Care Home: Link House

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What the care home does well The home provides a comfortable, safe and homely environment for people to live in. The care home is very well managed. Residents have detailed care plans, which enables staff to know how residents needs are to be met. Staff, are well trained and supported by the registered manager and have a sound knowledge of residents needs. The staff team work well together and have established a good working relationship with the community health care teams and local GPs. What has improved since the last inspection? The home has addressed all of the issues raised at the last inspection. Care plans and assessments now meet the Care Home Regulations, which ensures residents needs have been identified and are being met. The activities programmes have been reviewed to ensure residents have choice of activities. The acting manager has successfully completed an application to become the home`s registered manager. Risk assessments have been reviewed and improved. What the care home could do better: The home must continue to ensure the care home regulations are met. CARE HOME ADULTS 18-65 Link House Main Road Withern Alford Lincolnshire LN13 0NB Lead Inspector Ken Hague Unannounced Inspection 3rd January 2008 09:30 Link House DS0000002378.V355620.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 Link House DS0000002378.V355620.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. Link House DS0000002378.V355620.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Link House Address Main Road Withern Alford Lincolnshire LN13 0NB 01507 450403 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) Boulevard Care Ms Lana Wren Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Link House DS0000002378.V355620.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th October 2006 Brief Description of the Service: Link House is situated in the village of Withern, which is between the market town of Louth and the coastal resort of Mablethorpe. The village has a post office, general store and public house. Recreational facilities are accessed, via public transport, or booking the providers mini bus and are mainly in the nearby towns of Louth, Skegness and Mablethorpe. Service users choose from a programme of leisure and learning opportunities, which are supported by the home staff. The home is registered to accommodate up to eight service users with learning disabilities, who require personal care. The fees are £750.00 - 1250.00 per week depending on the assessed needs of each client. Additional charges are made for services such as chiropody, hairdressing and toiletries. Information about these costs as well as the dayto-day operation of the home, including a copy of the last inspection report, can be found in the home statement of purpose and service user guide. These documents are made available to all new potential residents and explain the resources and services offered, by the care home. A dedicated intermediate care service is not provided by the home. Link House DS0000002378.V355620.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The inspection took place over 4 hours. The registered manager was present throughout the inspection. Feedback was given at the conclusion of the site visit. The main method of inspection used was called ‘case tracking’ which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them and the staff, and where more appropriate observation of interaction between staff and residents and related care practices. A sample of care records was inspected. Two members of staff were interviewed and the opinions of four residents were sought. An (AQAA) Annual quality assurance assessment was completed by the care home and sent to the Commission for Social Care Inspection prior to the site visit. This is a selfassessment document completed by the providers of the care home. It sets out evidence from the provider to demonstrate that they are meeting the Care Home Regulations. It is normal procedure to obtain written feedback from residents prior to the site visit using a document called “have your say”. This document sets out a number of questions for residents to answer. In the case of this key inspection it was not possible to send out these documents within set timescales. Four residents completed these documents during the site visit. The opinions of the residents were also sought however during discussions held at the site visit. These views are reflected within this report. What the service does well: The home provides a comfortable, safe and homely environment for people to live in. The care home is very well managed. Residents have detailed care plans, which enables staff to know how residents needs are to be met. Staff, are well trained and supported by the registered manager and have a sound knowledge of residents needs. The staff team work well together and have established a good working relationship with the community health care teams and local GPs. Link House DS0000002378.V355620.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Link House DS0000002378.V355620.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 Link House DS0000002378.V355620.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): Standard 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are procedures in place which are used for the assessment of new residents to the service. This ensures that all of their personal care needs, health care and social needs are met. EVIDENCE: Three individual resident’s files were examined as part of the case tracking process. They all contained a full assessment including a risk assessment for each individual resident completed prior to the resident entering the care home. Any risk identified for an individual resident was transferred onto their care plan and a risk management assessment plan was put in place.The assessments sets out the care needs, social needs and health needs of each individual resident. The registered manager confirmed that residents are involved in the completion of care plans and in the review of their care plans. Signatures on the care plan support this statement . Staff also confirmed that residents are involved in the review of their care plans. Link House DS0000002378.V355620.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans identify all areas of need and provide detailed care instructions for staff; this enables staff to provide appropriate care. Residents’ health needs will be met. Residents privicy and dignity is respected by staff. EVIDENCE: Three resident’s care records were studied each had a comprehensive care plan on their individual file. These were signed and dated by both resident and the assessor. Care plans included the dietary needs of each resident. Their likes and dislikes in respect of food. Social life opportunities have been discussed with each resident their choices of activities are recorded. There was a comprehensive risk assessment, which identified any potential risk to the resident in each care record. Where a risk had been identified the management of that risk was transferred onto their care plan. Care plans were being reviewed with the resident in line with National Guidelines. Link House DS0000002378.V355620.R01.S.doc Version 5.2 Page 10 Three files of residents being case track all contained the health care needs of each resident. Care Records provided evidence of visits by community Healthcare visitors including general practitioners. Chiropody and opticians services are provided. Quality assurance documents supplied by the care home substantiated that residents were happy with the health care services provided to them. Staff are trained in the administration and storage of medication. Medication records are being completed in accordance with the national guidelines. Drugs are being stored correctly. Staff and the registered manager stated that resident’s can self medicate if they wish and a risk assessment confirms this would be safe practice. The last pharmacy report stated no problems were identified. A detail multi- agency action plan is in place to help a resident who at time will not take his medication. The registered manager confirms in the Annual Quality Assurance assessment (AQAA) that it is an expectation that “ Residents dignity and privacy is always respected. Residents spoken to at the site visit confirmed staff do treat them with courtesy and respect. Observations made on the day supported the statement. The evidence from the returned “have your say documents is that residents feel their dignity and privacy is being respected. Link House DS0000002378.V355620.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): Standard 12,13,15,16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A range of activities are provided for residents which enables them to have an active and interesting social life. The home’s menu offer choices and meets the dietory needs of residents. EVIDENCE: Activities offered to residents are set out in the AQAA. Residents stated in the “have your say” document that they are happy with the range of activities offered. The registered manager stated the choices the wishes of the residents regarding their social life are identified at the initial assessment. She described the range of activities, which are made available for residents to participate in. Residents are involved in the planning of activities. Daily games/activities are posted on the notice board and staff provide residents with the details of the activity of the day. Residents attend local community events such as plays and pantomimes in the Skegness area. Resident stated that they do go out to local restaurants for Link House DS0000002378.V355620.R01.S.doc Version 5.2 Page 12 meals. Entertainers visit the home weekly. Trips to places of interest are organised on a monthly basis of using the community minibus. Residents are assisted to attend local religious services. The registered manager supplied a copy of the menu, which demonstrated choices. Link House DS0000002378.V355620.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): Standards 18,19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s health care needs are met in the way they personally choose to receive help. The update medication policy of the care home is being followed ensuring that medication is administered safely. EVIDENCE: Staff have an in-depth knowledge of the residents needs. This was evidenced in staff discussions and discussions with the registered manager. Staff stated that making sure that resident’s needs are met in the manner and choice of the individual resident is given high importance. Staff said that emotional support is very important to many of the resident staying at the care home. It is therefore important for us to understand them as individuals. A discussion was held with a resident who stated he was very satisfied with the support he received. He stated “staff help me with my room and do make sure I can take part in activities. I like the outings the home provides. I like staying here.” Observations made during the site visit supported the fact that residents are treated with privacy, respect and dignity. Link House DS0000002378.V355620.R01.S.doc Version 5.2 Page 14 Staff and the registered manager confirmed that the medication policy of the care home is been followed. Staff discussions and the inspection of records supported the statement. One resident had problems agreeing to take his medication. Care records gave details of the management of his medication to ensure his health care needs are met. Link House DS0000002378.V355620.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): Standards 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from updated comprehensive complaints and adult protection procedures EVIDENCE: Residents confirmed that they have a copy of the complaints procedure and are able to raise concerns using this procedure at residents meetings. A copy of the complaints procedure is in the service users guide. The complaints procedure is displayed in the care home. Staff demonstrated knowledge of the complaints procedure and stated that in their opinion residents are able to raise concerns particularly through the residents meetings. No adult protection inquiries have been held or formal complaints received by the home since the last key inspection. Link House DS0000002378.V355620.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): Standards 24 & 30 Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. Residents live in a clean well maintained care home, which provides them with safe comfortable accommodation. EVIDENCE: The home has an ongoing maintenance program and improvement to the home have been made since the last key inspection. This includes the refurbishment of the Lounge. Two residents expressed their satisfaction with the environment of the care home and their own individual bedrooms. Three residents asked the inspector to look at their rooms to see how they had been personalised by the individual resident. Residents are enabled to look after their own bedroom with the assistance and support of the staff. A resident said “I find my room very comfortable”. There were no health and safety issues identify during the site visit. Link House DS0000002378.V355620.R01.S.doc Version 5.2 Page 17 The exterior of the care home is well maintained car parks and garden areas are very presentable. Residents can sit out in the garden area in the summer months. The home is furnished to a high standard. Link House DS0000002378.V355620.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): Standards 32,34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by well-trained staff, who has been recruited safely using the up-to-date recruitment policy of the care home. EVIDENCE: Staff stated that in their opinion there are always sufficient staff on duty to meet the needs of residents, included the night time period. Staff confirmed that they have been provided with training opportunities since the last key inspection include some specialised courses. These statement was supported by the training plan and training records of the care home. There was evidence of all new care staff being given inductions. On the day of the site visit 50 of care staff held an NVQ 2 or equivalent. One member of staff is currently talking an NVQ level 2 courses. The inspection of a recruitment records for one member of staff provided evidence that the homes recruitment policy is being consistently followed. All of the documents required by the care home regulations had been obtained prior to any member of staff commencing employment. Link House DS0000002378.V355620.R01.S.doc Version 5.2 Page 19 The residents stated that they feel safe living the care home. One resident stated “I can rely on staff to help me whenever I have a problem.” Staff stated the home is a safe environment in which to work. There were no health and safety or infection control issues identified during the site visit. Link House DS0000002378.V355620.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): Standards 37,39 & 42 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. There is Positive leadership; guidance and direction to staff to ensure residents receive consistent quality care. Staff are being adequately supervised. Working practices promote the health and safety of residents. EVIDENCE: There is a registered manager in post who obtained the registered managers award since the last inspection. Staff and residents stated that she is very approachable and supportive. Staff stated she is committed to ensuring services provided by the home are of a good quality. Residents stated that the home is run in their best interest. The registered manager demonstrated throughout the day of the site visit a sound knowledge of the care home regulations and the commitment to ensuring quality care is provided by the home. Link House DS0000002378.V355620.R01.S.doc Version 5.2 Page 21 There are updated policies and procedures in place, which ensure the financial interest of all resident’s are safeguarded. The home only manages the personal allowance for some residents. Records are kept to demonstrate that the homes policy is being followed. No health and safety issues were identified at the site visit. Link House DS0000002378.V355620.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 X 2 3 3 3 4 X 5 x 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 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 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 Link House DS0000002378.V355620.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. Refer to Standard Good Practice Recommendations Link House DS0000002378.V355620.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Link House DS0000002378.V355620.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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