Care Home: Leeza Court - Welcome House

What the care home does well The staff, service users and management of Leeza Court have taken significant steps to improve the home since the last inspection. The environment is conducive for the needs of the service users providing a bright, comfortable and homely environment. Residents in the home are supported and encouraged to be independent and are able to choose how they spend their time. What has improved since the last inspection? The outgoing manager of the home and staff team have worked exceptionally hard, with the support of the organisation, to address all of the requirements and recommendations from the previous inspection. The individual service user plans and risk assessments have been thoroughly reviewed and updated. This has also ensured that residents now work positively towards their personal goals such as developing independent living skills. In the past 12 months at least 3 service users have moved on to more independent accommodation. Residents now have a greater say in the day-to-day running of the home, which is reflected in the positive comments made by service users. In general, the record keeping and administration in the home has improved substantially including staff recruitment files, health and safety documentation and medication records.The organisation has improved the training programme offered to staff, introducing the common induction standards and providing external training courses covering all key topics. A programme of redecoration and renewal has begun in the home with residents having a meaningful say in the colour schemes. Staff numbers have been reviewed and increased to ensure that residents can be supported more flexibly in the community if they wish. Staff supervision is also now being carried out on a regular basis. The statement of purpose and service user`s guide have been updated and now provide better information for prospective residents. What the care home could do better: Only 1 recommendation has been made as a result of this inspection process. It is recommended that as occupancy numbers increase, with the service currently running at 50% occupancy, the staffing numbers will need to kept under review. A discussion was also held with the manager and operational director regarding the development of programmes to support service users in developing activities of daily living and independent living skills. CARE HOME ADULTS 18-65 Leeza Court - Welcome House Leeza Court 9 London Road Rainham Kent ME8 7RG Lead Inspector Joseph Harris Key Unannounced Inspection 15th November 2007 10:00 Leeza Court - Welcome House DS0000031629.V345889.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Leeza Court - Welcome House DS0000031629.V345889.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Leeza Court - Welcome House DS0000031629.V345889.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Leeza Court - Welcome House Address Leeza Court 9 London Road Rainham Kent ME8 7RG 01634 377667 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Welcome House Residential Care Homes Post Vacant Care Home 16 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (16) of places Leeza Court - Welcome House DS0000031629.V345889.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th January 2007 Brief Description of the Service: Leeza Court is a large detached property with accommodation on two floors, offering fourteen single and one double bedroom. The home is registered for 16 service users. Communal areas include a large lounge, a dining room, kitchen and conservatory. The home is located on the main road in Rainham, Kent. It is close to good transport links to the main Medway Towns and has pubs, local shops and facilities nearby. The home benefits from a large rear garden. The current fees for the service range from £540.00 - £865 per week. Information on the Home and the CSCI reports for prospective service users will be detailed in the Statement of Purpose and Service User Guide. Leeza Court - Welcome House DS0000031629.V345889.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection process culminated in a site visit to the home on 15th November 2007. The site visit commenced at approximately 10am and concluded at 4.30pm, lasting for around 6.5 hours. During the course of the visit a tour of the premises was undertaken and discussions were held with the operational director, manager, staff members and service users. A range of documentation was examined relating to the residents, staff, medication, health and safety and the day-to-day running of the home. The home also returned the Annual Quality Assurance Assessment (AQAA), which provides information to inform the inspection process. What the service does well: What has improved since the last inspection? The outgoing manager of the home and staff team have worked exceptionally hard, with the support of the organisation, to address all of the requirements and recommendations from the previous inspection. The individual service user plans and risk assessments have been thoroughly reviewed and updated. This has also ensured that residents now work positively towards their personal goals such as developing independent living skills. In the past 12 months at least 3 service users have moved on to more independent accommodation. Residents now have a greater say in the day-to-day running of the home, which is reflected in the positive comments made by service users. In general, the record keeping and administration in the home has improved substantially including staff recruitment files, health and safety documentation and medication records. Leeza Court - Welcome House DS0000031629.V345889.R01.S.doc Version 5.2 Page 6 The organisation has improved the training programme offered to staff, introducing the common induction standards and providing external training courses covering all key topics. A programme of redecoration and renewal has begun in the home with residents having a meaningful say in the colour schemes. Staff numbers have been reviewed and increased to ensure that residents can be supported more flexibly in the community if they wish. Staff supervision is also now being carried out on a regular basis. The statement of purpose and service user’s guide have been updated and now provide better information for prospective residents. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Leeza Court - Welcome House DS0000031629.V345889.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Leeza Court - Welcome House DS0000031629.V345889.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5. Quality in this outcome area is good. Service users are provided with suitable information about the home and their needs are assessed prior to moving in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has reviewed and updated both the Statement of Purpose and the Service User’s Guide. These documents now provide clear and accurate information about the home in an easily readable format. Some minor updates are now required following a change of manager at the home. It was reported that new and prospective service users are provided with a copy of the service user’s guide and staff will take time to explain any information if required. There have been no new service users since the last inspection, however systems are in place to ensure that any new referrals to the home have an assessment of their needs completed prior to moving in. The home requests information from the care manager/referrer including Care Programme approach (CPA) documents. The manager will always aim to visit the prospective resident in their current accommodation and complete an in-house needs and risk assessment. There is a clear contract in place appropriately covering all relevant terms and conditions of residency including fees. A copy of the contract is given to each resident and a signed copy kept on file. Leeza Court - Welcome House DS0000031629.V345889.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. Resident’s needs and aspirations are reflected in the individual plans and risk assessments. People are able to make decisions about their lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service user plans in the home have undergone a detailed review and have been updated accordingly. The previous manager, who has recently left the service, has worked hard to ensure that the needs and aspirations of service users are clearly defined and clear action plans have been put into place to ensure consistency of approach. The plans are linked to assessments and CPA documentation. It was reported that as part of the future development of the service their will be an increased emphasis on promoting independence and, to this end, it was advised that individual plans could set out clear steps and targets to provide guidance and evidence of daily living skills being developed, such as budgeting, cooking and community access. Leeza Court - Welcome House DS0000031629.V345889.R01.S.doc Version 5.2 Page 10 The majority of residents manage their own finances and are supported in making decisions about their day-to-day lives and future plans. A number of residents have recently moved on to more independent accommodation and another person is currently being supported to achieve this goal. The home does not take an appointee role for any individual and where this is required it is undertaken by someone independent of the service. As with the individual plans, the previous manager has updated all the risk assessments for service users ensuring that all perceived risks have been addressed. The risk assessments are linked to CPA information and provide clear guidance for staff to support residents in this regard. There is also evidence that service users have been involved in the risk and care planning processes. Leeza Court - Welcome House DS0000031629.V345889.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. Residents have opportunities to take part in meaningful activities and are able to have a lifestyle that suits their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has worked with service users since the last inspection to promote a wider range of activities. The staffing levels in the service have been increased ensuring that there are at least two staff on duty throughout the day time, which ensures that there is greater flexibility to support residents in the community should they require this. By and large most service users organise their own time and take part in daily activities independently. One resident now does voluntary work at a local charity shop and some residents have attended college courses in the recent past. It is reported that there is not a great deal of specific mental health resources in the immediate area, which Leeza Court - Welcome House DS0000031629.V345889.R01.S.doc Version 5.2 Page 12 provides an obstacle for some people. A number of residents were spoken to and they confirmed that they have a lifestyle that suits their needs. The staff in the home now support and encourage service users to take a more active role in the day-to-day running of the home including household chores, cooking, shopping and residents meetings. People are able to choose how they spend their time including when they get up and go to bed. Visitors are welcomed into the home at all reasonable times. Residents are able to choose who they see and there is sufficient space in the home to enable people to meet in private should they wish to do so. The manager has changed the way in which meals are planned. Residents now have meaningful input into menu planning and are involved in the shopping, preparation and cooking of meals. Some service users have identified that they wish to develop their cooking skills and staff now support service users in this in a planned and organised way. The kitchen is domestic in size, but provides enough space for people to work with staff members in preparing meals. Menu records show that a healthy and balanced diet is provided. Some service users choose to buy take away meals on a regular basis, but staff have worked with these individuals to promote a healthier, more cost effective diet. The kitchen was well stocked at the time of the site visit. Leeza Court - Welcome House DS0000031629.V345889.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. Service users are supported to meet their health and personal care needs appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The vast majority of service users are fully self-caring and require only prompting or encouragement to attend to their own personal care needs. The individual plans have been updated to reflect the level of support required to be provided by staff. Residents confirmed that staff are respectful of their needs and support them in a sensitive and dignified manner. The home maintains good healthcare records ensuring that information regarding any appointments is clearly documented including actions and outcomes of consultations. All service users are registered with local GPs and have access to complimentary healthcare such as dentists and opticians in the community. It was reported that the home receives good support from the local community mental health service and that residents have regular Leeza Court - Welcome House DS0000031629.V345889.R01.S.doc Version 5.2 Page 14 appointments with their CPNs or Care Managers and 6 monthly reviews are held within the multi-disciplinary team. The home has improved medication storage and processes. Administration records were clear and up to date and relevant policies and procedures are in place. The medication has been re-sited to a more appropriate location and the practice of residents queuing up for their medication no longer persists. The home has worked with Responsible Medical Officers to reduce and review medication regimes where appropriate. Leeza Court - Welcome House DS0000031629.V345889.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. Service user’s views are listened to and they are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The organisation has a clear complaints process in place, which is applied within the home. A copy of the complaints procedure is displayed in the home and residents stated that they feel able to make their views known and that they are responded to. The manager has developed improved systems to ensure that when an issue is raised there is a clear response and summary of actions taken to address the issue. There has been one complaint since the last inspection that had been suitably dealt with in appropriate timescales. All staff now receive Adult Protection training both through the induction process and through external training courses. Staff demonstrated a good working knowledge of abuse awareness and responsibilities to record and report any issues. There have been no reported adult protection alerts since the last inspection. Leeza Court - Welcome House DS0000031629.V345889.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. The home provides a suitable environment for the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Leeza Court is a large detached house in the centre of Rainham. It is situated on the main road close to bus stops and a short walk from the town centre. The organisation has commenced a programme of redecoration in the home with many of the rooms having been completed. The residents have the benefit of a large lounge/dining area and a number of smaller communal rooms including a designated smoking area. All of the service users spoken with stated that they are comfortable in the home and that they feel the environment meets their needs. One resident showed the inspector their room, which has been recently redecorated in a colour scheme of their choosing. Leeza Court - Welcome House DS0000031629.V345889.R01.S.doc Version 5.2 Page 17 There is one double room in the home, which is currently unoccupied. There is a large garden to the rear of the home, which now has improved security with added fencing. There is a large domestic-style kitchen and suitable laundry facilities in the home. The home is clean, hygienic and free from odour. Hazardous substances are stored appropriately and the home reportedly complies with environmental health and fire safety regulations. Leeza Court - Welcome House DS0000031629.V345889.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36. Quality in this outcome area is good. The service users are supported by a competent staff team in suitable numbers who are appropriately supervised. Staff receive necessary training and recruitment processes ensure the safety of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff in the home are being supported to work towards National Vocational Qualifications. Currently just under 50 of the staff team have achieved an NVQ level 2 or above, however all staff have been enrolled on NVQs. In discussion with staff it was evident that there was a good understanding of the needs of the service users and the aims of the home. The organisation has improved staffing levels, but it is advised that these remain under review as the occupancy levels in the home increase. Refer to recommendation 1. There are two staff on duty throughout the main working Leeza Court - Welcome House DS0000031629.V345889.R01.S.doc Version 5.2 Page 19 hours of the day (9am-6pm) and 1 member of staff in the evenings and sleeping-in. Two staff personnel files were viewed for recently appointed carers. These files demonstrated that all appropriate checks are carried out including two written references, POVA and CRB checks and employment histories. The organisation has significantly improved the training package offered to staff. This includes the introduction of the Common Induction Standards alongside the home’s own induction programme and the use of BVS induction videos. Staff now attended external training courses covering all mandatory training topics including fire safety, first aid and food hygiene. Other courses are also available to staff including managing aggression, care planning, medication and adult protection. The manager has instituted a supervision structure for staff ensuring that all staff have regular 1:1 sessions covering issues in the home, performance and training needs. Leeza Court - Welcome House DS0000031629.V345889.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. The home is well run and in the best interests of the service users. Health and safety issues are promoted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is in the process of a managerial change, however the outgoing manager was present at the inspection and she has demonstrated, over the past 12 months, excellent managerial skills. She has led the staff team in addressing all of the previous requirements and recommendations made and has, indeed, begun the process of developing the service over and above the previous regulation shortfalls. Leeza Court - Welcome House DS0000031629.V345889.R01.S.doc Version 5.2 Page 21 She has decided to move on for personal reasons and to develop her own education, however will remain involved in the home as a member of bank staff. The organisation has moved quickly to appoint a successor who is already in post and was Registered Manager at another of the Welcome Home services with proven track record. The organisation now has well-developed quality assurance systems overseen by the operational manager who conducts monthly monitoring visits and has regular involvement with the service. Satisfaction surveys have been completed and collated into an annual quality report. A number of in-house audits and staff competency assessments are completed on a regular basis. A range of records were viewed regarding health and safety issues, all of which were up-to-date including service and utility certificates, accident records and fire safety logs. Policies and procedures are in place covering safe working practices and staff have completed all necessary mandatory training. Leeza Court - Welcome House DS0000031629.V345889.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Leeza Court - Welcome House DS0000031629.V345889.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA33 Good Practice Recommendations To ensure staffing numbers are kept under review as occupancy levels increase. Leeza Court - Welcome House DS0000031629.V345889.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Leeza Court - Welcome House DS0000031629.V345889.R01.S.doc Version 5.2 Page 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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