Inspection on 02/02/07 for Wycar Leys The House

This inspection was carried out on 2nd February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Wycar Leys The House 25/01/06

Wycar Leys The House 25/08/05

Wycar Leys The House 07/09/04

Wycar Leys The House 02/06/04

Wycar Leys The House 15/03/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Wycar Leys The House Kirklington Road Bilsthorpe Newark Nottinghamshire NG22 8TT Lead Inspector Wendy Taylor Key Unannounced Inspection 2nd February 2007 13:00 Wycar Leys The House DS0000008766.V321445.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 Wycar Leys The House DS0000008766.V321445.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. Wycar Leys The House DS0000008766.V321445.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wycar Leys The House Address Kirklington Road Bilsthorpe Newark Nottinghamshire NG22 8TT 0870 3307522 08703307521 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) Wycar Leys Limited Ms Julie Ann Brandon-Smith Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Wycar Leys The House DS0000008766.V321445.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Wycar Leys Limited is registered to provide accommodation and personal care at Wycar Leys The House, Kirklington Road, Bilsthorpe, Newark, Nottinghamshire, NG22 8TT for a maximum of 8 people whose primary care needs are: Learning disability LD (8). 25th January 2006 Date of last inspection Brief Description of the Service: The House is a detached home, one of four properties on a large complex. It provides care and accommodation for 8 people who have a learning disability. It has a large enclosed garden surrounding the property and the service users access this safely and independently. The garden has a large trampoline fixed for service users. The home is close to the village and service users have access to a minibus for journeys further away. The service users have access to large grounds surrounding the complex. The House shares some facilities with the other homes in the complex such as a central kitchen and laundry. The current weekly fees for living at the home are £1500:00 to £2500:00. Wycar Leys The House DS0000008766.V321445.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place during February 2007; and the visit to the home was carried out over 4 hours on one day. The care and support received by two service users was followed in detail. The service users were not able to fully express their views to the inspector due to their communication needs, but detailed observations of their care and support were made throughout the visit. Care records, staff records and general house records were looked at. Staff, the acting manager and the regional manager were spoken to in depth; and information already held by the commission was also used as part of the inspection process. The acting manager and the regional manager were available throughout the visit. Throughout the visit service users were relaxed and confident in their interactions with staff; and the staff said that they liked working at the home. What the service does well: What has improved since the last inspection? What they could do better: There are no requirements or recommendations made at this inspection. Wycar Leys The House DS0000008766.V321445.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Wycar Leys The House DS0000008766.V321445.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Wycar Leys The House DS0000008766.V321445.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is clear information available about the home that helps service users and their supporters to make informed choices about where to live. They also know that needs can be met by way of a thorough assessment. EVIDENCE: Pre inspection information shows that policies are available for referrals and admissions, and there is evidence that the policies have been reviewed since the last inspection visit. There is evidence that the statement of purpose and the service user guide are available to relatives as well as service users, and the service user guide is available in picture format. Individual contracts are also available. Detailed assessments are in place and they cover issues such as relationships, medication, safety, sleep and activity. Although service users may not be able to fully participate in the assessment process due to their communication needs, there is evidence that relatives and other supporters such as social workers are consulted. There have been no new admissions since the last inspection visit. Wycar Leys The House DS0000008766.V321445.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive the care and support they need, in a manner that suits them, due to a comprehensive care planning process. Their choices and decisions are acknowledged by a well-informed staff team. EVIDENCE: Care plans are in place for needs such as behaviour, developing independence, inclusion in the running of the home, consent and managing personal finances (see also Standards 11-17 and 18-21). There are also plans available for service users who are not able to sign to indicate their involvement. The acting manager said that relatives and advocates are involved where service users are unable to express their views, and this is clearly documented. Each care plan is detailed and gives clear information to staff regarding support needs. The plans refer to privacy, dignity and the opportunities to make choices. There is evidence that the plans are regularly reviewed and they cross reference with risk assessments, which cover issues such as the use of the kitchen and behaviours. Wycar Leys The House DS0000008766.V321445.R01.S.doc Version 5.2 Page 10 There is general information in personal files relating to needs such as autism; and pre inspection information shows that there are policies available for privacy, dignity, choice, rights and risk assessing. Staff said that the wider service is currently developing a framework for person centred planning approaches, which helps to plan future goals and aspirations with service users. Throughout the visit staff demonstrated a very clear understanding and awareness of service user needs, and they were able to describe in detail how individual service users express things such as mood, pain, likes and dislikes. It was observed that the service users body language, actions and behaviours dictated the way in which their support is provided, and staff responded in a timely and appropriate manner; for example when a service user led them to a kitchen cupboard containing the kettle, they made a drink for them, or responding to indications that a service user wished to be left alone. Wycar Leys The House DS0000008766.V321445.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users enjoy access to a wide range of community and home based activities; and they benefit from a healthy and balanced diet. EVIDENCE: Care plans are in place for family contact, community presence and travel. Individual plans are also in place, which show involvement in activities such as swimming, horse riding, social outings to local pubs, parks and cinemas, and general shopping trips. Service users were observed to be using their house and garden areas for whatever activity they chose, such as riding their bicycles, using swings, using a trampoline and reading with staff. They have access to their own activity room within the garden, which has a ball pool and a wide selection of art materials. The room and its equipment are kept ready to use at any time so that service users don’t have to wait for things to be set up. Service users also have access to an on site activity centre, which has a snooker table, music area, pottery area and computer room. There is also a Wycar Leys The House DS0000008766.V321445.R01.S.doc Version 5.2 Page 12 go-kart track on site, with a dual assisted go-kart that service users are able to use. There is evidence that activities are risk assessed, and staff demonstrated a clear knowledge of each service users safety needs. They were also observed to be supporting service users to respect the privacy needs of the people they live with. Menus are provided on a four weekly rotation and main meals are cooked in the central kitchen. There are alternatives available for each meal and the menus are balanced and varied. There is also a kitchen in the house, in which service users can cook what they want and get drinks when they want, with support. Fresh fruit was available as well as other snacks, and pre inspection information shows that there are policies available for food safety and nutrition. Wycar Leys The House DS0000008766.V321445.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from robust personal and health care arrangements, and comprehensive record keeping practices ensure that care and support is timely and appropriate. EVIDENCE: Care plans are in place for needs such as general health and well-being and oral hygiene. There are also clear risk assessments in place for individual health needs such as epilepsy. Records are kept of visits to the GP, dentist, chiropodist and any other health professional supporting the service user. The previous inspection report shows that end of life arrangements are discussed with relatives and recorded. There is also a personal health needs profile sheet available in the event of a service user needing to attend hospital in an emergency, which is regularly reviewed. There is evidence that health action plans are currently being completed for each service user. Staff said that service users have access to a Consultant Psychiatrist who’s services are purchased by the provider; and the provider also purchases the services of a speech and language therapist, who will train Wycar Leys The House DS0000008766.V321445.R01.S.doc Version 5.2 Page 14 staff in communication methods as well as working directly with service users. Staff demonstrated a very good understanding of needs such as autism through discussions and their general practice. There is a policy available for medication usage within the home. Since the last inspection visit, as a result of practice issues, the policy has been reviewed to include prescription information being re written by two service managers for safer practice. Administration records are fully completed and storage is secure and appropriate. Administration procedures are displayed on the front of the medicine cabinet, and procedures were followed during the visit. Pre inspection information shows that there are policies available for areas such as continence, pressure relief, first aid and moving and handling; and notifications to the commission show timely and appropriate responses to accidents and injuries. Wycar Leys The House DS0000008766.V321445.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are protected by robust policies and procedures, well-trained staff and detailed record keeping practices. EVIDENCE: Pre inspection information shows that there are policies available for safeguarding adults, concerns and complaints and whistle blowing. There are no complaints recorded since the last inspection visit, and staff said that the complaints procedure is currently being translated into picture format. Complaints records and general house concerns records are now separated so that information is more easily tracked. One safeguarding adults referral has been made since the last inspection visit, however it was unsubstantiated following investigation. The acting manager very clearly described the reporting and investigation process that was undertaken, and the staff support and monitoring processes that were put in place as a result. Other staff also demonstrated a good understanding of safeguarding adult issues. Information is available to staff about non-confrontational support approaches, and they are trained to use physical intervention methods. The acting manager said that physical intervention is used only as a last resort to safeguard service users and staff; and records show that there are very few instances of this occurring since the last inspection. The records for the use of physical Wycar Leys The House DS0000008766.V321445.R01.S.doc Version 5.2 Page 16 intervention are every detailed, and there is evidence that they are monitored closely by the acting manager as part of the quality assurance process. Wycar Leys The House DS0000008766.V321445.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from an environment that is well maintained and meets their safety needs; and they enjoy comfortable personal space. EVIDENCE: During the visit the house was found to be very clean and hygienic, and all substances that could be hazardous to health were stored appropriately. Risk assessments and data sheets were available for those substances. Gloves and aprons were available for staff to use, and good hand washing procedures were seen. Communal areas are furnished in line with service users needs and there are special fixtures and fittings to prevent harm to the service users and damage to the environment. Minutes of staff meetings show that staff are trying to introduce new furniture and make the house more homely at a pace that suits the needs of the service users and that is acceptable to them. The home is Wycar Leys The House DS0000008766.V321445.R01.S.doc Version 5.2 Page 18 generally well decorated and maintained; and the regional manager arranged for a new window covering to be fitted in the ‘quiet room’ during the visit. Service users bedrooms are more personalised with TV’s, hi-fis, personal art and photographs; whilst retaining specialist fixtures and fittings for safety needs. There is evidence in records that service users have taken part in choosing the décor for their own rooms. Window coverings at a window in one bedroom were discussed and the regional manager made immediate arrangements to improve the privacy screening. Wycar Leys The House DS0000008766.V321445.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are protected by a comprehensively trained, well-supported and safely recruited staff team. EVIDENCE: Recruitment records are well organised and confidentially stored. They contain application forms, identification, criminal records bureau checks and references. Staff sign to say that they have received a staff handbook with regularly updated policies and procedures. Records of interviews are kept on file and the acting manager said that service users are involved in the interview process, as their reactions to people are an important factor in decision-making. Staff said that they receive regular supervision and records confirmed this. The records show that sessions take place on a monthly basis and in between times if requested or needed. There is also evidence of annual appraisals. Training records show that staff undertake an induction process that includes 8 to 10 days of following an allocated and experienced member of staff in their Wycar Leys The House DS0000008766.V321445.R01.S.doc Version 5.2 Page 20 work. An induction pack is completed over the course of three months and is based on nationally recognised training frameworks that cover general and specialist care skills. The acting manager said that training in physical intervention and behaviour management is undertaken as a priority for newly appointed staff and records confirm this. Records show that staff receive training in areas such as report writing, fire safety, food hygiene, moving and handling, infection control and first aid. They also have access to courses that enable them to gain nationally recognised care qualifications; and they undergo medication administration assessments, which are recorded in their files. Minutes of staff meetings show that there are regular updates and discussions about, for example, appropriate interactions with service users, record keeping, health and hygiene and safeguarding adult procedures. Pre inspection information shows that there are policies available for recruitment and supervision; and rotas show that there are enough staff on each shift to meet individual needs. Wycar Leys The House DS0000008766.V321445.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41, 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from a robust quality assurance system; and their health, safety and welfare needs are protected by excellent record keeping practices and a strong management team. EVIDENCE: There is currently an acting manager in place at the home who has extensive experience in the care and support of people who have a learning disability. She is awaiting the outcome of a recent registration interview with the commission. Both she and the regional manager have clear and detailed knowledge of the service users needs, including their individual ways of communicating, and their likes and dislikes. Staff said that there is very good support from the management team, including the service provider. Wycar Leys The House DS0000008766.V321445.R01.S.doc Version 5.2 Page 22 Pre inspection information shows that policies are available for areas such as quality assurance, fire safety, health and safety, physical intervention, record keeping, emergencies and crises and management of service users money. The information also shows that the policies have recently been reviewed. Quality assurance processes include an annual satisfaction survey. In response to a recommendation made at the last inspection visit the survey has been expanded to include visiting professionals. Outcomes of a recent survey show that people are generally very pleased with the standards of care and support that service users receive. There are daily, weekly and monthly checklists of audits for the acting manager to carry out such as personal allowances, environment, accident forms, complaints and fire warden checks. The acting manger also carries out a regular audit of service user expectations such as decision-making, relationships, leisure and participation to ensure that those service users who are not able to express themselves clearly are still able to engage fully in all aspects of daily life. There are clear and detailed daily notes that show what activities the service user has been involved in, how their health is and how their care plans have been implemented. Regular testing of electrical equipment is recorded as well as water temperatures. Fire safety records contain an up to date risk assessment, which is annually reviewed. There are also up to date records for monthly testing of fire equipment, emergency lights and fire exits; and evacuation records and weekly alarm checks. All records are kept in an orderly, detailed and consistent manner; and all of the regular record audits are clearly shown. Wycar Leys The House DS0000008766.V321445.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 3 3 X 4 X 5 3 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 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 3 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 4 X 4 X 4 4 X Wycar Leys The House DS0000008766.V321445.R01.S.doc Version 5.2 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Wycar Leys The House DS0000008766.V321445.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Wycar Leys The House DS0000008766.V321445.R01.S.doc Version 5.2 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!