Care Home: Lancastria

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What the care home does well This home provides a good level of care in a clean bright homely setting. One person said: `I like living here because they are nice and we go on holiday.` People have their needs well assessed and the written plans of care are carefully considered to offer the most appropriate level of support. Staff know the people who live at the home well, and they understand how each person communicates their wishes. People are kept safe by good assessments of what may be a risk and daily activities are planned with this in mind. People can become involved in a wide range of activities and also choose day trips and longer holidays. People can choose what they prefer to eat and menus show a range of healthy options. One person said: `I like doing baking and helping with the dinner.` The home handles medication well. Staff receive good training and are well recruited to deliver the care needed, they are enthusiastic about their work. A health care professional said: `The staff are always cheerful and the home always seems happy. They work well with us.` What has improved since the last inspection? What the care home could do better: The manager could gain an NVQ level 4 in care and management to improve her capacity to manage the home. The dining area could be improved to give more space to people when they are eating together. The sofas in the lounge could be replaced to make the lounge more comfortable to relax in. CARE HOME ADULTS 18-65 Lancastria 138 Elwick Road Hartlepool TS26 9PF Lead Inspector Karen Ritson Key Unannounced Inspection 9th September 2008 09:30 Lancastria DS0000021751.V371828.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 Lancastria DS0000021751.V371828.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. Lancastria DS0000021751.V371828.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lancastria Address 138 Elwick Road Hartlepool TS26 9PF 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) 01429 235207 F/P 01429 235207 Voyage.com Milbury Care Services Ltd Lisa Elizabeth Bailey Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Lancastria DS0000021751.V371828.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: 2. Learning Disability - Code LD, maximum number of places: 6 The maximum number of service users who can be accommodated is: 6 19th September 2006 Date of last inspection Brief Description of the Service: Lancastria is a detached house located in a residential area of Hartlepool within easy walking distance of a variety of community facilities. There is a large garden at the rear of the property providing a private recreational area for service users, and a car parking area to the front of the house. The home is registered to provide care and accommodation for up to six persons with a learning disability. The cost of living at the home is currently around £1100 per week and does not include the cost of chiropody, hairdressing and toiletries. Lancastria DS0000021751.V371828.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The inspection for this service took 14 hours. This includes time spent gathering information and examining documentation before and after an unannounced site visit and in writing the report. The site visit took place on 09/09/08 between 09:30 and 13:30. Information for this inspection was gathered from the following: • • • • • • • • • A tour of the premises Observations of care throughout the day of the site visit. Speaking with staff on duty at the home. Speaking with people living at the home. Case tracking people on the day of the site visit. Notifications sent to the commission from the home since the last inspection. Examining policies, procedures and records kept at the home. Examining information regarding the home on the file kept by CSCI. Considering comments made by relatives, health care and social services staff. All key standards were looked at during this inspection. The manager was not on duty, however a senior carer was available throughout the morning and was present for feedback following the inspection. What the service does well: This home provides a good level of care in a clean bright homely setting. One person said: ‘I like living here because they are nice and we go on holiday.’ People have their needs well assessed and the written plans of care are carefully considered to offer the most appropriate level of support. Staff know the people who live at the home well, and they understand how each person communicates their wishes. People are kept safe by good assessments of what may be a risk and daily activities are planned with this in mind. People can Lancastria DS0000021751.V371828.R01.S.doc Version 5.2 Page 6 become involved in a wide range of activities and also choose day trips and longer holidays. People can choose what they prefer to eat and menus show a range of healthy options. One person said: ‘I like doing baking and helping with the dinner.’ The home handles medication well. Staff receive good training and are well recruited to deliver the care needed, they are enthusiastic about their work. A health care professional said: ‘The staff are always cheerful and the home always seems happy. They work well with us.’ What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Lancastria DS0000021751.V371828.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 Lancastria DS0000021751.V371828.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): 2 Quality in this outcome area is good. People’s needs are properly assessed prior to admission to the home, which ensures their care needs may be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People have their needs assessed before they come to live at Lancastria. The manager and staff liaise with professionals and families to find out about peoples needs. They also spend time with people before they came to the home, to find out more about them. The assessment places the person in the centre of care planning. This gives an overview of each person, their needs, important links, health care needs, likes, dislikes, interests and hobbies. There was evidence that people had been consulted over their care in the assessment documents. All health care professionals involved are listed with contact details. Each person has a medical profile, with a list of all up to date medication with administration details kept on file. One member of staff said: Lancastria DS0000021751.V371828.R01.S.doc Version 5.2 Page 9 ‘The home would never offer a place to someone if it was felt they couldn’t be cared for properly here or if they didn’t fit in with the needs of others here.’ This information ensures that people’s needs are understood so that appropriate care can be offered. Lancastria DS0000021751.V371828.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7, and 9 Quality in this outcome area is good. Care plans are written in sufficient detail to reflect the care and support required to meet needs. People are supported in making decisions about how they choose to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Written plans of care are drawn up which involve representatives whenever possible, the plans include details about how staff can communicate with individuals effectively and describes ways in which people can be encouraged to be involved in decisions about how care is offered. Plans also show that health and social care professionals are consulted over best practice. All GP and other hospital appointments are logged separately which makes it easier Lancastria DS0000021751.V371828.R01.S.doc Version 5.2 Page 11 to track health care issues. Goals are included in plans and notes show how people work towards these. Each person has a written preferred daily routine and how this is to be achieved. Risk assessments are in the process of being updated and now provide more detail in all relevant areas of care, for example; moving and handling, meal preparation, outside the home, kitchen safety, behaviour, using the vehicle, activities and holiday accommodation. This ensures that individuals are enabled to carry out activities of their choice whilst being kept as safe as possible. One person said: ‘I can do things I want like go out and I’ve just been on holiday. It was good. We danced and we were very tired, but I liked it.’ Staff said they felt people in the home had the opportunity to make decisions about their care and how they live their lives, and that the ethos of the home was about maximising and improving these opportunities. One member of staff described how the service was responsive to changing needs: ‘The people living here vary in what they are able to do from day to day. It is our job to make sure they can become involved and have as much control as possible over what they do, based on how capable they are each day.’ Lancastria DS0000021751.V371828.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is good. People who use services are able to make choices about their life style, and are supported to develop their life skills. Social, educational, cultural and recreational activities meet individual’s expectations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person has a preferred weekly activities plan which is regularly reviewed and flexibly approached according to what each person wishes to do each day. Activities include art and crafts, cinema nights, bowling, painting, disco, walking through the park, listening to music, going out for meals to local cafes. One person attends a living skills class each week, two people had enjoyed Lancastria DS0000021751.V371828.R01.S.doc Version 5.2 Page 13 going to an indoor water park recently, others enjoyed going to the supermarket or for rides out in the homes’ own vehicle. Several people had been on holiday to Centre Parcs and had returned home the day before. Funding is available for one to one attention when necessary to allow people to enjoy their preferred activities without compromising the attention needed by the others at the home. People are enabled to keep in touch with family members, to visit others and to have visitors to the home. The home has a policy on visiting, friendships and intimate personal relationships in order to ensure people have the opportunity to live a fulfilling life. A meal time was observed and the food was of a good standard. Menus have been produced with preferences in mind and these are flexible so that people can change their minds if they choose. People are helped to get involved in preparing meals, in planning and shopping for meals. Those people who require regular weight checks receive this support and nutritional assessments are carries out for each person. One person said: ‘I like the food. I am going to cook biscuits this afternoon I’ve asked to do it and I can.’ An afternoon baking session was observed. People were clearly enjoying making biscuits and were being assisted according to their needs. Lancastria DS0000021751.V371828.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 People who use the service experience good quality outcomes in this area. People have their health care needs met in the way they prefer. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Staff said there were sufficient staff on duty at all times to provide flexible and responsive support to people living at the home. This was confirmed through looking at rotas. Preferences for how care is delivered, and how to ensure this happens are noted on care plans. People choose their own clothes, toiletries and personal effects where they have capacity. The home has a key worker system, which means that each carer has special responsibility for looking after the specific needs of named individuals at the home. One person said: ‘I know who my worker is, she goes out shopping for things with me and we get clothes and other things I need.’ Lancastria DS0000021751.V371828.R01.S.doc Version 5.2 Page 15 Additional specialist support is accessed when needed, for example, a physiotherapist has been involved in the care of one person, district nurses call, a dentist makes home visits also. Each person has a health care plan. Health is regularly monitored and people have access to outpatient appointments, and regular health checks. These are all documented. The home operates a monitored dosage system for medication. This system is very clear and easy to operate. A guide for each person’s medication, a photograph of the person and a description of any other medication accompany each administration sheet. This means that medication errors are minimised and the safety of people is protected. Those staff who administer drugs have all received training in the safe handling of medication. All medication is also detailed on care plans. This is a helpful cross-reference and further protects people from errors of administration. Lancastria DS0000021751.V371828.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use the service experience good quality outcomes in this area. People are enabled to voice their concerns and to have these acted upon and they are kept safe. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The people living at the home have access to a complaints procedure, which is made accessible in a picture format. The home holds regular meetings and people have the opportunity to raise issues here, also the operations manager visits the home regularly and consults with people about any concerns they may have. Details of what has been done to put things right are recorded. Staff said that people were encouraged to voice any complaints and that these were taken seriously by the management and acted upon wherever possible. Staff have had training in how to keep people safe, in how to manage challenging behaviours in a non-physical manner and in the awareness of abusive practice. The home also has up to date procedures and a policy on how to protect people from harm. Lancastria DS0000021751.V371828.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 and 30 People who use the service experience good quality outcomes in this area. The environment is suitable for the people who live at the home. It is clean, homely and safe. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The home is bright, clean and homely. The lounge is welcoming, with a laminate flooring. The home has budgeted for new sofas in this room, which would enhance comfort as the existing sofas are tired and a little shabby. Bedrooms are personalised, with items that reflect specific interests, eg farming photos, flat screen TV, sensory lights or soft toys. The doors of communal and toilet facilities were marked with pictures to assist people to recognise each room and increase independence. Some areas had new carpet Lancastria DS0000021751.V371828.R01.S.doc Version 5.2 Page 18 and blinds were on order for the utility room. The dining area is still rather small and there is little that can be done to improve this at present. Some improvements have been made since the last inspection. A broken toilet has been mended, the heating system has been repaired and various other improvements are being considered. The laundry is suitable for the needs of the people living at the home. Lancastria DS0000021751.V371828.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 People who use the service experience good quality outcomes in this area. Staff are well trained to offer good care. They are well recruited and suitable checks are in place to ensure people are kept safe. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The staff are well trained to offer the care needed for the people who live at Lancastria. They have an induction and foundation programme and have additional training in specific areas of care such as challenging behaviour, dementia awareness, mental health, autism, epilepsy, non physical intervention and learning disability which help them to offer the correct care. Most staff also hold NVQ in care at level 2 or 3. Staff use an EL-Box for in house training which is a computerised training resource. None of the staff spoken to like this system, and felt it was lacking in Lancastria DS0000021751.V371828.R01.S.doc Version 5.2 Page 20 human interaction. They said it is difficult to get answers to questions and prefer it when a person teaches them. Staff are well recruited according to policy and procedure, with references and CRB checks in place to protect the welfare of people in their care. Lancastria DS0000021751.V371828.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 and 42 People who use the service experience good quality outcomes in this area. The management and administration of the home is based on openness and respect. The home has a quality assurance system, which ensures the home continually reviews performance and the health and safety of people are protected. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The manager was not on duty the day of the inspection as she had just returned from holiday with several people living at the home, however, staff Lancastria DS0000021751.V371828.R01.S.doc Version 5.2 Page 22 said they were well supported in their role by the manager and that she was approachable. They all said they enjoyed working at the home. One member of staff said of the manager: ‘She helps you out, I can go to talk with her about anything.’ Another said: ‘I am really proud to work here, the support is fantastic from management and the people get very understanding care.’ Staff said they had regular supervision and house meetings where staff were encouraged to give a view. They could also speak with the manager whenever they needed to. Staff also said the manager was thoughtful with rotas and listened to requests, taking them into consideration wherever possible without placing a strain on the smooth running of the service. The manager has significant experience in a similar role and has been in post for over a year at Lancastria. The home has its own quality assurance system, which comprises a series of internal audits, visits from operational management, and surveys of people living at the home. The results of these, which the home calls an annual service review, are used to develop a quality assurance plan of action for the coming year. The home has a range of environmental risk assessments and a fire risk assessment to ensure people are protected from the risk of fire or an unsafe building. Also various health and safety documents were examined and were up to date and in order. Lancastria DS0000021751.V371828.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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X 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 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Lancastria DS0000021751.V371828.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. 1. 2. 3. Refer to Standard YA28 YA37 YA24 Good Practice Recommendations The provider should consider ways to provide an enlarged dining area. The manager should achieve qualifications at NVQ4 in care and management. The manager should ensure the sofa in the lounge is repaired or renewed. Lancastria DS0000021751.V371828.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Lancastria DS0000021751.V371828.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. 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