVIDENCE: We were unable to talk with residents due to communication difficulties but residents appear at ease in the home’s environment and from observation they look content and enjoy good relationships with the staff. The atmosphere in the home is relaxed, welcoming and sociable. Staff support residents to maintain family links and help them to correspond with relatives who receive letters and Post cards and are informed of significant events in the home. Visiting relatives indicate satisfaction with the standard of care, facilities and services provided. Communication is said to be good and they are made welcome when visiting the home. Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 15 Essential life style plan assessments have been simplified and developed on behalf of each resident. These address each resident’s social and emotional needs from their own perspective. Likes, dislikes and personal preferences are recorded to help develop individual personal plans tailored to the precise needs of each resident. Individual programme plan meetings (IPPs) have been arranged for all four of the residents and two had been completed at the time of the visit. Two relatives were visiting the home at the time of the meeting to attend an individual programme plan meeting. Each spoke highly of the home expressing more than satisfaction with the standard of care facilities and services provided. Standards were described as excellent and staff were said to be skilled and caring. Discussion with relatives and staff confirms that residents are benefiting from this increased level of planning and dialogue with their representatives. They are getting out more and are engaging in activities that are suitable to their particular needs and personal preferences. Discussion with staff and observation confirms that they engage residents in the day-to-day domestic routines associated with running the home including cleaning and tidying the house and making shopping trips in the local community. Residents greet all visitors at the front door and staff interact with residents on a frequent basis engaging them in two-way communication. Visiting relatives said they always receive a good welcome to the home. The resident they were visiting expressed her delight in greeting her mum and brother. Reading of records and discussion with staff confirms that a healthy varied and nutritious diet is on offer. Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 16 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 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a site visit to the service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Much has been achieved in the home since the last inspection. Lucklaw is well managed and staff are focused on meeting residents’ needs in accordance with their personal preferences and the guidance provided by health care professionals. The home’s assessment and care planning systems are progressive and ongoing. They are designed to ensure that residents receive effective personal and healthcare support. Up to date individual health care records confirm close working with health care professionals in the interests of ensuring each resident’s health care needs are met. Staff work closely with residents, their relatives and other representatives to ensure that residents needs are met in accordance with their wishes and personal preferences. Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 17 Person centred planning is very much in evidence. Essential life style plans are being developed and Individual Programme Plan meetings are ongoing. These assist each resident aided by their representatives to express their wishes, needs and personal preferences from their point of view. Staff are working creatively to explore ways and means of meeting residents needs and helping them to take advantage of opportunities for socialising and social inclusion. Discussion with staff and observation confirms that affection is given to residents based on a foundation of mutual regard. How affection is expressed and responded to should be entered on the respective individual’s care plan to ensure that staff are provided with guidelines in the interests of protection, monitoring and review. A medication check found that medicines are received, stored, administered and recorded in accordance with the requirements of the National Minimum Standards and the regulations. Staff including the most recent recruit have received appropriate training in the administration of medication and are able to demonstrate their competence when handling and recording medicines. Medicines received are appropriately recorded and the home enjoys good working relationships with the supplying pharmacist who provides support and advice as required. Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 18 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. Quality in this outcome area is good. This judgement has been made using available evidence including a site visit to the service. Satisfactory arrangements are in place for the protection of vulnerable adults and making complaints. EVIDENCE: No complaints have been received since the date of the last inspection. Warrington Community Living has effective arrangements for receiving and handling of complaints that are confirmed in a detailed policy for the guidance of staff. This should be re-produced in a format that is suitable and accessible for current and future residents. Various methods of communication should be explored including audiovisual media. Robust procedures for responding to suspicion or evidence of abuse or neglect are in place including whistle blowing as in accordance with the Public Interest Disclosure Act 1998. Training records confirm that ten of the eleven staff members have received appropriate training on the implementation of adult protection procedures. Further training needs identified via the home’s staff appraisal systems will be addressed in accordance with each staff member’s personal development plan. Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 19 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, 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a site visit to the service. Residents live in a safe, well-maintained and comfortable environment, which is suitable for their needs. EVIDENCE: Lucklaw is a bungalow located in a residential area of Warrington. The premises are in keeping with the local community, and provide spacious, comfortable, bright and cheerful accommodation that reflects the needs and preferences of the residents. Interior decoration, furniture fixtures and fittings are of a good domestic standard and residents’ bedrooms reflect individual needs and characters. Adaptations have been made to the premises over time to accommodate changing needs of residents, including the provision of overhead hoist tracking and alterations have been made to facilitate access to the home and the back garden. An assessment previously conducted by a suitably trained member of staff had indicated that the bath is too low and the health and safety of staff assisting residents to bathe may be jeopardised. The registered manager advised that an occupational therapist will be consulted as to the suitability of
Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 20 the bathroom and any necessary changes will be made to ensure the safety of residents and staff. The main bathroom is equipped with a WC. Unfortunately, the only other WC’s in the home are those located in two residents’ en-suite facilities. This means that staff and a resident who does not have en-suite facilities are required to use the WC’s in other residents’ bedrooms when the main bathroom is engaged. This is inappropriate as it compromises the privacy and rights of residents. The registered persons must provide appropriate toilet facilities to ensure the privacy and dignity of residents. The home is not provided with a sluice facility. However appropriate arrangements are made for the handling and disposal of waste and infection control. The manager advised that plans have been drawn up to provide appropriate toilet facilities in the near future. The home is clean and well presented throughout. Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 21 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, 33, 34, 35 and 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a site visit to the service. All required recruitment checks must be in place before staff are employed to ensure the protection of vulnerable people. EVIDENCE: The staff group present as an effective team. They work together with the benefit of shared aims and objectives and are clear about their individual roles and responsibilities. Visiting relatives and health and social care professionals have confidence in their abilities and levels of commitment. Visiting relatives are made welcome in the home and are involved in the development of plans to meet residents’ needs. They are kept informed of important developments and express more than satisfaction with the standard of care on offer. Health care professionals, including a GP and a supporting nurse indicate that staff communicate clearly, demonstrate a clear understanding of residents’ needs and work in partnership to ensure needs are met. Staff were seen to conduct their work with care, good humour and evidence of affection for the residents. They advised that morale is good. They said they are appropriately supervised and supported by the new senior support worker and the manager. The senior support worker has given each staff member additional responsibilities according to their particular strengths and interests.
Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 22 Staff said that they feel involved with the management and development of the home. They have confidence in the new senior support worker and manager and say that they are well managed. Communication is good and the staff team has a new sense of purpose and direction. Warrington Community Living has appropriate recruitment procedures. However, reading of a sample of two staff recruitment records and discussion with the manager indicates that staff are not always recruited in accordance with the full requirements of the regulations. The manager advised that he had been unable to acquire an employer’s reference for one member of staff. He had made further enquiries but had not made records of his attempts to ensure that appropriate recruitment checks were in place. The registered persons must ensure that staff are recruited in accordance with the requirements of the regulations in the interest of the protection of residents. New starters undergo induction training and work in a supernumerary capacity until they are assessed as competent to undertake their given role. The home’s induction arrangements do not currently incorporate skills for care criteria but the senior support worker is appropriately qualified to assess staff and intends to liaise with “Skills for Care” to make the necessary arrangements in the near future. Staff receive relevant training that is targeted and focussed on improving outcomes for residents. Up-to-date staff training records confirm that the vast majority of staff have received training in moving and handling, first aid, fire, communication and record keeping, administration of medications and rectal diazepam, the PEG feeding device, protection of vulnerable adults, food hygiene, medication and the promotion and management of continence. Some have received training in risk assessment, sensory awareness, health and safety and the control of substances hazardous to health. Each member of staff has a personal development plan and arrangements are being made to address any identified staff training needs. Information provided by the manager indicates that the NVQ training programme is well advanced with almost 50 (5 out of 11) of the home’s staff having achieved an NVQ level 2 in care or above and a number of others but not all staff pursuing the qualification in the near future. Minimum staffing levels are adhered to at all times ensuring the well being of residents. Rotas show well thought out ways of making sure that the home is staffed efficiently. Staff are employed in threes, fours and fives at certain times to ensure that residents have opportunities to go out and engage in social events and activities. Staff meetings take place regularly and arrangements are made to accommodate them on the staff rosters. Supervision sessions are regular and staff find them helpful.
Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 23 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. Quality in this outcome area is good. This judgement has been made using available evidence including a site visit to the service. Residents benefit from a well run home. EVIDENCE: Lucklaw is well managed. Assessment and care planning systems are progressive and new management initiatives have supported staff to take the lead on various aspects of service delivery. The staff group presents as a skilled and well-organised team. The manager and senior support worker are focused on developing and maintaining effective arrangements for the care and support of each resident by working with their relatives and health and social care professionals. The registered manager is a Registered Nurse Learning Disabilities and an experienced manager and practitioner in the field of learning disabilities with many years experience. He is pursuing the “registered manager’s award” as in accordance with a condition of registration. Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 24 Information provided by the manager confirms that some further progress has been made to introduce effective quality assurance processes in the home. The manager had introduced a “residents’, relatives” and other interested parties satisfaction questionnaire. This is to be sent out to all relevant people and the results are to be collated and published in a report on quality issues open to residents’ representatives. Warrington Community Living seeks to ensure the health and safety of all employees and residents. Risk assessment and risk management is central to the conduct of the home. The manager and senior support worker ensure that risk assessments are carried out for all safe working practice topics and significant findings are recorded and reviewed. Information provided indicates that fire precautions are in place and routine maintenance checks of gas and electrical systems, hoist, electrical appliances, fire alarms, extinguishers and emergency lighting systems are undertaken and are up to date. Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 25 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 2 2 3 3 3 4 X 5 2 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 X 26 X 27 2 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 2 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 X 3 X 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 X 3 X 2 X X 3 x Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 26 Yes 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 YA1 Regulation 4 (2) and 5 (2) Requirement The registered persons must develop the service users guide to ensure it includes a standard form of contract and supply a copy of the statement of purpose and service users guide to the Commission and make a copy of these available on request for inspection by every resident and any representative of the residents. Previous timescale 31/01/06 not met. Timescale for action 31/10/06 2 YA27 23 (2) (j) The registered persons must 31/10/06 provide appropriate bathing facilities as in accordance with residents’ assessed needs to ensure a safe environment. Previous time scale 01.04.05, 25/08/05 and 01/04/06 not met) The registered persons must provide appropriate toilet facilities and when these are in place staff should not routinely use residents’ private facilities. (Previous time scale 01.04.05, 25/08/05 and 01/04/06 not met) 31/12/06 3 YA27 23 (2) (j) Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 27 4 YA34 18 and 19. 5 YA39 24 (1) The registered persons must 07/09/06 ensure that staff are recruited and employed in accordance with the requirements of the regulations in the interest of the protection of residents. The registered persons must 31/10/06 establish and maintain a system for reviewing at appropriate intervals and improving the quality of care provided at the care home and shall supply to the Commission a report on any such review of the quality of care provided. Previous timescale 27/02/06 not met. 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 YA1 Good Practice Recommendations The registered persons should make the statement of purpose, service users guide and statement of terms and conditions available to residents and their representatives. This will ensure they have the information they need when making decisions about the home. The registered persons should explore ways and means of developing the service users guide and statement of purpose to make them more accessible to current and potential residents. Audio and visual methods of communication my prove useful including audiotapes, compact disc, and digital videodiscs. Residents’ and their representatives’ views should feature in the home’s service users guide, where appropriate. The registered persons should ensure that the advice and recommendations of care professionals as to the care of the individual is confirmed in the individual’s care plan. This will help to ensure their needs will be met in a consistent and appropriate manner. 2 YA1 3 YA6 Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 28 4 YA6 The registered persons should share assessments and care plans with each of the resident’s representatives. This will help staff to develop arrangements for care, which reflect the individual’s needs, aspirations and personal preferences. The registered persons should ensure that service users’ needs for affection are detailed in the care plans with guidelines for staff as to appropriate responses. The registered persons should re-produced the complaints procedure in a format that is suitable and accessible for people with a learning disability various methods of communication should be explored including audiovisual media. The registered persons should ensure that care staff hold a care NVQ 2 or are working toward the qualification by an agreed date or the registered manager can demonstrate that through past work experience staff meets the standard. The registered persons should ensure that the home’s staff induction training reflects “Skills for care” criteria. 5 YA18 6 YA22 7 YA32 8. YA35 Warrington Community Living - Lucklaw DS0000027018.V299559.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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