Care Home: Lavender Fields (1)

What the care home does well People living at Lavender Fields told us they were very happy living at the home and were clear that it is not a permanent place and they would be supported to find alternative accommodation when the time is right for them. The staff arrange for the residents to attend day services which include college courses and work placements. The organisation carry out a annual survey to look at any improvements that can be made to improve and create as independent a life as possible for the residents. The staff create a homely environment where the people who live there have a say in how it is run and choose furniture and colour schemes. The staff are committed and a full and varied training programme is available to ensure that staff have the correct skills to meet the residents needs. What has improved since the last inspection? Over the last year the staff have supported three young people to move out into the community into their own accommodation. An additional adapted vehicle has been purchased to allow further visits into the community more regularly. The staff levels have been increased in the evening which has allowed more residents to access evening activities of their choice while still supporting those who wish to remain at home. What the care home could do better: Information contained in the care plans should be more person centred and ensure details are included of what each person is able to do for them selves and what support the staff need to give to ensure that all the health and personal care needs are met. Key inspection report Care homes for adults (18-65 years) Name: Address: Lavender Fields (1) 1 Lavender Fields Lucas Lane Hitchin Hertfordshire SG5 2JB     The quality rating for this care home is:   three star excellent 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: Alison Butler     Date: 1 2 0 4 2 0 1 0 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 25 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: Lavender Fields (1) 1 Lavender Fields Lucas Lane Hitchin Hertfordshire SG5 2JB 01462454508 01462440186 liz.turton@lc-uk.org www.lcdisability.org Leonard Cheshire Disability Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Juliette Alison Harman Type of registration: Number of places registered: care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability terminally ill Additional conditions: The home may only accommodate service users between the ages of 16 and 24. Date of last inspection Brief description of the care home 1 Lavender Fields is a purpose built care home with nursing, registered to provide care and accommodation for up to 10 young physically disabled people between the ages of 16 and 24 years. It is owned and operated by the Leonard Cheshire organisation. The young persons unit is part of a social care complex that sits in its own landscaped grounds close to the town centre of Hitchin, with its shops, transport and social amenities. The home is built on one level and has two wings with large bedrooms, each with full en-suite facilities and access to a patio area overlooking the grounds. There is a communal lounge, kitchen and dining room and a large study/activity room that Care Homes for Adults (18-65 years) Page 4 of 25 10 10 Over 65 0 0 Brief description of the care home includes an information technology suite. 1 Lavender Fields is intended to provide a transitional service supporting, encouraging and equipping young people to gain the life skills and confidence they need to enable them, where appropriate, to move on to more independent living settings. For information on the fees for the home contact should be made with the manager. Information about the home and the service it offers is contained in the Statement of Purpose and the Service User Guide. A copy of these and the most recent inspection report are available in the home. Care Homes for Adults (18-65 years) Page 5 of 25 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: three star excellent 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 last key inspection of this service took place on 17 May 2007, we have also conducted yearly Annual Service Reviews (ASR). An ASR is a report that we write for good or excellent services that have not had a key inspection in the last year. It does not routinely include a visit to the service. When completing an ASR we use the information received and make a judgement on the outcomes for the service. The ASR shows how we assure ourselves and the public that the quality of the service has not changed since the last key inspection. This unannounced inspection was carried out by one inspector representing the Care Quality Commission. However for the purpose of this report this will be shown as we. The inspection started early morning and provided us with the opportunity to observe staff interacting with residents and the daily routines. We conducted a tour of the home, examined personnel and care records. Comments we have received either through responses to our surveys we sent out prior to the inspection, or during the Care Homes for Adults (18-65 years) Page 6 of 25 inspection have been included throughout the report. Information received by us was reviewed and this included the Annual Quality Assessment (AQAA). This is a self assessment document that focuses on how the home meets the outcomes for the residents and also provides some statistical data. Care Homes for Adults (18-65 years) Page 7 of 25 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 25 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 25 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. People who live at Lavender Fields can be assured that they have their needs fully assessed prior to admission and are given appropriate information to make an informed choice. Evidence: From speaking to the residents and the information we received from the surveys stated they had been involved with choosing and deciding to move into the home. Those residents spoken to were very happy with their care and understood that it is not a long term placement and that they would be supported to move on to other accommodation that would best support their needs. The company have produced an information pack which usually an allocated key worker would go through with the resident on arrival to ensure that they have been provided with the necessary information about the home. The manager told us following feedback from the residents a review of the admission procedure is being conducted to ensure that they are getting it right. The file of a newly admitted resident was examined and showed that a full assessment had been carried out prior to admission and provided sufficient information on the Care Homes for Adults (18-65 years) Page 10 of 25 Evidence: personal care and health care needs, and this information is used to form the basis of the individual support plan (ISP) Care Homes for Adults (18-65 years) Page 11 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Lavender Fields can be assured that they are involved in their own care planning and are consulted on every aspect of community life to allow them to live as independent a life as possible. Evidence: Residents spoken to confirmed that they are fully involved in the writing and agreeing of their own care, they told us they set their own goals about what they would like to achieve and by when. The residents told us that they meet with their key worker to discuss the goals and make any changes that are necessary to help them achieve their goals. When we looked at the plans not all of them had been signed and dated by the author to provide a good audit trail, and some had no evidence that they had been reviewed. This we were assured would be addressed at a team meeting to make it clear to staff the importance of this. The manager told us that a review of the ISP paperwork is taking place throughout the organisation and we were assured that additional training would take place to ensure that staff are clear on the process and what is required by them to make them person centred for all residents. Residents we Care Homes for Adults (18-65 years) Page 12 of 25 Evidence: spoke to told us they are able to visit the local community as they wish. If they require support from staff they told us that they need to provide some notice to the manager so they can ensure that adequate staffing numbers are available. Care Homes for Adults (18-65 years) Page 13 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Lavender Fields can be assured that they will be encouraged to live full and active lives which meet their needs. Evidence: Most people in the home attend college or a place of work. The home provides a purpose built kitchen which has been adapted to ensure that residents are able to access it and be as independent as possible. Menus are chosen in consultation with the residents and times for eating are varied depending on the activities planned each day. A variety of activities are attended by the residents including youth clubs, football club, local churches. There is no structured programme within the home as residents make their own choices for the activities in which they take part and are supported by staff as necessary, residents are encouraged to be as independent as possible. On the day of the inspection one resident was being supported to attend a wedding in London Care Homes for Adults (18-65 years) Page 14 of 25 Evidence: and was very much looking forward to the day. One resident holds down a job and is supported by a personal assistant who they interviewed and chose for themselves. The residents maintain relationships with their families and friends and the only restriction on visiting is with consideration of others who live at Lavender Fields. Care Homes for Adults (18-65 years) Page 15 of 25 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 who live at Lavender Fields can be assured that staff understand their personal and health care needs and how they prefer them to be met. Evidence: Care plans examined showed that not information was up to date and some areas had not been signed and dated which does not provide a good audit trail. The manager told us that the organisation is in the process of reviewing the paperwork and has assured us that this will be addressed through this process. All the surveys we received stated that the care staff and managers treat them well. Comments we received during the inspection include staff are very nice staff are very supportive and my needs are met very well. The home has access to a physiotherapist who is able to provide support to the residents as required. The medication and storage were generally found to be well kept, with the exception of a risk assessment for a resident who goes home on social leave and the parents take responsibility for their medication. We were assured this would be addressed as a matter of urgency. Care Homes for Adults (18-65 years) Page 16 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Lavender House can be assured that their views and any concerns they have will be listened to and acted upon. Robust policies and procedures are in place to protect them from abuse. Evidence: Information from the surveys and the residents we spoke to told us who they would speak to if they had any concerns about any aspect of their care and felt that their concerns would be listened to and acted upon. There is a clear procedure in place and residents told us that they had been given information on raising any concerns they may have. We examined the complaints folder and there is a form that is used for recording the complaint or concern which includes detailing the action that has been taken and the outcome. The manager told us every month as part of the quality assurance process any concerns and complaints are sent to head office. Residents told us that the manager is approachable and they feel they can speak to her at any time. There are appropriate procedures in place for safeguarding vulnerable people. Those staff spoken to were clear about safeguarding procedures and their responsibility to report appropriately. The manager told us that all the management team will have training in Mental Capacity and the Deprivation of Liberty to ensure they fully understand the process. This will the be cascaded down to all staff over the coming year. Care Homes for Adults (18-65 years) Page 17 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Lavender Fields can be assured that they live in a welcoming, warm, clean and well maintained environment that meets their needs. Evidence: A tour of the home was conducted and we saw cleaning staff working throughout the home, which ensured a fresh and clean environment is maintained. Decoration of a residents room was taking place. The resident confirmed that they had been consulted on the choice of colour and was looking forward to it being completed. Some areas of the home were looking worn and tired especially the woodwork but there is an ongoing redecoration programme in place to address these areas. The entire home is wheelchair accessible to meet the residents needs. The kitchen has been awarded five stars from the food standards agency which means that there are good practices in maintaining food hygiene standards. Policies and procedures are in place for the control of infection which includes the Department of Health essential steps guidance and audit process. Care Homes for Adults (18-65 years) Page 18 of 25 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. People who live at Lavender Fields can be assured a robust recruitment procedure is in place to keep them safe and there are sufficient competent staff on duty to meet their needs. Evidence: There is a stable and consistent staff team and staff told us it is very nice here, we feel we are offered appropriate training, the team work well together, although one comment told us they would like more support and to be listened to. Staff were seen to be offering support in a caring and encouraging way. Examination of the rota showed us that staffing levels were appropriate to meet the needs of the residents. The manager told us they have not used agency staff over the last twelve months which has maintained continuity for the residents. We examined the training matrix which showed us when staff were due to attend training and what training has been completed, this also showed that there had been good attendance and the variety of training courses were available to ensure the staff are competent and have the required skills for their roles. The manager told us that all staff receive supervision at least six times a year and this includes information on their development plan, evidence is held on individual files. The company have introduced an on line induction programme and on the day of the inspection we spoke with two member of staff who were working through this. They told us that they were finding it OK and were able to Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: ask questions if they were unsure of what to do next. An examination of staff files showed that all the required checks had been carried out for all staff prior to commencing their employment at the home. A volunteer coordinator has been employed by Leonard Cheshire and has the responsibility for all volunteers and they follow the same robust procedures as for paid members of staff. The manager told us that they have increased the number of staff on duty in the evening to provide additional support for residents who wish to go and out and still provide support for those wishing to stay at home. Care Homes for Adults (18-65 years) Page 20 of 25 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. People who live at Lavender Fields can be assured that the home is run in their best interests and that their health, safety and welfare is protected through a series of checks. Evidence: The manager was registered by the commission in July 2009, she has commenced the Registered Managers Award and it is hoped that this will be completed by the end of the year. Staff and residents confirmed that there is an open door policy and that they feel able to go to any member of staff if they had any concerns or ideas for improving the service. The resident told us they felt that they had a lot of say in how the home is run and meet to discuss any changes that are thought about that could improve the running of the home. As part of the quality assurance process Leonard Cheshire carry out an annual survey and a report is completed on the findings and an action plan formulated which looks at ways to improve the service. The results for this year have yet to be finalised. A monthly audit takes place looking at all accidents and incident that have taken place Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: and this may identify any trends or additional support that may be required for the benefit of the residents heath and wellbeing. Equality and Diversity issues are understood by staff and they are addressed within the Care plans, which describes appropriately how a residents needs are to be met. The maintenance person is responsible for ensuring the completion of the fire safety records and these were seen to be well maintained. a record is made of any issues and they are responsible for them to be put right. The manager completed the AQAA within the given timescales and it gave us the information required. Care Homes for Adults (18-65 years) Page 22 of 25 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 23 of 25 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 24 of 25 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 25 of 25 - 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. 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