Care Home: Lanthorne Court

What the care home does well Lanthorne Court has a person centred approach to supporting the people living there. Each person has a communication passport and an individual portfolio as well as other folders with daily updated records. These contain all the information needed to support the person in the way they prefer and how to communicate with them. People are actively supported to make choices and decisions that affect their lives. The people living in the home are assessed regularly to make sure the service is meeting their needs. People are supported to have an active lifestyle. They are encouraged and supported to do as much as possible for themselves. The home meets the physical and healthcare needs of the people who live there. There is input from specialists and local GPs. There is a good range of training including person centred planning and mental capacity act awareness. People are protected well by the homes policies and staff training in safeguarding. What has improved since the last inspection? This is a new service. Since Turning Point have registered Lanthorne Court there have been various improvements to the environment. These have included decorating and repairs and installing two wash basins in people`s bedrooms. What the care home could do better: The manager has identified which areas of the service they want to improve and has a development plan for this. This includes further developing the communication support for people. There are plans to consider electronic communication aids and also some of the staff are going to attend intensive interaction training, which is training in a specialist communication approach. Key inspection report Care homes for adults (18-65 years) Name: Address: Lanthorne Court Lanthorne Court Lanthorne Road Broadstairs Kent CT103PB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Julie Sumner     Date: 1 4 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Lanthorne Court Lanthorne Court Lanthorne Road Broadstairs Kent CT103PB 01843864788 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.turning-point.co.uk Turning Point Name of registered manager (if applicable) Mrs Lorraine Elson Type of registration: Number of places registered: care home 19 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 19. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) Date of last inspection Brief description of the care home Lanthorne Court is a purpose built campus accommodation opened in 1988. This was established as a service for people with learning and physical disabilities and was previously under the management of Eastern and Coastal Kent Primary Care Trust. It is now under the management of Turning Point. Lanthorne Court consists of three bungalows. Bungalows 2, 3 and 4 are connected via Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 19 Brief description of the care home a communal entrance and activities and office area. Bungalow 1 has closed. Accommodation is provided for 15 people with learning and physical disabilities. Each person is supported by one or two staff at a time. Each person has their own bedroom that has been decorated to their own taste. Within each bungalow there are assisted bathrooms and shower rooms, disabled accessible toilet facilities, communal lounge and kitchen. Within the complex, there is a laundry, store rooms and a large activity and sensory room. There is a large garden at the back of the building with paved areas, seating areas and raised beds. The staff have started a sensory garden. Transport is provided to enable the people living in the home to access community facilities. There is parking at the front of the building and bus stops nearby. Lanthorne Court is located in Broadstairs, a small sea-side town in Thanet, Kent. It is within a short distance of numerous places of interest as well as local shops, colleges, leisure and entertainment facilities. The fees are agreed differently for each person depending on their assessment of needs. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The manager sent us an annual quality assurance assessment (AQAA) which tells us about the service provided, what improvements have been made and how they plan to develop it further. The AQAA was very clearly written and gave us all the information we needed. We visited the home without telling anyone we were coming so that we could get an idea of what the usual day is like for people living in the home. We were in the home from 10.30 in the morning to around 4:30 in the afternoon. We were introduced to all the people living in the home and the staff. We spent some time with manager. We walked round parts of the home and had a look around. We talked to all of the staff who were in the homes when we visited. We spent some of the time sitting with two of the people who live in Lanthorne Court, we also talked with three people in their bedrooms and said hello to all the other people living there. Care Homes for Adults (18-65 years) Page 6 of 28 We had a look around in the homes and outside. We looked at some of the policies and procedures. We looked at plans and records for supporting the people living in the home. We also looked at staff records like what checks have been made before they started work and training they have been given. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Time is taken to make sure people have the information they need in a way they can understand to help them make a decision about moving into each bungalow. Each persons needs are assessed so that the service can make sure they can meet them before someone moves in. Evidence: There is a statement of purpose and service user guide giving details and information about what the each home within the grounds has to offer. There is an easy read version of the statement of purpose with large print and pictures. The service user guide has large print, colour pictures and photos. It includes what the home looks like, what people can expect in the home, activities and photos of the staff. It is very clear and different versions can be provided to suit individual needs. The families and people who are important to each person are involved in choosing the home. People are all offered trial stays and visits so they can be sure the home can meet their needs. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: We looked at three assessments from the different bungalows. The service assess people through a person centred planning approach involving the person with the way they communicate. The families and people who are important to each person are also involved in their assessment. They give a clear outline of each persons needs and the persons plan of how to support them is based on these. The assessment focuses on current needs and includes health care, personal care, communication and socialisation needs. The company are developing the service that is going to be provided to the people currently living in Lanthorne Court. New accommodation is being organised and a service that is tailored to each individual is being planned for. The manager explained that there is a focus on assessing each person including developing their communication support to enable them to be involved in the assessment and determine the service that will be what they want and will meet their needs. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in Lanthorne Court are supported very well using a person centred approach. They are supported well with their communication needs and these are being further developed which will benefit them. Evidence: Each person has a detailed care and support plan in an individual folder which has been compiled in a person centred way. We looked at two plans in detail and two more generally. Nearly all the people who live in the home are unable to speak to tell the staff what they want. The staff interpret each persons needs from the information in the communication assessment and through their own knowledge of the person gained over the years. Staff use objects of reference, makaton and picture cards to assist if needed when talking to the people in the home. The staff talked to us about how each person has been involved in compiling their plan of care and support. The plan is written clearly for the staff to refer to in a main folder and in a smaller folder for day to day use. There is a lot of information in the folder but staff said they Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: do not need to go through the whole plan repeatedly. Many of the staff have worked with the people living in the home for several years and know them well. They said the folder is really useful for new staff and to refer to. The smaller folder has all the day to day records in and also includes the activities timetable and any relevant information needed. There are risk assessments covering all aspects of a persons care, support, activities and environment. They are in the main folder and then the information from the risk assessment is incorporated into the care plan guidance. We saw that these give staff clear guidelines for how to support people and minimise risk. Each person has their own communication passport which is a portable folder containing information about the way they communicate. This has photos and pictures with descriptions of what sounds, facial expressions and behaviour mean and what aids need to be used to assist a conversation. We looked at two of these and could see how helpful they are. We also used them when we were with the people living in the home. The manager explained that they have made a referral for assessment of electronic communication aids likes switches for some of the people who live in the home. Intensive interaction training is also being organised for some of the staff. The staff said they are working on developing the communication support to each person so that they will be able to be involved more effectively in making the decision of where they would like to live. The staff also explained to us how they support each person to make day to day choices like what to wear and what to eat. One person had recently been shopping and the staff demonstrated how the person who is partially sighted had chosen her clothes. We could see that the staff actively support each person so that they make these decisions. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have opportunities to take part in a range of activities at home and in the community. People are supported to keep in contact with their family and friends. Food is nutritious and balanced and people enjoy participating in cooking the meals. Evidence: We visited the different bungalows and saw people doing different things. Some people were out at clubs or shopping. People were listening to music, sitting in the lounge with gentle music and sensory lighting effects. Some people were participating in activities individually with a member of staff. We talked to the people in the home with the staff and looked at some of the folders and timetables that showed what activities are planned for each person. The staff said that they are focusing on varying the activities and increasing the activities outside in the local community. We could see that some people were planning to go out for Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: lunch, go shopping, go to the amusement arcades, go on a bus to Ramsgate and one person is going to the multi-sensory theatre. When the staff were telling us about some of the activities one of the people we were sitting with laughed when her favourite activity was mentioned. Families and people who are important to each person are involved in their support in the home. People go out with their families and they visit the home. We saw that there were details of who is important to each person including their families in their support plan. Staff told us stories of how they have successfully got in touch with estranged relatives and have reunited them to great benefit for all. One of the people living in the home showed us her digital photo album and was very proud of her family who she pointed out and are extremely important to her. Holidays are arranged for the people living in the home. We spoke to one of the people who had recently returned from holiday with her family and was supported by the carers from Lanthorne to do this. They said they had enjoyed it and they showed us their photo album. The staff have been able to make the daily routines flexible and have tailored the day around each persons wishes which have been gathered through person centred planning. Staff said some people like to go to bed early some people like to have a routine and others like to go to bed a bit later. How people like to be supported and whether they like going to bed and getting up early or late is written in their support plan. We looked at what was written in four of these and it described how staff were to approach the person and what they liked to do. Each description was different. The kitchens are quite small but there is enough room for one person to be in there when the staff are cooking the meal and they are able to participate in some way depending on what they like doing. We saw that a person was in the kitchen watching what was happening and having a pieces of food and fruit to feel and explore. Staff said that some people stir the food and they also make cakes. People are given the opportunity to get their hands in bowls of food and dough that are not part of the meal but give them the experience of it. Staff also explained that they are introducing individual menus. This is because the people living in the home have such different preferences and nutritional needs. Some people need to maintain or lose weight. Some people do not and have a sweet tooth. Some people need thickener in their drinks due to swallowing difficulties. All these differences are being managed well so introducing individual menus is a good development of this. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know that they will have the support they need to stay healthy. People have the support they need regarding their personal care. Medication practice is safe protecting the people who live in the home. Evidence: Staff have got to know each person very well and have found out how they like to be supported with their personal care. Routines have been established for them and guidelines have been written for the staff in the persons support plan folder so that everyone is doing the same thing. The manager said they are carrying out a matching exercise with the staff and people living in the home so that the individual will have more choice in the staff involved in their personal care. The people living in the home are supported to access the local health care facilities. The speech and language therapists, occupational therapists, dieticians, community learning disability nurses and physiotherapists have all been involved at different times when people have needed further support or assessment. We saw some of the guidelines and assessments in the individual folders we looked at. We also spoke to the staff about how they support individuals. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: A variety of specialist equipment is provided to support each person. These include specialist beds, hoists and chairs. Each person has a health action plan which is included in their personal portfolio. We looked at two of these. They gave details of recent appointments and recommendations from health care specialists. Where people have specific medical needs there are written guidelines for how to support this. We looked at some of the detailed support and records for supporting epilepsy. The staff describe how the condition affects an individual and describe seizures when they occur. We saw that when there has been a change in a persons health needs that specialists have been involved. Staff have been given training if this is different to current health support needs in the home. We looked at the training records and could see that the staff have had training to meet the health needs of the people who live in the home. The people we saw in the home looked clean and healthy. People were wearing clothes that are appropriate for their age and they looked comfortable. We looked at the medication storage and administration in no. 2 Lanthorne Court. Medication is dispensed using the Boots monitored dosage system or individual containers which are clearly marked. Each person has their own medication folder. In this there is a description of what medication they are prescribed and what it is for. Then there are instructions of how they take it. One of the people living in no. 2 takes her own medication. There are 2 other people in other bungalows who also take their own. The descriptions of what support they need to do this is in their medication folder. Each persons medication administration record sheet is also kept in their own folder. There are descriptions and protocols for medication prescribed as required. The registered manager audits the administration of the medication at random times to make sure there are no errors. We found the medication procedures to be safe and tailored to each person. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home are supported to voice their concerns and there are good procedures and training to safeguard them. Evidence: The company has produced a complaints procedure with straight forward instructions and pictures. The manager said that the key workers hold one-to-one meetings with the people living in the home to give them an opportunity to express their views. We saw that the people living in the home were listened to and staff were responsive to them. The people living in the home are also each supported by an independent advocate. When a decision needs to be made about medical treatment or major lifestyle changes like moving home the manager and staff hold a best interests meeting. Turning Point have a Customer Feedback policy which is available to all the people living in the home, their families and the staff. Complaints and feedback leaflets are available to the individual and their families and are also displayed on the notice boards. There have been two complaints about the service provided and both have been resolved. We saw 3 compliments in the folder for no. 3 Lanthorne Court. In addition to this, one relative had e-mailed some concerns that he wanted to be considered regarding the proposed new services. He also complimented the staff about the care, Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: love and attention his sister receives at Lanthorne Court. The staff receive training in safeguarding awareness and Protection of Vulnerable Adults (POVA) as part of their induction training. This continues in team meetings and individual staff one-to-one meetings with the manager. We saw that safeguarding was one of the areas discussed in the most recent team meeting at no. 3 Lanthorne Court. Enhanced Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks are carried out prior to employment. There is a procedure for safeguarding adults which shows a clear line of action to be taken by staff. There have been four safeguarding alerts since the service was registered. All of these have been investigated by the safeguarding team and all have been responded to appropriately by the manager and company. We looked at how people are supported with their money and found that the procedures are good and that people are supported to be as independent as possible. Each person has their own finance file with details of what support they need. It also includes a list of what belongs to them. We saw that people are supported to choose what they want to buy and where they want to go. Staff said they are involved as much as possible in paying for shopping or events. Receipts are kept and attached to the record of how each persons money has been spent. Each person has a money tin and a record of what has gone in and been paid out. All the records are checked and signed by two staff and the money is checked at least three times a day. The manager also audits the money and records periodically. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment is warm, clean and safe and staff have put time and effort in to making it as homely as they can. Evidence: Lanthorne Court was purpose built some years ago. There are some features like a communal laundry, connecting corridors and doors and kitchens and bedrooms that are small and do not have adequate washing and toileting facilities. The environment does not meet all the registration requirements but it is safe. The company have decided that it would be better for the people living here to move out of Lanthorne Court to more suitable accommodation. In the meantime they have made some changes and made it as homely as possible. We had a look around the communal areas of all three bungalows and some of the bedrooms. There is a variety of furniture, some of which is specialised to suit individuals. There is good light. The bathrooms are spacious. Parts of the homes have been decorated and necessary repairs have been made. Some of the larger bedrooms have had wash basins fitted but there is not enough space to fit them into most of the bedrooms. Bedrooms have been decorated to suit each person. We saw that the staff have taken the time to find out what each person likes and equipped their bedroom with furniture and equipment for this. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: Cleaners and maintenance staff are employed. Some of the staff have had infection control training and the manager is organising further training so that all staff are up to date. Staff are provided with equipment and protective clothing. There are adequate washing facilities and supplies of cleansing gel for the staff to use to maintain good infection control. Sanctuary housing are responsible for all the home building maintenance. The staff call them if there is a problem. There are spacious and well kept grounds with raised flower beds and paving. There are seating areas and some of the staff have started a sensory garden. They have also grown some vegetables and we saw a pumpkin growing outside one of the peoples bedroom window. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has plentiful staff available at all times to support the needs, activities and aspirations of the people using the service in an individualised and person centred way. Evidence: The manager and staff explained that each person is preparing to move to a new service that the company will provide. At present they are developing core teams of staff for each person so that they will have their own staff team. Staff are being matched to the people living in the home with regard to skills and interests. We looked at some of the plans for this. Each person will have their own individual rota so they know who is supporting them when staff explain and there are staff photos on the notice board. We looked at one persons new rota plan. The manager also said that the people living in the home who are male will have the option of male carers. Turning Point has a thorough recruitment process to make sure the people applying for the job at Lanthorne Court are who they say they are and will work in the right manner. The manager asks for identification like a passport and 2 references from people who know the person including their previous employer. They request a Criminal records bureau (CRB) check and protection of vulnerable adults list (POVA) check to make sure they have not done anything in the past that will indicate that Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: they are unsuitable or cannot be trusted. Staff work for a trial period of time in the home while everyone gets to know each other and the member of staff decides whether this is the right job for them. We looked at three staff files and saw that all these checks had been carried out. The manager said in the AQAA that they would like to improve by including the people living in the home in the recruitment process at interview, not just with showing prospective employees around their homes. New staff have induction training prior to working in the home so that they know what is expected of them. This is tailored to the needs of the service and is designed with reference to National Vocational Qualification (NVQ) training. We saw some of the induction training in the files and spoke to the manager about this. All the staff have attended essential training for health and safety law. Training is provided to the staff to meet the individual personal and health needs of the people using the service. We spoke to the registered manager and staff and looked at some of the training records. There are some gaps that the manager is aware of and plans to address. We saw that training is provided regularly and staff have the opportunity to study specialist courses. Staff have also attended training in person centred planning and awareness of the mental capacity act. Deprivation of liberty safeguards and intensive interaction training (to support people with communication difficulties, recommended by the speech and language therapist) is planned. Staff are supported to undertake a national vocational qualification (NVQ) to level 3 and Service Managers are expected to hold the Registered Managers Award. There is a programme of NVQ training. Twenty care staff have completed their NVQ 2 or 3, which is about three quarters of the overall team. Some of the senior staff have NVQ to level 4. The company also have a competency framework that staff have to work to. Each member of staff has an individual meeting with the manager to talk about their work and how they would like to develop. Team meetings are held monthly and as part of these they also do refresher discussions to check the overall competency of the staff. A newsletter is produced for the staff by the company. A few copies are sent to each service. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered manager is able to describe a clear vision of the service and has a clear sense of direction. They have good people skills and understand the importance of person centred care and effective outcomes for the people who use the service. Evidence: The registered manager has many years experience working with people with learning disabilities. Some of this experience was gained from working in Lanthorne some years ago although she has been away from here working in other services, including residential and domiciliary and then come back. She has trained as a nurse for people with learning disabilities (RNLD), has a BSc Hons in social science and A1 assessors award and has achieved an NVQ level 4 in management. We looked at the quality monitoring systems and talked to the manager about them. The manager explained how the system works. Different areas of the running of the home are looked at each month so that at the end of the yearly cycle all areas have been covered. A report is then written to say what the home is doing well and what might need to improve. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: We looked at the folder. Part of the process is to gain feedback from people who use the service and people who are in contact. The manager plans to send questionnaires out to people. The people living in the home are supported to express their views through the one to one meetings with their key worker and also from the managers observations. There are clear records in the home that are easy to find in the office when needed. Records are kept for precautions regarding fire safety and for environmental health. The staff know where the policy file is to refer to when needed. There is a fire marshall on each bungalow who carry out the weekly fire safety equipment checks. The home has risk assessments for the building and working practices. The home and equipment is well maintained to make sure people are living in a safe environment. Staff receive necessary training for the health and safety of the people living in the home and working in the home. Where there are gaps in training the manager has a planned programme to address them. Policies and procedures are regularly updated and are available to all on the Turning Point intranet. They recently had a full emergency evacuation trial and the manager said that it was very successful and was impressed with the speed that the whole of Lanthorne Court was evacuated. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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