Care Home: Lorne House

Similar services:

• 22 Sandown Road
• The Highlands
• Dilston College Of Further Education
• West View House
• Prince Bishop Court
• Park View (15)
• Craigmore House
• 1 Lanark Close

What the care home does well The home is a friendly place. It is quite small. People know each other well. The staff help people to do the things they want. People think that the staff are kind. They like the manager. They can talk to him if they have a problem. One person said ‘The manager is funny. We have fun when he is on.’ Another person said ‘It’s good living here. I wouldn’t change anything. I am happy.’ People go on holidays to the places they choose. They go out to jobs and to concerts and shows if they want to. The home is clean and comfortable. It has a lovely garden. It is close to the town and buses. People have their own big rooms, with their own things in. What has improved since the last inspection? The home has done all the things that the last inspection report said it must do. The manager finds out all about people’s needs before they move in. Care plans say more about what people need and want. They have pictures and are easy to understand. All staff now talk to their manager regularly about how they do their jobs. Files are tidier and it is easier to find important papers and records. Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 What the care home could do better: The home provides information with pictures and in words that are easy to understand. But it does not yet offer it in other languages. Staff get training at college about the differences between people. They should also get training at work, about how they can make sure they treat everyone fairly and respect the ways that they are different. The records of the training that new staff get should show that they are all told how to keep people safe before they start work. The home asks people who live in the home and their relatives what they think about the service. They fill in surveys. The manager should write a report every year saying what people think and want. The report should say what the home plans to do. Key inspection report CARE HOME ADULTS 18-65 Lorne House 66 Yarm Road Stockton-on-Tees TS18 3PQ Lead Inspector Michaela Griffin Key Unannounced Inspection 17th June 2009 10:00 Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 Page 1 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. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 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. Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) 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 Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lorne House Address 66 Yarm Road Stockton-on-Tees TS18 3PQ 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) 01642 617070 lorne_house@ntlbusiness.com Lorne House Residential Home Trust Limited Mr James Dunbar Leslie Care Home 14 Category(ies) of Learning disability (14) registration, with number of places Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of persons shall not exceed 14 adults with learning disabilities inc 3 with mental and physical disability 13th August 2008 Date of last inspection Brief Description of the Service: Lorne House is registered with the Commission for Social Care Inspection (now the Care Quality Commission) under the Care Standards Act 2000 as a care home providing care and accommodation for 14 adults. The building is a three storey Victorian terraced house, with a large two storey extension providing modern facilities. It is well maintained and provides a pleasant and safe environment for the people who live there. People who use wheelchairs or have mobility problems can move about on the ground floor, where there are bedrooms as well as communal rooms. The home has a pleasant, sheltered, private, back garden with a lawn, flower beds, paths and outside seating. People can also enjoy the garden from a large modern conservatory that overlooks it. The home is on a busy residential street, near to the town centre of Stockton. There is a regular bus service and there are shops and other community facilities within walking distance. There is off street parking at the front. People who live in the home are encouraged to be as independent as they can be and to lead the lifestyles they choose. The weekly fees are from £436 to £1195 (June 2009). Lorne House DS0000000011.V376059.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 – good service. This means the people who use this service experience GOOD quality outcomes. The manager completed and returned an Annual Quality Assurance Assessment (AQAA). The AQAA is the services self-assessment of how they think they are meeting the National Minimum Standards. This information was received before the inspection and was used as part of the inspection process. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the service are not being put at risk of harm. In future, if the requirement is repeated, it is likely that enforcement action will be taken. The inspection took place on one day. It was unannounced, so many of the people who live and work there were out for most of the day. The inspector interviewed the manager and another member of staff. Four people who live in the home talked to her and told her what they think about the service. The inspector also looked around the home and checked paperwork and the files. What the service does well: What has improved since the last inspection? The home has done all the things that the last inspection report said it must do. The manager finds out all about people’s needs before they move in. Care plans say more about what people need and want. They have pictures and are easy to understand. All staff now talk to their manager regularly about how they do their jobs. Files are tidier and it is easier to find important papers and records. Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 Page 6 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Lorne House DS0000000011.V376059.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 Lorne House DS0000000011.V376059.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): We looked at Standards 1 and 2. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The home makes sure it will be able to meet peoples needs before they move in. EVIDENCE: The home provides information about what it offers to help people to make an informed choice. People get the opportunity to ask questions when they visit. The information is provided in easy to read written English, with pictures. The home should offer information in alternative languages (including Braille) as well, for people who can not or do not read English at all and on audio tape. It should also let people know that the information can be provided, on request in other ways. This will let people know that it welcomes, and is ready to include, people who have visual impairments or whose first language is not English. The files of the two people who moved into the home in the last year were examined. They showed that their needs were fully assessed before they moved in. They also had details of how the two people were gradually introduced to the home. They met the other people who live there and spent time with them to see if they would all get on. Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 Page 9 People do not move into this home until they have had a chance to see if they like it and if it can meet their needs and provide the lifestyle they want. One person said ‘I came to see it and I liked it.’ The pre-admission assessment documents should include a section on sexuality, gender identity and significant relationships. This will remind staff that they should not assume than everyone is straight or heterosexual or that each person’s gender identity is the same as the one assigned to them when they were born. Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 Page 10 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): We looked at Standards 6, 7 & 9. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People have care plans outlining what they need and want. People can make choices in their daily lives. People are encouraged to lead full lives, with support to protect them from harm. EVIDENCE: The home has developed person-centred plans. They are based on each person’s assessed needs and also on discussions with them about how they prefer their care and support to be given, their likes and dislikes. The care plans provide clear instructions to staff, they also describe what the individual is like as a person and what is special about him or her. Care plans are produced in a form that is easy to understand with pictures. The files of two people who have lived in the home for some years were checked. They showed that their care plans are reviewed regularly and changes are made, to make sure that they still match their needs and wishes. Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 Page 11 The people who live in this home are involved in all decisions about their care. The home’s person-centred approach helps draw the attention of staff to issues of fairness and diversity. The home provides support in a way intended to meet individual needs and preferences. The home encourages staff to treat people with equal respect and to recognise the differences between them. Each person’s care plan shows how the home encourages her or him to be independent but get the support needed. One person described how staff give him as much help as he needs. ‘They let me look after myself. I only need a bit of help now and then.’ There were copies of assessments carried out by the home, to check if there are any risks for each person in doing the things that they want to. Great care has been taken to respect people’s rights as adults, to let them do what they want, while reducing the risk of harm as much as possible. For example, one person who has seizures prefers not to wear a protective helmet while out and about in the community or at work. His care plan identifies the risks that he could suffer a head injury in a seizure and then describes what can be done to try to prevent this. This plan has been in place for some time and he has not been injured so far and feels more confident about going out to public places. Another person explained that he goes out in the local community by himself and how he knows how to travel safely. ‘I’ve been out to the shops today. I went on the bus because it’s raining.’ All care plans should include information about the sexuality of the individual that is relevant to enabling him or her to lead a full life without being at risk of harm or exploitation. This should not just be dealt when it is identified as a problem. Person-centred plans should have enough information to remind staff that people with learning disabilities should be able to make a choice about whether or not they want to be sexually active and to have intimate personal relationships. They should also remind staff that some people may need support and extra information in order to make a choice and to keep safe, and that some people may not have the capacity to do so. Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 Page 12 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): This is what people staying in this care home experience: We looked at Standards 12, 13, 15, 16 & 17. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People are involved in activities they enjoy, in and outside the home. Service users are encouraged to maintain relationships with their families, friends and neighbours. EVIDENCE: The home has a weekly activity plan and each person has an individual programme of daily activities, in and outside the home. People have very different lifestyles and this shows that the home helps people to lead the lives they choose. Some people follow interests they had before they moved in and some have developed new interests and new skills. Everyone is encouraged to be independent and to make choices. People have the same sort of opportunities as others of the same age to be included in the life of the community. Some people have jobs. One person Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 Page 13 works part time in a café. Another person is involved in a drama group. Individuals talked about the different things they do in their leisure time. The home has its own mini-bus. The staff take small groups on trips to the coast and special events. Some people go to discos every week, in Hartlepool and Billingham. The home has a fund raising committee and this provides each person with an extra allowance to spend on their choice of entertainment. Several people have used this to go to concerts and shows. For example, some have booked to see Mama Mia at Sunderland Empire soon. One person said that he had recently been to see an Elvis impersonator at Billingham Forum. He has also been to the circus. He said ‘It was brilliant. I saw clowns and Chinese acrobats.’ One person said that he likes to go out during the day and on summer evenings, but never when it’s dark. He explained that he spends his time how he wants to. ‘I go out everyday. I keep busy. There’s plenty to do.’ One person described how he spends his time how he chooses and prefers not to have things organised for him every day. He is very independent and often prefers to stay at home and watch television in a lounge by himself, so he is not interrupted by other people while he watches his favourite programmes. The home arranges holidays for small groups. People talked about holidays they had been on with staff, what a good time they had and how they are always asked where they want to go. One said ‘Some of us went to Blackpool last week and some are in Torquay this week. We had a great time.’ The home is on a busy street within walking distance of Stockton town centre and major bus routes. There is also free on-street parking nearby. So that makes it convenient for people to visit. The home ensures that people have as much contact as they want with their families. Visitors are always made welcome and the staff take some people home regularly for visits or overnight stays. And they also help people to speak to relatives who live further away, by phone. One person’s family lives in London. The staff accompany her on the train and leave her with them for a holiday, and then come back and collect her. One person said ‘Sometimes I go to my brother’s. He lives in Stockton. The staff take me.’ Meals are also provided to suit individuals, at the time they want. And they can have drinks or snacks any time between meals. People can eat in the large, pleasant, dining room or take food to their own rooms if they prefer. People said that they like the food. One person said that the home gives him the food he prefers. ‘I don’t like fish. So they give me ham and chicken.’ Another person explained that when he goes out for the day the staff make him packed Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 Page 14 lunches. The home also has barbecues when the weather permits and people said that they like them. Some like to help in the kitchen and to set tables or clear away after meals. Some people are learning to cook. One person said that he is learning to cook because he plans to move into his own home eventually. Another person said he wants to stay in Lorne House but wants to learn how to cook the things he likes. Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): We looked at Standards 18, 19 & 20. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People get the support they need, in the way they prefer and their health care needs are met. Medication is handled safely by trained staff. EVIDENCE: Each individual’s person-centred plan now includes a health action plan. These have been developed with the health coordinator from the local community learning disability team. They give details about every aspect of the person’s health care needs and what action must be taken to meet each one and who must take it. Each person’s file includes records of contact with health practitioners, hospital visits etc and any treatment or advice given. The files also have evidence that the home monitors people’s health and promotes healthy life styles, while respecting individuals’ choices. One person said ‘I am careful what I eat.’ Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 Page 16 Files also have front sheets with basic information that all staff need to be able to find quickly to care for people safely, for example about allergies. The home has policies and procedures for ordering, storing, disposal and safe administration of medication. They are set out as guidelines for staff to follow. These have recently been up-dated to take into account the latest best practice. One of the team leaders takes responsibility for ensuring that medication is stored and administered safely and that staff know how to follow guidelines. All staff receive relevant training and their competency is assessed, to make sure that the training has given them the knowledge and skills they need. The records showed that the medication given out to service users is carefully recorded. The home has developed a protocol, which means step by step instructions, to enable individuals who wish to look after and take their own medication to do so safely. But this has not yet been used, as no-one is managing their own medication yet. The manager said that this is one of the ways he intends to improve the service in the next year and encourage people to be more independent. One person’s care plan showed that a review meeting had agreed with her that she could begin to look after her own medication. But there was nothing on file to explain why his has not yet happened. Individual records should show what progress has been made in achieving agreed goals, or, if none has been made, why not. Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): We looked at Standards 22 & 23. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People are encouraged to express their views about the service and they are confident that they will be taken seriously. The home’s policies and procedures protect people from abuse and harm. EVIDENCE: The home has a complaints policy and procedure. This is clear with an easy to read version with pictures on, for people who do not read written English fluently. It is displayed on the notice board in the entrance to the home. The home surveys relatives regularly and asks them if they know how to make a complaint. The surveys for people who live in the home should also ask them if they know how to complain. The home has not received any complaints in the last year. But it asks people for their views on the service in other ways, for example in regular residents’ meetings. The staff say that they try to sort out problems before they become complaints. People said that they can talk to the manager or their key worker. One person said ‘I would go to see James [the manager] if I had a problem or there was something that I wasn’t happy about.’ The home has a policy and procedure for Safeguarding Adults. This tells staff the signs to look for that someone has been abused. It tells them what to do if Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 Page 18 they are told that someone has been abused or neglected or if they suspect that this has happened or could happen. This information is clear and written in plain language. Staff have had training about how to keep people safe and there is a refresher course scheduled for all staff in July 2009. The home has cooperated with the local authority in investigations into allegations that vulnerable people have been abused. The service shared information appropriately and followed the recommendations made. The home’s recruitment policies and procedures also protect people by ensuring that the home does not employ someone who has something in their backgrounds that could make them unsuitable to work in a care service. The recruitment records of a new member of staff were examined during the inspection. They showed that the procedures had been followed and that the required checks by the Criminal Records Bureau had been carried out and references had been provided by the previous employer. Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): We looked at Standards 24 and 30. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The home provides a safe, clean, comfortable place to live, with communal space and individual rooms that meets people’s needs. EVIDENCE: Lorne House is a three storey Victorian terraced house, with a large two storey extension providing modern facilities. It is well maintained and provides a pleasant and safe environment for the people to live and work in. There are bedrooms on the ground floor that are suitable for people who use wheelchairs or have mobility problems and there is plenty of space for them to move around. The home has three lounges and a dining room, where people can do indoor activities and have meetings, as well as eat together. There are ample bathrooms and toilets and they include adapted, accessible rooms and equipment for people with mobility problems or who need help with personal care. Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 Page 20 The home has a pleasant, sheltered, private, back garden with a lawn, flower beds, paths and outside seating. People can also enjoy the garden from a large modern conservatory, which provides another seating area for smaller groups or people who want to relax in a more peaceful environment. Each person has a large single bedroom individually decorated and furnished. They have their own things around them, like small pieces of furniture, pictures and ornaments, television and music equipment. The people interviewed said they are happy with their rooms. One person said: ‘I’ve got a nice room. It’s big enough for me to do anything I want.’ The home employs a cleaner, handyman and laundry assistant. Other staff share housework tasks and enable people who live in the home to help, if they are able to and want to. It was clean and tidy, when the inspector looked around. One person who took part in the home’s survey wrote that the home is ‘very well-furnished, clean and well-maintained.’ The home has an annual maintenance programme and a programme of improvements. There are plans to refurbish one of the lounges and to develop another kitchen area upstairs, for people to develop their independent living skills. Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): We looked at Standards 32, 34 and 35. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The home employs enough staff and they get the training and support they need to care for people who live in the home. EVIDENCE: The home employs 18 care staff as well as the manager. Their ages range from their early twenties to late fifties. Three of the care staff are men. All the permanent staff are from the majority white British community (like the people who live in the home), but two of the temporary staff are from black and ethnic minority communities. The home has an equality and diversity policy and does not deliberately discriminate against or exclude anyone from applying for a job. This is good because people who use services benefit if individuals who have the skills and personality required for the job are not put off applying. The senior management should review this policy and its working practices regularly to check that it is not unintentionally or indirectly discriminating against any Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 Page 22 individual or section of the community, for example on the grounds of gender, belief or sexuality. Staff should have training on equality and diversity issues, so that they understand and respect the differences between people. They should have the opportunity to discuss how they put the principles into practice and any concerns they have, through supervision and team meetings. The home has an annual training programme, and money has been allocated to fund the courses planned. The training programme is based on the identified needs of the people who live in the home and the interests of the staff. It includes mandatory training, that is the training all staff must have regularly to keep people safe and well, for example on helping people to move about and on the safe handling of medication. Staff are also encouraged to achieve National Vocational Qualifications in Care and are rewarded when they do by pay increases. Most of the staff have already achieved this nationally recognised qualification and all the team leaders have level three, which is higher than the recommended minimum of level two. The home has a structured induction programme for new staff, which is when they get the basic training they need to support people safely. This was not fully recorded in the files of the new employees that were checked during the inspection. The manager must ensure that the responsible team leader keeps clear records of the initial training provided and evidence that the employee has understood the guidance given and agreed to do what is expected. The home has introduced a new system for ensuring that all staff have one to one meetings with their line manager to discuss their work and their support and training needs. They also get annual appraisals of their performance. These supervision meetings are programmed to ensure they happen regularly, at least eight times a year. Records are kept of what is discussed and agreed, to ensure that it is carried out. The way that people who live in the home talked about the staff indicate that they have close relationships with them and are happy with the support they provide. One person said ‘The staff are all nice, they all want to be the best.’ Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 Page 23 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): We looked at Standards 37, 39 and 42. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The home has a suitable manager who knows the service and service users well. The health, safety and welfare of service users are promoted and protected. EVIDENCE: Lorne House was set up in 1995 and is the only service provided by a small local charitable trust. The home was developed through the initiative of a group of parents of people with learning disabilities whose motivation was to protect and promote the interests, rights and welfare of people who use the service. The directors are volunteers and take a personal interest in the people who receive the service. Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 Page 24 The manager has the appropriate qualifications and experience to run this sort of home. He is assisted by an administrator and four team leaders. There have been some major improvements to the service since the last inspection. Some of these were facilitated by an increase in the funding the home receives from Stockton council and the home’s fourteen places are now all occupied. Some were achieved through the cooperation of the manager, staff and directors who reviewed working practices and systems. The home asks people for their views on the service and how it can be improved, through annual surveys and regular meetings. The relatives of people who live in the home are now represented at and have a chance to contribute to the regular meetings of the board of directors, and all are invited to attend the Annual General Meeting. People who live in the home have regular residents’ meetings and the home also brings in the assistance of a local citizen advocacy service, when individuals need support to reach decisions and express their views. Feedback from people who use the service and their families must be brought together and summarised in a report every year. Their views should be addressed in an action plan that describes changes proposed for the following year. This will show people that the home take their views seriously and makes good use of them to improve the service. The home protects service users and staff by having a clear health and safety policy and procedures. The manager carries out regular checks to make sure that these guidelines are followed. Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 Page 25 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 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 4 STAFFING Standard No Score 31 x 32 2 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 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 x 3 x 2 x 3 3 x Version 5.2 Page 26 Lorne House DS0000000011.V376059.R01.S.doc 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. 1. Standard YA32 Regulation 18 Requirement The manager must ensure that the responsible team leader keeps clear records of the initial training provided during the induction of new staff. Records must include evidence that the employee has understood the guidance given and agreed to do what is expected. Feedback from people who use the service and their families must be brought together and summarised in a report every year. Their views should be addressed in an action plan that describes changes proposed for the following year. This will show people that the home take their views seriously and makes good use of them to improve the service. Timescale for action 01/12/09 2. YA39 24 01/07/10 Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 Page 27 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 YA1 Good Practice Recommendations The home should offer information in alternative languages (including Braille), for people who can not or do not read English at all and on audio tape. This will let people know that it welcomes and is ready to include people who have visual impairments or whose first language is not English. The home’s policy on supporting people to manage their own medication should be implemented. Individual records should show what progress has been made in achieving agreed goals, or, if none has been made, why not. The senior management should review its equality policy and its working practices regularly to check that it is not unintentionally or indirectly discriminating against any individual or section of the community, for example on the grounds of gender, belief or sexuality. All staff should also have training on equality and diversity issues. This is so that they can help make sure that they recognise the ways that people are different and treat everyone fairly. They should have the opportunity to discuss how they put the principles into practice and any concerns they have, through supervision and team meetings. 2. YA20 3. YA35 Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 Page 28 Care Quality Commission North Eastern Region Citygate Gallowgate Newcastle upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.northeastern@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 © (2009) 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. Lorne House DS0000000011.V376059.R01.S.doc Version 5.2 Page 29 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!