CARE HOME ADULTS 18-65
Wycar Leys ( The Lodge) Wycar Leys Ltd Kirklington Road Bilsthorpe Newark Nottinghamshire NG22 8TT Lead Inspector
Dee Shelvey Unannounced Inspection 7th February 2006 10:15 Wycar Leys ( The Lodge) DS0000055785.V278684.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Wycar Leys ( The Lodge) DS0000055785.V278684.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Wycar Leys ( The Lodge) DS0000055785.V278684.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Wycar Leys ( The Lodge) 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) Wycar Leys Ltd Kirklington Road Bilsthorpe Newark Nottinghamshire NG22 8TT 0870 3307522 0870 3307521 Wycar Leys Limited Tracy Tucker Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Wycar Leys ( The Lodge) DS0000055785.V278684.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 8 beds to be used for Learning Disability Date of last inspection 11th October 2005 Brief Description of the Service: The Lodge is one of four homes, for people with a learning disability, on a site a short distance away from the village of Bilsthorpe. It provides first floor accommodation for 8 service users. It has a large dining kitchen on the ground floor and two lounge areas on the first floor. The home runs independently to the others on site and has its own manager and staff team. The Lodge shares some facilities with the other homes; these include a central kitchen, laundry, transport and extensive grounds. All areas of the home are easily accessible to service users. Wycar Leys ( The Lodge) DS0000055785.V278684.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over two and three quarter hours. No requirements had been raised following the last inspection and the focus was on assessing standards not covered on that occasion. The methods used were reading documents and examining records, discussions with the manager and speaking with service users over lunch. What the service does well: What has improved since the last inspection?
No requirements or recommendations were raised following the last inspection but the home continues to review its practice and make adjustments when necessary. Since the last inspection the manager had compiled a training record for individual staff. This will assist in highlighting when refresher courses are required and also indicate any possible omissions from an individuals programme. Wycar Leys ( The Lodge) DS0000055785.V278684.R01.S.doc Version 5.1 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. Wycar Leys ( The Lodge) DS0000055785.V278684.R01.S.doc Version 5.1 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 Lodge) DS0000055785.V278684.R01.S.doc Version 5.1 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 the following standard(s): 1 and 3. Prospective service users will have sufficient information about the home and know that it will meet their needs. EVIDENCE: The statement of purpose and service user guide were reviewed regularly and contained all the information necessary to meet the standard. The documents are available in pictorial form. Prior to admission all service users undergo an assessment of needs and the home will not admit if they cannot meet the identified needs. Staff receive training in communication skills but where people have complex needs the methods of communicating only become clear with greater knowledge of the individual. The home has a very stable staff group resulting in them getting to know residents well and learning how to communicate with them. Wycar Leys ( The Lodge) DS0000055785.V278684.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8 and 10. Service users are consulted on all aspects of the home and can be sure that staff respect their confidences. EVIDENCE: The staff look for appropriate ways of involving the residents in all decision making. To do so staff have short informal meetings with residents often on a one to one basis. This gives them the opportunity to engage the service users attention and get a meaningful response. Service user opinions are gathered in the quality assurance exercises and they are also involved in the staff selection process. The home had an excellent policy on confidentiality and all staff were expected to be aware of the content. The home had a policy on the data protection act and all personal information was stored in a locked office. Wycar Leys ( The Lodge) DS0000055785.V278684.R01.S.doc Version 5.1 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,15,16 and 17. Service users have a good quality of life with the opportunity to develop skills and maintain contact with families. Their rights are respected and they receive a healthy diet. EVIDENCE: Service users are encouraged to develop daily living skills and to improve their communication method. Occasionally a member of staff will work one to one with a resident to cook a meal. In addition the staff spend time with individuals who need to express their emotions and offer support. All service users had contact with their families and some go on unsupervised extended stays at the family home. Two service users attend the local college and all of them access local amenities. Those who wish to attend a place of worship generally do so with their family but, the local vicar has a good relationship with the home, and if a resident wished to go to church it would be arranged. The service users at the Lodge need a structured routine to maintain their feeling of security and their assessments indicate that they can only cope with
Wycar Leys ( The Lodge) DS0000055785.V278684.R01.S.doc Version 5.1 Page 11 a limited number of choices at one time. Having said this however the home offers flexibility unless the service user insists on a routine as part of their disability. During the lunch hour service users assisted staff with the simple chores of laying the table, making drinks and serving the meal. The lunch consisted of jacket potatoes with a selection of fillings. Where necessary service users went to look at the food to enable them to make a choice. The staff ate with the service users and it was a pleasant relaxed social occasion. One service user is provided with a vegetarian menu to suit her cultural and religious needs. Wycar Leys ( The Lodge) DS0000055785.V278684.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 and 21. Service users are protected by the homes policies and procedures for handling medication. Individuals are treated with respect and wherever possible the home ascertains how they wish to be treated during aging and illness. EVIDENCE: The assessments of service users capabilities show that currently no one is able to manage their own medication. There were satisfactory policies and procedures in place to ensure that the handling of medication was safe. The senior staff responsible for administering medication have completed a twelve week certificated course on the safe handling of medication at the West Nottingham College of Further Education. Staff were observed administering the lunchtime medicines and they followed the procedures correctly. The staff had attempted to determine the service users wishes on the subject of aging and death but this had been very difficult since service users had limited communication skills. The manager had spoken to families on the subject and assured them that residents would remain at the Lodge for as long as their needs could be met. Aids and equipment would be obtained if necessary and if appropriate a transfer to another home within the site could be arranged.
Wycar Leys ( The Lodge) DS0000055785.V278684.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 Service users are listened to and their views would be acted upon. EVIDENCE: The home had a satisfactory complaints procedure including timescales for investigations and the methods of contacting other agencies if not satisfied with the outcome offered by the home. No complaints had been received since the last inspection. Wycar Leys ( The Lodge) DS0000055785.V278684.R01.S.doc Version 5.1 Page 14 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 26,27,28 and 29. The service users live in a safe homely environment with sufficient facilities to meet their needs. EVIDENCE:
All the bedrooms had been fitted with “tough” furniture that had a domestic style but was strong enough to withstand rough handling. The layout of the rooms were determined by the service users who had also individualised their rooms. The staff looked for solutions to individual problems and had “frosted” the glass in the window of a room where the resident removed all other covering thus maintaining his privacy and protecting his dignity. The home had sufficient bathing and toilet facilities and taps had been fitted with temperature control valves to ensure that water was delivered at a safe temperature. In addition there was ample communal space with a large kitchen/diner on the ground floor and two lounges on the upper floor. There is a large activities room on site that is shared equally between the homes and this is an area where residents can all socialise. There is an enclosed garden safe for all residents. It ensures their safety from motor vehicles entering the site and those people who might wander away are able to use it without supervision. None of the current service users require any aids or adaptations but they would be provided if necessary.
Wycar Leys ( The Lodge) DS0000055785.V278684.R01.S.doc Version 5.1 Page 15 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 35. Service users are supported by competent staff who receive induction and follow up training. EVIDENCE:
Two staff personnel files were examined and these contained evidence of induction and core skills training e.g. food hygiene, fire safety awareness and first aid. The members of staff had also completed courses on communication skills, very important to meeting the needs of the residents. The staff observed with residents during the inspection used a variety of methods to communicate and as the residents obtained what they wanted or responded to requests it appeared very successful. The home is concentrating on putting staff through the NVQ system and of the 18 currently employed 4 have an NVQ level 2 or above, 7 are working to obtain the award and 3 are about to register. The staff training records were a little confusing as they were not in chronological order and this could give rise to confusion, especially about when refresher courses were needed. The staff training needs are now being audited via the supervision sessions but individual programmes should then be devised for the year. Staff training is currently centred on NVQs but the national minimum standard states that when working in learning disability services homes should use Learning Disability Award Framework- accredited courses to provide underpinning knowledge for progress towards achieving R/NVQs. Although staff training needs are being audited through supervision session this is not resulting in the drawing up of a yearly training programme
Wycar Leys ( The Lodge) DS0000055785.V278684.R01.S.doc Version 5.1 Page 16 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): 39 and 43. Service users can be sure that the home is managed in a competent manner with their views under pinning the service. EVIDENCE: The home manager does a monthly audit of all the homes practice and systems which is used by her managers in the supervision of the home. The opinions of service users and /or their families are surveyed annually; the service users form being in a pictorial format for ease of understanding. The results of the last survey showed that several people were unaware of the complaints procedure. A copy was immediately distributed. The Lodge is one of a small group of homes on the Wycar Leys site. It is well run by a qualified and self-motivated manager who has the support of both other homes managers and upper management when necessary. The lodge has a budget for residents’ activities all other budgets are managed centrally. There are no vacancies at the home and this would suggest financial security. All relevant insurances are in place for the protection of staff, residents and visitors to the site.
Wycar Leys ( The Lodge) DS0000055785.V278684.R01.S.doc Version 5.1 Page 17 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 X 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 3 27 3 28 3 29 3 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X 3 X 3 LIFESTYLES Standard No Score 11 3 12 X 13 X 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 3 X X 3 X X X 3 Wycar Leys ( The Lodge) DS0000055785.V278684.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA35 YA35 Good Practice Recommendations Staff training records in chronological order would be less confusing and highlight the need for refresher courses. That staff should use Learning Disability Framework accredited courses. Wycar Leys ( The Lodge) DS0000055785.V278684.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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