Care Home: Lilas House.

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What the care home does well One tenant said that `good communication between the staff and tenants` makes Lilas House `a very happy place to live`. The service continues to provide excellent outcomes for people living there. The assessment of new people are undertaken by well qualified staff who showed an empathy for people with a learning difficulty. Although, there have been no new tenants since the last inspection, one person has transferred from a sister home and these records confirmed that they have clear guidelines for admission in place. Each tenant has a support plan of care needs in place and these are the tenants property, the plans confirmed that they contained individualised goals and aims for each person to aim for to continue a good level of independence. Tenants continue to lead the way in how the home is run, by staff gaining their views and opinions to plan future events and supporting their decisions with everyday issues. Tenants were spoken to and had no concerns about the service, confirming that the staff were `very supportive` and ` the meals were very good`. One tenant said `I am happy here, I like the people, I like my activities and don`t want tomove out`. What has improved since the last inspection? There has been some adaptations to accommodate a tenant whose health care needs have changed with the acquisition of a hoist to enable them to remain at the home and continue to access the communal areas. Continuing seeking support from other professionals. Introducing visual aspects to tenants support plans using pictorial formats. The manager said in the AQAA they `have become fully staffed through active recruitment, reporting, recording and communication has improved`. `The tenants have been supported and guided to seek opportunities to enhance their lives`. The evidence of this was seen during this inspection when checking records and by speaking to both tenants and staff. What the care home could do better: The home is well managed, there were no concerns raised during the day and no requirements were issued to improve the service. Key inspection report Care homes for adults (18-65 years) Lilas House Name: Address: 5 Cadogan Road Cromer Norfolk NR27 9HT three star excellent service The quality rating for this care home is: 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: Hilda Stephenson Date: 1 7 0 3 2 0 1 0 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. 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 mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983   Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2010) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Information about the care home Name of care home: Address: Lilas House 5 Cadogan Road Cromer Norfolk NR27 9HT 01263511210 01603279529 l.jeesal@virgin.net www.jeesal.org Jeesal Residential Care Services Limited care home 6 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 6 0 learning disability Additional conditions: Date of last inspection A bit about the care home Lilas House is a three storey end of terrace property situated in the centre of Cromer. It is registered as a Care Home for up to six adults with a learning disability. Each service user has their own bedroom. There are two bedrooms, with a shared en suite bathroom, on the ground floor and four bedrooms on the first and second floors. There is a shared lounge and dining room on the ground floor. The Home does not have a garden but there is a small patio area to the side of the Home. The Home is very close to the shops, seafront and other facilities in the town of Cromer. 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 & Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct and Management of the Home Poor Adequate Good Excellent How we did our inspection: This is what the inspector did when they were at the care home The focus of the inspection undertaken by the Care Quality Commission (CQC) is upon outcomes for people who use the service and their views on the service provided. The process considers the providers capacity to meet regulatory requirements, minimum standards of practice, and focuses on aspects of service provision that needs further development. One inspector conducted the unannounced visit on 17th March 2010. The main method of inspection used is called case tracking which involves selecting people who use the service and looking at the quality of care they receive by speaking to them, observation, reading their records and asking staff about their needs. The deputy manager and two members of staff were spoken with as part of the visit, records relating to medication management was also inspected to form an opinion about the quality of care provided. A partial tour of the building was undertaken which included peoples bedrooms and communal areas they frequent to make sure that the environment is homely and safe. A review of all the information we have received about the home since the last key inspection was performed was considered in planning this visit, which included the Annual Quality Assurance Assessment which was provided by the registered manager on the, the six responses we received to Have you Say service user surveys and the eight responses we received from the staff surveys which were distributed in the home prior to the site visit. Two surveys were received from other professionals who visit the service. What the care home does well One tenant said that good communication between the staff and tenants makes Lilas House a very happy place to live. The service continues to provide excellent outcomes for people living there. The assessment of new people are undertaken by well qualified staff who showed an empathy for people with a learning difficulty. Although, there have been no new tenants since the last inspection, one person has transferred from a sister home and these records confirmed that they have clear guidelines for admission in place. Each tenant has a support plan of care needs in place and these are the tenants property, the plans confirmed that they contained individualised goals and aims for each person to aim for to continue a good level of independence. Tenants continue to lead the way in how the home is run, by staff gaining their views and opinions to plan future events and supporting their decisions with everyday issues. Tenants were spoken to and had no concerns about the service, confirming that the staff were very supportive and the meals were very good. One tenant said I am happy here, I like the people, I like my activities and dont want to move out. What has got better from the last inspection What the care home could do better The home is well managed, there were no concerns raised during the day and no requirements were issued to improve the service. 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 Hilda Stephenson CPC1 Capital Park Fulbourn Cambridge Cambridgeshire CB21 5XE 01223771300 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 http:/www.cqc.org.uk/. You can get printed copies from enquiries@cqc.org.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. Prospective tenants have their needs assessed, are provided with written or pictorial information about the procedure and are well supported through this initial placement. Evidence: There have been no complete admissions to Lilas House since the previous inspection, although one tenant has transferred from a sister home. There have been no alterations with the pre-admission procedure and therefore the rating remains at a good standard for tenants. The deputy manager was in attendance for part of this inspection and explained the admission procedure if their were to be any vacancies. The written information was read that is given out to new tenants, which is also in a picture format explaining the pre-admission process. The contract explaining the fees, extra payments and room to be occupied is contained within the documents in each individual bedroom. Six surveys were received from tenants and all of these stated that they were asked whether they wanted to move into the home and were provided with the information for them to make their own decision to move in. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Tenants have an individual plan of care in place. Evidence: Individual support plans, daily diary and health plan is kept in each of the tenants bedrooms. Six surveys received stated that tenants can always make their own decisions during the day. Speaking to two of the tenants they were aware of the support plans and one tenant showed the Inspector there documents in there room. Each tenant has a key worker who does that little extra for them and monitors the care and support offered. It was evident that tenants manage their own time, activities and work life balance and the records explaining these are kept within the bedrooms and on the noticeboard in the hall. One survey did state that it would be nice to have more staff so they could do more things outside the home. Although, when speaking to tenants they appear to be well supported when they go out, and that the cold weather had limited the outside activities for much of the winter season. One of the senior support staff explained how the staff accommodate tenants when they wish to go out, arrange holidays or days out. 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. Tenants are well supported to make their own decision regarding their preferred lifestyle choices. Evidence: Two support plans were read. These were of an excellent standard containing a wide variety of needs, history, hobbies, family background and goals for the future. Each plan showed their timetable for the week, explaining when activities, college, outings had been arranged, also showing their free time too. This was displayed in a picture format to minimise confusion of what and when these had been arranged for. The tenants spoken to knew about these schedule and one showed me there own plan. During the inspection all six tenants were in for their lunch and three tenants left to attend their college session for the afternoon, leaving three tenants in the home. One of the tenants showed the Inspector there room, which was nicely decorated and contained items regarding their hobby and interests. Due to communication difficulties there was a pictorial board in place to assist with communicating their interest which shows how the staff are developing various methods to assist tenants with communication difficulties, and this should be commended. Apart, from one comment received suggesting the home could do with more staff for outings, several stated that they were happy with the Independence they have at Lilas House. Another tenant stated I am happy, I like it here, I like the people, I like my activities and dont want to move out. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Tenants have access to health care. Evidence: The home has ramps throughout the ground floor for people who are wheelchair users. The staff have one portable hoist and one fixed hoist in place for a specific tenant as well as a pressure relieving bed, with the relevant assessments in place for staff to follow safely. The health care professionals are contacted when the staff require advice or assistance with frailer tenants to ensure they receive the care and support. Records were seen of visits made by the GP to monitor the health of two of the tenants. The health book of two tenants showed that the dentist, chiropodist and hospital appointments were in place indicating the health and potential complications are identified and monitored. These records were of an excellent standard and one of the tenants confirmed the help and support they were currently receiving. Staff spoken with were knowledgeable on the medical conditions and risks involved caring for tenants, and thorough risk assessments were in place as well as supervision for new staff when assisting these tenants with complicated medical conditions. The medication was checked for those tenants who were case tracked and the records were clear and concise. The relevant ordering and returning of medication was in place, with detailed records for controlled drugs in use. Risk assessments were in place and procedures to follow when tenants take medication out with them and when they are away from the home such as there holidays. Overall, the health and welfare of the tenants were well assessed and monitored. Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Vulnerable adults are protected and have their views listened to and acted upon. Evidence: Each tenant has a copy of the complaints procedure in their room either in a written or pictorial format. When speaking to two of the tenants they had no complaints about the service. Staff were knowledgeable about dealing any concerns that tenants may have, and they join the tenants one evening each week to discuss concerns, views and opinions for the week ahead. The manager has good records of staff training for adult protection in place which were seen in the staff files. Staff also confirmed they understood the various forms of adult protection and why it is so important when caring for people with a learning disability. 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. Tenants live in a comfortable homely environment. Evidence: Lilas House is three storey town house which has adaptations within, for people to live their safely. Wheelchair users have access to the ground floor only. There are stairs with bannisters to access the upper floors. Each tenant has their own room and can decorate and furnish their rooms for their own individual taste. At the rear of the building is a good size dining room, walking through to the well maintained kitchen and into the lounge containing comfortable furnishing. Access to the rear yard and outside seating is through the small laundry room. The building is secure and tenants and staff use a magnetic fob to enter and leave the home. Visitors sign the visitors book which indicates an increase in numbers in case of a fire occurring. One tenant showed the Inspector their room which was well decorated and contained various personal possessions including items of interest for them to maintain their hobbies. There were improvement plans in place for the following year, the lounge having been completely refurbished with a new carpet and sofas being replaced. The home was clean and comfortable although not all areas were checked during this visit. There is two offices on the first floor where the records and confidential meetings can take place. There are adequate laundry facilities and infection control measures in place. 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. Tenants are supported by adequate numbers of well trained staff. Evidence: The deputy manager made available all staff records that were requested. Two staff files were checked following the recruitment procedure, training records and details of supervision. The records were detailed, well maintained and each step of the recruitment procedure had been followed precisely. Records showed that new staff are vetted before commencing employment and they follow the homes induction programme to enable them to gain an understanding of the care and support required of them. The AQAA stated that out of twelve of the staff team seven had achieved the recommended vocational training. Speaking to staff on duty one had nearly completed this to increase the numbers further. The level of training for staff were good examples within the staff files showed some had completed first aid, challenging behaviour, mental health, moving and handling, fire, national minimum standards, epilepsy, autism, health and safety, diabetes and the vocational training. The manager records supervision of staff which is carried out on a monthly basis which is over and above that required. One tenant commented that they would like more staff to accompany them, although during the week this is slightly limited due to the regular college, work and other activities going on where staff are out with tenants. This does not appear to limit outings at present. During the weekend there is usually adequate numbers of staff to support tenants for there preferred outings. During the inspection the staff team were welcoming and treated the tenants with dignity and respect. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Tenants are supported to make their own decisions while living in a well managed home. Evidence: The deputy manager was in attendance for part of the day and made all documentation available for inspection. The manager who has worked at the home for several years was off during the inspection. The previous quality assurance survey was read and how the manager had put the results into action. The manager stated in the AQAA that a new survey of quality was currently being processed to confirm views from family members and external professionals as well as the tenants views, to plan for the annual development plan. Two external surveys from other professionals were received prior to the visit, providing very positive views regarding the service. The manager holds finances for tenants with records in place to eliminate mistakes. One such record was checked and found to be very well documented. Staff supervision records were seen within the staff files, and how training and personal achievements are organised. The required health and safety checks of the fire records, water temperatures, boiler maintenance, risks from moving and handling, infection control and aggressive behaviour were also checked and found to be well maintained. The current insurance and registration certificate is in place and displayed. 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: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2010) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. - 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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