Care Home: Lincolnshire House

What the care home does well The service continues to provide a very homely and friendly environment for the people who live there. The staff and people living in the home have very good relationships with each other and the atmosphere between them is positive and relaxed. This means people using the service are very settled and feel they can rely on the staff for support they may need. People using the service continue to be consulted and involved in the management of the service and participate in the way it is run. The wishes and feelings of people living in the home are taken seriously and they are treated with dignity and respect and able to make choices and decisions about how they live their lives. What the care home could do better: Support plans belonging to people using the service should continue to be developed to ensure the individual needs of people living in the home are appropriately met. Staff should have accredited training on the safe use and handling of medicines to ensure people using the service are kept safe from potential harm. The training programme for the service should continue to be developed to ensure staff have the right skills to meet the needs of people living in the home and for promoting their independence. Random inspection report Care homes for adults (18-65 years) Name: Address: Lincolnshire House Brumby Wood Lane Scunthorpe North Lincolnshire DN17 1AF The quality rating for this care home is: The rating was made on: three star excellent service 17/04/2007 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead Inspector: Rob Padwick Date: 2 4 0 3 2 0 1 0 Care Homes for Adults (18 – 65 years) Page 1 of 11 Information about the care home Name of care home: Address: Lincolnshire House Brumby Wood Lane Scunthorpe North Lincolnshire DN17 1AF 01724844168 01724281123 admin@lincshouse.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Lincolnshire House Association Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration: Category(ies) : physical disability Additional conditions: That the home can only accept the specified service user HC with mental health needs. Date of last inspection: Brief description of the care home: Lincolnshire House provides accommodation for 33 adults with a physical disability in several individual purpose built bungalows. The most recent being opened in March 2002. All the bungalows are furnished to a high standard and are self contained incorporating appropriately adapted kitchens, dining rooms, lounges, laundry and bathrooms. All bedrooms are for single occupation with 23 of these having en-suite facilities. 6 bedrooms have a wash hand basin in the room and there are three flats, with a married couple supported to live in one of them. Particular attention has been given to provide adaptations such as overhead tracking, portable hoists, automatic bathroom lighting, automatic key coded entrance doors and extra wide door access all promoting individuals independence. A new building has been erected in the grounds to replace Care Homes for Adults (18 – 65 years) Page 2 of 11 care home 33 Number of places (if applicable): Under 65 33 Over 65 0 1 7 0 4 2 0 0 7 the old education block. The building is used for educational classes and social events. The grounds are well maintained and fully accessible to wheelchair users. CCTV has been installed to monitor the entrances of the premises for security purposes. The home is close to local amenities and the town centre of Scunthorpe. Lincolnshire House Association is a non profit making organisation. Information in the self assessment for the service dated 1/2/10 indicates the fees for the financial year ending April 2010 range between £429.00 and £864.00. The statement of purpose for the home details what services the weekly fees cover. Care Homes for Adults (18 – 65 years) Page 3 of 11 What we found: This random inspection visit was carried out on 24th March 2010 and lasted 6.5 hours. The service was not told in advance when it would take place. The manager was available throughout the period of our visit and as well as speaking to her, we talked to staff on duty and people who live in the home. Comments from them are included in this report. We looked around the service, including bedrooms and shared areas and we inspected the records of peoples care, staff files, health and safety documents and other records kept by the service. Choice of Home: The service has a Statement of Purpose and Service Users Guide to help people thinking about moving into the home make an informed decision about it. We were told no one had moved in since we last visited the service and there was evidence in the case files of an appropriate admission process with assessments carried out by staff in the home or the Local Authority, to ensure it can appropriately meet their needs. Individual Needs and Choices: We looked at the case files of three people living in the home and all of these contained individual support plans developed from their assessment of needs. The support plans contained details about personal strengths, preferences and needs which people using the service confirmed they were very much aware of and we were told us staff involved and consulted them about these, to ensure they are in as much control of their lives as is possible and supported in a way they are happy and in agreement with. The last time we visited the service we made a recommendation to ensure there is a consistent quality and content in the daily and key worker records and the self assessment for the service told us they had Developed a new style of care plan with more information that was being gradually introduced. We saw evidence of improvements made in the support plans in this respect and those inspected contained a generally good standard of daily recordings with evidence they were being regularly reviewed to ensure they remain up to date. People living in the home told us staff supported them to make decisions about their lives and take responsibility for themselves and the case files we inspected contained a range of assessments about the management of known risks to them. People living in the home confirmed they continue to make choices about their lives and are consulted and able to contribute to decisions about the home and there was clear evidence of this in the case files and records inspected. One person told us We are one big happy family. It makes everyone feel welcome; there is a great sense of belonging and involvement. Lifestyle: People using the service told us about choices and decisions they could make to ensure Care Homes for Adults (18 – 65 years) Page 4 of 11 they experience a life style that meets their expectations. The service has a large purpose built communal facility that is used for meetings and education courses and people told us about courses they attended in things like arts and crafts. The home has a number of dedicated staff to coordinate activities and we were told some attended adult education and university courses in things like computing and music. Routines in the home continue to be flexibly arranged to enable maximum choice and we were told some choose to follow hobbies and interests by helping in charity shops and voluntary work with church groups, whilst another helps out at Scunthorpe United and the local Bus station. The service has use of three vehicles for making trips out and we saw evidence in daily notes of regular outings to leisure centres for gym, swimming and bowling sessions. One person told us about a forthcoming trip to see Dancing on Ice they were planning to make and we were told how others were assisted to fulfil personal goals in using public transport independently. Whilst feedback from people using the service confirmed they were generally very happy with the lifestyle they had, some people told us they would Like to go out more to different places. People using the service continue to be encouraged to play an active role and take responsibility for household tasks and one told us how she sometimes helped out with washing up after the evening meal. The home has a visitors policy and welcomes the involvement from friends and relatives. We were told people who use the service are supported to visit their families and about fund raising events such as quiz nights and sponsored abseils to which family and friends are invited. People living in the home told us they can make choices and decisions about what food is served and the catering manager continues to meet with them on a weekly basis to ensure they are provided with a healthy and nutritional diet that meets their likes and preferences. Case files inspected contained evidence of support from dieticians, together with monitoring of weight where this was appropriate. Personal care and healthcare support: People living in the home indicated they continue to be very happy with the way staff support them with their health care and personal care. The case files belonging to them contained evidence of person centred approach that takes individual wishes and needs into account. One person living in the home told us The standard of care is very good, I feel I am treated as an individual, whilst another commented The home looks after and cares for us very well. Training records contained evidence of a range of specialist and other courses to ensure staff have the right skills, although some staff feedback indicated this still could be further developed. Case files belonging to people living in the home contained support plans detailing a range of health and personal care issues, together with information for staff about how these should be met. There was evidence of good liaison and prompt input from professionals in the community when this was required and people using the service indicated they felt valued as individuals and confirmed they were treated with dignity and respect. Medical notes gave evidence of support in meeting identified health issues and people using the service confirmed they were supported to attend medical Care Homes for Adults (18 – 65 years) Page 5 of 11 appointments when needed. The last time we visited, we made requirement that records of medication administered to people living in the home are maintained accurately and kept up to date. We randomly checked a sample of these and found them all to be appropriately maintained, with accurate staff recordings. Medication storage facilities were found to be very well kept and we saw evidence of regular checks of medication received and sent back to the local pharmacy. The self assessment told us New staff are not allowed to administer medication until they have completed their medication training and they are monitored by senior staff before they take on this responsibility to ensure they are confident and competent in administering medication. We were told medication training was currently provided by staff in the home and whilst this was reported to be very thorough and we found no evidence any deficits in the medication records, a recommendation is made about this. Concerns, complaints and protection: People using the service told us they were Very happy and enjoy living in the home. We saw evidence of regular consultation with them to ensure it is delivered in a way they are happy and in agreement with. One person told us We are all treated equally and given choices, we are involved in meetings and running the complex. An official complaints policy and procedure is in place to ensure the concerns of people living in the home are taken seriously and feedback from those we spoke to indicated they were very clear about what to do if they had any complaints. We received no complaints about the home since the last time we visited it and the complaints record in the home contained evidence of appropriate action to resolve the one complaint received during the past year. Relative comments included in this stated We think Lincolnshire House provides excellent care and social activities, all of the staff who we have met have been very helpful and obviously dedicated. We saw evidence of regular training on the Protection of Vulnerable Adults that is included in the induction of new staff and those staff who we spoke to were aware of their responsibilities in this regard and how to report suspicions or allegations of abuse. There have been no safeguarding referrals made by the home over the past year to the Local Authority and we have not been made aware of any concerns in this respect. Environment: The service consists of a number of good quality purpose built single storey bungalows on a large and accessible site. Accommodation is spacious with wide corridors for easy access to wheelchair users. Buildings are equipped with a variety of specialist aids and adaptations to maximise the independence of people who use the service and the bedrooms inspected were personalised to reflect individual preferences, with some fitted with environmental controls to operate lighting, telephone, DVD, television, computer and call system etc. The service was very well maintained and in a good standard of repair and we saw evidence of a variety of regular checks to ensure the safety of people who use the service. The buildings were warm, clean, comfortable and Care Homes for Adults (18 – 65 years) Page 6 of 11 tidy and we were told in the self assessment that Lincolnshire House works within Health Protection Agency Guidelines for infection control and that Infection control training is given to all staff during their induction and then repeated yearly. Staffing: Staffing levels were observed to be appropriate for meeting the needs of people living in the home and there was a good atmosphere throughout, with friendly and warm relationships existing between staff and people who use the service. Staff were observed to be cheerful and to enjoy doing their jobs and demonstrated a positive regard for people living in the home. Staff who we spoke to were committed and motivated to doing their work and discussion with them indicated they had a good understanding of the needs of people who use the service and the values of the home. Staff files contained evidence of an appropriate induction programme for the home, with mandatory training and other specialist courses, including challenging behaviour, epilepsy, dementia and tissue viability. Some staff however, as previously indicated, told us this could still be further improved. Staff take part in an NVQ programme in Health and Social Care and whilst the self assessment told us over 50 of staff had achieved a qualification in this, a recommendation is made for consideration of tailoring this more to promoting independence. Staff files contained evidence of a robust recruitment procedure for the home which includes the involvement of people who use the service. All staff files inspected contained the appropriate documentation required with evidence of thorough checks to ensure new staff are safe to work with the people who live in the home. There was evidence of regular professional supervision in the files inspected to ensure staff are able to do their jobs, together with annual appraisals to enable career development. Conduct and management of the home: The manager has substantial experience and a good understanding of the needs of the people that use the service and has completed her Registered Managers Award and obtained an NVQ 4 in care. The Manager told us she is also a staff NVQ assessor for the home. The home continues to have a strong ethos of inclusion and involvement of people who use the service and has an open and approachable management style. We saw evidence of regular meetings with both staff and the people who live in the home, in order to ensure they can participate in decisions and have the opportunity to influence the way it is run. We observed a positive atmosphere throughout and saw evidence of friendly relationships that exist between the people who use the service and both staff and management. The self assessment for the service was generally well completed with comments to support the evidence provided, however more details about how it is planning to improve would have been useful. We saw evidence of regular monthly surveys on a range of topics sent out to people with an interest in the home and of action plans Care Homes for Adults (18 – 65 years) Page 7 of 11 developed from these when this was required. The self assessment told us the home has a gold award from the Local Authority Quality Development Scheme and achieved Investors in People status. We saw evidence of regular monthly management reports of the home, which involved consultation and involvement with both people who use the service and staff who work in the home. There was evidence of regular checks of the building and equipment and all of the service records we looked at were up to date and accurately kept to ensure the health, safety and welfare of people who use the service are properly promoted and protected. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18 – 65 years) Page 8 of 11 Are there any outstanding requirements from the last inspection? Yes Outstanding Statutory Requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action No Care Homes for Adults (18 – 65 years) Page 9 of 11 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 The Registered Person should continue develop the support plans belonging to people using the service and monitor the quality and content of the information recorded in daily diary and key worker records to ensure the individual needs of people living in the home are appropriately met. Staff should have accredited training on the safe use and handling of medicines to ensure people using the service are kept safe from potential harm. The Registered person should continue to develop the training programme for staff to ensure they have the right skills to meet the needs of people living in the home and promoting their independence 2 20 3 35 Care Homes for Adults (18 – 65 years) Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. 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