Care Home: Lees Hall Road

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Lees Hall Road 333 Lees Hall Road Thornhill Lees Dewsbury West Yorkshire WF12 0RT three star excellent service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lynda Jones Date: 1 8 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. They reflect the things that people have said are important to them: 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 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Lees Hall Road 333 Lees Hall Road Thornhill Lees Dewsbury West Yorkshire WF12 0RT 01924459689 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): noemail18/10/07 St Anne`s Community Services Name of registered manager (if applicable) Mrs Elaine Anne Firth Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 8 0 care home 8 learning disability Additional conditions: Date of last inspection A bit about the care home Lees Hall Road is a registered care home that provides support for up to 8 adults who have a learning disability with emotional disorders, mental health issues, have offended or have the potential to offend. The purpose of the home is to support people to move on to alternative, appropriate accommodation. The home is part of St Annes Community Services. There are six single bedrooms and a self-contained flat and bed-sit for one of the service users, plus a staff sleep-in room and office. There is a large kitchen and separate dining area. There are also two lounges; one is used as a quiet area or games room. Lees Hall Road is a purpose built detached house and has a large garden where service users are able to sit out or help with gardening. The home is located within close proximity of bus and train services and there are local shops and medical facilities within walking distance. Information about the home and the services provided are available from the home in the Statement of Purpose and Service User Guide. 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 How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. The Commission for Social Care Inspection (CSCI) inspects services at a frequency determined by how the service has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website www.csci.org.uk. The purpose of the inspection was to make sure the home was providing a good standard of care for the people who use the service. Before the inspection, evidence about the home was reviewed. This included looking at any reported incidents, accidents or complaints. This information was used to plan the visit. The manager of the home completed an Annual Quality Assurance Assessment (AQAA) before the visit to provide additional information. We looked at a number of documents during the visit and visited areas of the home used by the people who live there. We spent time talking with the people at the home, staff and the manager. Comments made to us during the day appear in the body of the report. Survey forms were sent to people living at the home, health professionals and staff. A number of these had been returned and information from them has been used in this report. The service was last inspected in December 2007. What the care home does well People told us they were treated well and the staff listen to what they have to say. They know how to make a complaint and they have someone to talk to if they have any concerns. They also told us the home is always fresh and clean. One person said I am happy. My confidence has grown and I have become more independent. Staff are committed to supporting people to lead purposeful and fulfilling lives and to be as independ as possible. Personal plans are up to date, they are highly individualised and show that the service is keen to support people to lead fulfilling lives and to be as independent as possible. The home has an open culture where individuals are supported to share any concerns in relation to their own protection and safety. The home is clear when an incident needs to be referred to the Local Authority as part of local safeguarding procedures. In the surveys we asked visiting health professionals to tell us what the service does well. These are some of their comments: they maintain the dignity of a diverse group, encouraging and supporting individuals to reach their potential safely to make the transition to a more independent style of living. they assess and manage risks within the care management team they empower people to take control of their own environment supporting people to be independent and maintaining firm boundaries and support structures they have a strong staff team they maintain a pleasant environment We also asked asked staff to tell us what they do well. They said: treat each person as an individual by valuing their needs and helping them to fulfill their potential ensure that staff have up to date training so they are equipped with the knowledge to support people efficiently. One member of staff saidI enjoy my work & get job satisfaction when I see the difference in the clients confidence and skills after living at Lees Hall Road for a short time. What has got better from the last inspection What the care home could do better These are some of the things the staff have identified and hope to improve upon over the next 12 months: Produce some better information about the home. They are thinking of a video showing the layout of the home and garden. They want to continue to encourage people to try taster sessions of activities that they might enjoy. They plan to encourage people to become more independent in the kitchen by training them how to use equipment. They want to improve the facilities in the bedsit. They want to look at ways of supporting and enabling night staff to undertake NVQs. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Lynda Jones St Pauls House 23 Park Square Leeds LS1 2ND 0113 220 4600 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 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 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 . Individual needs are assessed before any decision is made about moving in. People are provided with information about the service and invited to visit to see if it is the right place for them. Evidence: Everyone is assessed before they move into the home to make sure that their needs can be met there. We looked at the records for two people who moved into the home towards the end of last year and there was evidence that detailed assessments had been carried out. In the Annual Quality Assurance Assessment (AQAA) that was sent to us before the inspection we were told that the manager and deputy manager visit every referred person to do an initial assessment and discuss what people need and what the home can offer. In the surveys we asked people if they wanted to move to Lees Hall Road, five people said yes, one person said no. This is what people said in their surveys: because I liked it so much I moved in I visited the home before I moved in. I am happy I was given a place The AQAA said We have carefully planned visits prior to the service users moving in which include overnight stays, they are encouraged to involve their family or advocate in this process. Evidence: We asked if there are any plans to improve the information that people are given about the home and we were told We are planning to produce an information leaflet about the home, then make a service user friendly information video/DVD showing the layout of the building and garden. 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 are encouraged to make decisions about their lives and are involved in planning their care and support. Evidence: In the AQAA the manager said everyone has a person centred plan that is reviewed every six months. We were told that the plan is developed in partnership with each individual and it sets out how peoples needs will be met through positive, planned interventions. The plans also include a comprehensive risk assessment. We looked at care plan and risk assessment records for three people who live at the home. We found them to be person centred and individual to each person. They gave clear guidance on peoples needs. There is evidence that the plans are reviewed and evaluated regularly to make sure they are still relevant for people, this makes sure they are still meeting peoples needs properly. The records show that people are actively consulted about what is in the plan and show that each person is involved in the reviews of their own plan. The daily records are of a high standard, they are informative and give a good, detailed account of the day to day support people receive. People are encouraged to make choices, to be as independent as possible and excercise some control over ther lives. In the surveys we asked people if they made decisions about what they want to do each day. Most people said usually, one person said never but went on to say I have to be in a good mood. Evidence: We asked people if they could do what they wanted to do during the day, evening and weekends. Most people said they could. The AQAA said Service users have an individual timetable of activities, these are devised on a weekly basis incorporating some one to one time with a staff member, during these periods the service user chooses their activity eg Meal out, cinema, pub, shopping trip, sporting activities etc. Service users chose their own individual holiday destinations. People participate in the running of the household by planning the menus and taking turns to do the household shopping with support from staff. From talking to the staff it is clear that they know people really well. They are patient, respectful and encouraging in their approach to individuals. In the AQAA we asked the home to tell us what improvements they have made in this area over the last 12 months. They said Supported 2 service users to find voluntary work placements and referred 1 service user to a suitable day service. We now have an independent chair person from Cloverleaf Advocacy service who chairs the Get Together meetings each month and takes minutes. Evidence that each service user has an individual weekly timetable of activities. Evidence that we support service users to enrol and attend college courses that they enjoy. We also enable staff to accompany some individuals that need one to one. Good rota management; staffing levels reflect the needs of the service users enabling them to pursue individual social activities. One service user has attended the cinema, something he had never done before. We have supported another service user to join a new athletics club. 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 who use the service are able to make choices about their lifestyle. Social, educational, cultural and recreational activities meet peoples expectations. They also benefit from a good, healthy and varied diet. Evidence: People take part in a variety of activities of their choice. The AQAA told us Service users are offered a variety of activities suitable for their development, including support to find suitable work placements, college, sports, shopping and art sessions. The service actively encourages and provides varied opportunities for individuals to choose from. They use the facilities that are available in the local community such as sports centre, library, coffee mornings at the local church, cafes, pubs and shops, using public transport. People are also given the chance to enjoy their own company if this is what they prefer. People are given good support to keep in touch with family and friends. Some individuals stay with their families on a regular basis. Everyone is offered a healthy diet that meets their dietary needs. We were told the food at the home is very good. Everyone plays a part in the domestic routine of the home eg menu planning, cooking meals, doing their own laundry and sharing cleaning Evidence: chores. One person told us we all have our daily chores. 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 . Peoples general healthcare needs are well met and based upon their individual needs. Evidence: People are treated with respect and their privacy and dignity is maintained at all times. Good records are kept of health appointments and their outcomes. Staff make sure that people are given support to attend appointments to meet their health needs. Two people have a Health Action Plan; these are new. They attended a meeting that launched the new Health Action Plan for people with learning disabilities in Kirklees on 13 November 2008 and a member of staff member accompanied them. Eventually everyone will have one of these plans to make sure that their healthcare needs are being met. People are referred to health professionals when needed. There are good records of how and when this had been done for people. The AQAA said (we) Arrange support for service users from relevant healthcare professionals eg local GPs, dentists. Referrals are made if required to clinical psychologists, psychiatrists, occupational therapists, physiotherapists, speech therapists, chiropodists and opticians We asked health professionals who have contact with the service if peoples health care need are met at Lees Hall Road. We received four responses, three said always, one said usually, with assistance from appropriate health care professionals. They also said they thought the staff had the right skills and experience to support people. All staff are trained to administer medication. There are audit systems in place for medication which is checked daily. Two people administer their own medication; risk Evidence: assessments are in place to monitor this and make sure that people are safe. The health professionals who wrote to us said this area was well managed. 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 use the service are able to express their concerns and are protected from abuse. Evidence: The home has a clear complaints procedure which is given to everyone when they move into the home. Either a member of staff or an advocate goes through the procedure with each person to make sure that they understand it. In the surveys people told us they know how to make a complaint.They said they know who they would speak to if they are unhappy about anything. Most people said they would talk to staff or someone from the advocacy service. The home has an open culture and people are encouraged to express their views, the people who live there hold regular meetings which they call Get Togethers, they did not like the term Residents Meeting they thought it sounded too formal. They have an advocacy representative present at the meeting who takes minutes and makes sure everyones views are represented. Staff from the home do not attend. Issues arising from the Get Togethers are then presented at the next staff meeting by a member of the household, they take it in turns to attend. We were invited to attend a meeting where this took place. The meeting was excellent, the household representative raised a list of issues and a full discussion took place. Most of the questions raised were answered, those that could not be answered immediately were taken forward to the next staff meeting. In the surveys, people told us the staff listen to and act what they say. The AQAA said Staff respond promptly and report and record complaints, they are fully aware of policies and procedures regarding adult protection matters and work within them. Staff have received training and are aware of their responsibility to safeguard people in Evidence: their care. Our records show that they follow the correct procedure and report all incidents promptly. 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 . The environment is homely, comfortable, well maintained and provides a safe place for people who live at the home. Evidence: A tour of the building was carried out with one of the people who live there; three people invited us to see their rooms. The home is well maintained and it is clean and hygienic throughout. There is a cleaning rota and everyone has a part to play in keeping the house clean and tidy. We were informed that regular planned maintenance visits are carried out by the maintenance department and a procedure is in place for reporting emergency issues. Everyone has their own belongings around them and they have stamped their own personality on their rooms. We were invited to see the accommodation in the bedsit and the flat where the occupants are supported to develop their independent living skills. There are plans to upgrade the kitchen in the bedsit this year which will be a big improvement. The shared areas of the house are pleasantly decorated, comfortably furnished and homely. When we last visited the home we said the carpet and sofas in the large lounge should be replaced; this has been completed. The AQAA said One service user has achieved a garden project, he has cleared a large compost area. Garden waste has been removed and the fencing has been repainted. The exterior of the house has also be repainted. One service user took on several projects during the summer to improve garden features this was part of his weekly activity chart. 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 home is appropriately staffed and staff are trained and competent to meet the needs of the people who use the service. Evidence: The home is appropriately staffed to meet the needs of the people living there and to make sure people are safe. The staff are flexible and the rota is planned to make sure that planned activities, meetings and appointments can always take place. The AQAA said Staff are supportive to meet the needs of service users and are flexible to change shifts at short notice. There is a diverse staff team that has a balance of all the skills, knowledge and experience to meet the needs of service users. We were told there is a low turnover of staff and many people have worked at the home for a number of years. They demonstrate a good knowledge of the people who live at the home and were able to provide information about each individual. We saw good interactions between people who live at the home and staff. People were very relaxed with staff and were pleased to see them when they arrived. People were chatting, laughing and joking, and enjoying the company of staff. There was a good atmosphere. People said they liked the staff and they said they were kind. In the surveys we asked if the staff treated people well. The response was positive, one person said they treat me with respect. The recruitment procedure is thorough, new staff only start work in the home when references and checks are carried out to make sure they are suitable. Staff confirmed this in the surveys they completed. All new staff undertake a detailed induction programme. Evidence: The AQAA said The recruitment and selection process meets the requirements of relevant legislation, equal opportunities and anti-disciminatary practice. The service is highly selective, with the recruitment of the right person for the job. All staff have enhanced CRB checks and these are updated every 3 years. The staff are trained and competent to carry out their work. The AQAA told us 9 staff out of 16 have achieved NVQ 3. The deputy manager has achieved her Registered Managers Award. Shift leaders have worked hard to assess and support staff to achieve NVQ level 3. Home manager has achieved her NVQ level 4 certificate. 1 staff member has a Diploma in Social Science. In their surveys staff told us they have regular updates of mandatory training and they also receive some training from the psychologist who works with some of the people living there. In additon they said they have some input into their staff meetings from outside agencies who also work with people living there. 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 home is well managed. The interests of people who use the service are seen as important to the manager and all of the staff. The health, safety and welfare of service users is generally protected. Evidence: The home has an experienced manager who has successfully completed NVQ Level 4 in Care and has 18 years experience in managing care and support for adults with learning disabilities. She works alongside members of the staff team and they said she meets with them regularly to provide support and discuss care practice. There is a strong staff team made up of people who are well trained and want to continue to improve the service. They actively promote the rights and encourage the independence of the people living there. There is a strong focus on person centred thinking and in being open and transparent. People living at the home are actively encouraged to shape the service and have a say in how the home is run. The AQAA we received from the home contains clear, relevant information that is supported by a wide range of evidence. It told us about changes that have been made and about improvements they want to make to the service. Staff have a range of policies and procedures available to them and there is evidence that the organisation reviews procedures regularly so that they reflect current thinking and practice. All of the records examined during the visit were up to date and of a Evidence: good standard. The AQAA said The home has efficient systems to ensure effective safeguarding and management of individuals money including records keeping. Records are kept securely and staff are aware of the requirements of the Data Protection Act. The organisations area manager provides support and visits on a on a monthly basis and reports on the conduct of the home. All staff receive regular supervision. Arrangements are in place to make sure of safe working practices. The home has a comprehensive range of health and safety policies and procedures in place. Staff are given opportunity to read and become familiar with these during their induction. Health and safety checks are carried out around the home and fire records are maintained. In the AQAA, the manager confirmed that all health and safety checks are up to date. Are there any outstanding requirements from the last inspection? Yes  No  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 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 Description 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 Description 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 Helpline: 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 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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