Care Home: Lorne House

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What the care home does well Information is available about the service and what can be provided to help people and their families to make decisions about their future care needs. People can visit and have short stays to help with these decisions. People are given help and support to make choices in their daily lives. A variety of activities are provided and people can choose to take part if they want to. Lorne House provides opportunities and support for people to maintain their interests and any hobbies they may have. Lorne House looks after people well and writes down what help everyone needs. People are supported in their medical appointments, and staff work well with other professionals and agencies to keep people well at Lorne House. Staff are trained to help them understand how to meet the needs of people who use the service and give them the support they want. Lorne House makes sure that suitable staff are employed and that all checks are made to keep people safe. The management team supports staff working at Lorne House.People are supported to keep in touch with their families and friends. Visitors are made welcome and the atmosphere in the home is relaxed and friendly. People can choose what they want to eat from the healthy and varied menu. Alternative options to the main menu are always provided, and snacks and drinks are available at all times. Surveys show that people are happy with the care that is given by staff at Lorne House. What has improved since the last inspection? Records are now easier to access because out of date information has been taken out of the files. The service now has guidelines to follow for what to do if someone was to die suddenly. Lorne House now has a full staff team. CARE HOME ADULTS 18-65 Lorne House 14 Lorne Street Kidderminster Worcestershire DY10 1SY Lead Inspector Dianne Thompson Key Unannounced Inspection 26th June 2008 09:30 Lorne House DS0000018509.V366535.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 Lorne House DS0000018509.V366535.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. Lorne House DS0000018509.V366535.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lorne House Address 14 Lorne Street Kidderminster Worcestershire DY10 1SY 01562 630522 01562 631074 lornehouse@hotmail.com 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) Mr Gerardo Saporito Mrs Brigida Saporito Mrs Gina Margaret Vaughan Mrs Brigida Saporito Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Lorne House DS0000018509.V366535.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th November 2006 Brief Description of the Service: Lorne House is a care service that provides personal care and accommodation for 9 adults with learning disabilities. Support is provided in a homely setting, enabling people to lead as ordinary lives as possible. The service is located in a quiet residential area that is accessible to the centre of Kidderminster. Kidderminster rail station is a few minutes walk away. The premises consist of two adjoining terraced houses, which have been combined and adapted for their present purpose. All bedrooms are single and have an en suite bath or shower facility. A garden at the rear is mainly used for growing vegetables and fruit. The house opens onto a terrace, which is a pleasant facility in good weather. The business is family owned. The owners live next door and are involved in the day to day running of the service on a full time basis. The owners are referred to in this report as the providers. The current fees for the service are available in the service user guide. Lorne House DS0000018509.V366535.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 stars. This means the people who use this service experience excellent quality outcomes. This was an unannounced inspection visit to see what the service was like for the people who live at Lorne House. Time was spent talking to some of the people who live at Lorne House and some of the staff working there. We looked at some of the records, policies and procedures in the office. We talked to other people to get their views about the service. The manager completed an Annual Quality Assurance Assessment (AQAA) and sent this to the Commission for Social Care Inspection (CSCI). The AQAA is where the manager tells us about the service provided at Lorne House and the ways they plan to make the service better. A tour of the premises was also made. Information gathered from other sources, such as surveys and information sent to the CSCI has been included in this report. What the service does well: Information is available about the service and what can be provided to help people and their families to make decisions about their future care needs. People can visit and have short stays to help with these decisions. People are given help and support to make choices in their daily lives. A variety of activities are provided and people can choose to take part if they want to. Lorne House provides opportunities and support for people to maintain their interests and any hobbies they may have. Lorne House looks after people well and writes down what help everyone needs. People are supported in their medical appointments, and staff work well with other professionals and agencies to keep people well at Lorne House. Staff are trained to help them understand how to meet the needs of people who use the service and give them the support they want. Lorne House makes sure that suitable staff are employed and that all checks are made to keep people safe. The management team supports staff working at Lorne House. Lorne House DS0000018509.V366535.R01.S.doc Version 5.2 Page 6 People are supported to keep in touch with their families and friends. Visitors are made welcome and the atmosphere in the home is relaxed and friendly. People can choose what they want to eat from the healthy and varied menu. Alternative options to the main menu are always provided, and snacks and drinks are available at all times. Surveys show that people are happy with the care that is given by staff at Lorne House. 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. Lorne House DS0000018509.V366535.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 DS0000018509.V366535.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): 2, Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Information is provided to help people and their families decide if the service can meet their future care needs. People are given opportunities to visit and assessments are completed before people move in to make sure that Lorne House is suitable. EVIDENCE: Lorne House has policies and procedures in place to assess potential people to live at the home. Information about the service included in a Statement of Purpose and Service User guide is available for all enquirers and residents. We saw the statement of purpose and discussed with the manager the recent changes that had been made, which included the changed contact details for the Commission for Social Care Inspection (CSCI). The admissions procedure states that full community care assessments are required and in addition Lorne House complete their own assessments. Care plans are written from the information gathered during assessments, visits and discussions with families and other interested parties. The manager says in the AQAA that they ‘hold introductory visits for the client, their next of kin, friends and advocates’. Lorne House DS0000018509.V366535.R01.S.doc Version 5.2 Page 9 Lorne House is now fully occupied. People are given an information pack containing a copy of the statement of purpose and service users guide on admission. The service user guide gives information about the service that people can expect, together with details about the fees, the complaints procedure and a copy of their contract with the service. The assessment for a recent admission to Lorne House was seen. The assessment provided information about likes, dislikes, skills, abilities and interests. Everyone who lives at Lorne House now has a key worker allocated to them and all key workers are encouraged to be involved in the assessment process from introductory visits to focussed support, to the three monthly review and confirmation of placement. Surveys confirmed that information is shared about the service to help people contribute to decisions that involve their relatives. Lorne House DS0000018509.V366535.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Personal and healthcare needs are identified in care plans. These plans provide information to make sure that care and support is provided in a way that people want, and in a way that respects privacy and dignity. The current recording system duplicates information and is confusing. People who use the service are supported to make decisions about their lives and are provided with opportunities to take part in all aspects of life in the home. Risk assessments show how risks are to be reduced and how independence is promoted and maintained. EVIDENCE: We looked at individual files for two people. Information contained in the files is now easier to access as the archiving discussed at the previous inspection has been done. Lorne House DS0000018509.V366535.R01.S.doc Version 5.2 Page 11 We looked at care plans that contained appropriate information about individual needs and how they were to be met. The manager states in the AQAA that they now complete a pen picture of each person to give information about preferred daily routines, likes and dislikes, foods enjoyed and activities people like to do. Each person is allocated a key worker to oversee his or her care. This allows staff to work on a one-to-one basis and contribute to the care planning process for each person. The manager says in the AQAA that ‘key workers have been introduced to enable effective care planning and key worker tracker forms introduced’. Information in care plans cover all aspects of each person including their daily living needs, health and personal care, physical well-being, social interests and relationships, religious and cultural needs and any other specific areas. Details about the ways people communicate are provided. Care plans are available in a range of formats that includes symbols, audiotapes or the written word. Statements are included to explain where people have little or no understanding of the care plan process. Staff complete records with people who use the service to make sure everyone is involved as much as possible in their everyday lives and choices, including the running of the home. Care plans show that regular reviews take place and dates for the next review are planned. We saw that one review took place in September 2007 with the next review planned for December 2008. Information is updated to reflect any changes that have been highlighted particularly in relation to general and health care. All care plans are used as a working document and outcomes agreed with people who use the service are recorded. People using the service also sign their care plans. The service aims to develop a person centred approach to care planning. This was discussed at the previous inspection, and although some improvements have been made to the care plan format the development is hampered by the use of two systems. This means that the recording system is fragmented with the potential for inconsistent recording. This was discussed with the manager who was advised to focus on one system and discontinue the medical based record keeping system. The service is to arrange training for staff so that Person Centred Care Plans (PCP’s) can be developed with everyone who uses the service. This will help to make sure that the service provided is more individually focussed. The Lorne House DS0000018509.V366535.R01.S.doc Version 5.2 Page 12 manager has completed training in the mental capacity act and intends to review how this should be applied to the service as care plans are reviewed and developed. Risk assessments are completed to keep people safe and look at ways to make sure that people are able to be as independent as possible. We saw completed assessments for personal finances and for some activities. Surveys confirm the care and support provided at Lorne House is what they expected or agreed with the service. People who use the service say they are ‘happy living at Lorne House’ and ‘like the staff’. Lorne House DS0000018509.V366535.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are supported and encouraged to take an active part in their choice of activities. Everyone is encouraged and supported to maintain links with their families and to develop friendships. Dietary needs are well catered for with a varied and healthy menu provided. EVIDENCE: People living at Lorne House are encouraged and supported to make choices about activities and daily living with as much control over their lives as they are able. People make choices about how to spend their day and this was observed throughout the inspection visit. We saw people dancing to music, singing along to a karaoke machine, playing games in the conservatory and spending time in the garden. Some people were at day centres and other people were out shopping at the time of the inspection. Lorne House DS0000018509.V366535.R01.S.doc Version 5.2 Page 14 Activity records show that community relations are being developed through using the local shops, pubs, churches, hair dressers, sports centre, and the post office. The manager states in the AQAA that ‘we have a church workshop each month with the parishioners where people sing, make storyboards and celebrate special festivals by creating posters for the church notice boards’. One person says they like doing ‘basketball activities and going to church’ where they do other activities too. The range of activities available includes swimming, bingo, cinema, train rides, hairdressers, and the ‘nite out club’. People are supported to attend work experience opportunities offered by Beacon Employment. Holidays are arranged each year and different options were being considered at the time of the inspection. Some people have been on holiday to Hayling Island. We saw from care records and contact sheets that regular contact with friends and family is being supported. People who use the service are able to see their visitors in private, and surveys confirmed that they are made welcome. The service provides meals that are varied and nutritious, with alternative options available where preferred. Snacks and drinks are available throughout the day. People are consulted about their choice of food and diets. The manager states in the AQAA that ‘clients choose a weekly menu together and alternatives are offered if the meal is not to their taste’. ‘We encourage clients to be as actively involved with meal planning, purchasing, preparation and cooking’. People were observed making sandwiches for lunch during the inspection visit. Lorne House DS0000018509.V366535.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Individual health and personal care needs are being well met by the staff at Lorne House. Care plans are completed and reviewed regularly. This makes sure that staff have the information they need to provide consistent support. Lorne House has a medication policy and procedure for staff to follow to ensure that all medication is administered and stored safely for the protection of everyone who uses the service. The policy needs to be developed to include guidelines for administering prescribed medication as required. EVIDENCE: Everyone who lives at Lorne House has a care plan for their personal and health care needs and the ways they prefer their support to be given. Records show that regular checks and monitoring are carried out. Information is given about health diagnoses to help staff develop their knowledge and understanding about various conditions. Lorne House DS0000018509.V366535.R01.S.doc Version 5.2 Page 16 Admission assessments include a record of people’s weight at the time they moved into Lorne House. We saw from records that any changes in support are communicated through daily records and care plan reviews. Health and medication reviews are held annually or as changes occur. People have good access to medical support and include chiropodist, opticians, occupational therapist, dentist and doctors. Guidelines show how people prefer to be supported in accessing health care facilities and a record of visits to the doctors or other medical professionals is maintained. A record of routine treatment given by the chiropodist was seen. The manager states in the AQAA that ‘all clients are supported with health care appointments and reviews. Clients are kept informed of medication changes as a result of a review and the options available to them’. We saw that there is a clear audit trail where concerns have been identified. One care plan showed that a concern had been raised, the action that was taken and the outcome, such as an improvement to the individual’s health was recorded. Staff were seen to support people in a respectful way, making sure that dignity and self-esteem was important for each person. Although communication with people who use the service for visitors may be difficult, people appeared to be comfortable and at ease in their surroundings. Surveys confirm that staff look after people well and with respect. A policy and procedure is in place for the administration of medication. The manager is advised that a protocol is needed to guide staff when administering medication that is taken ‘as required’. Guidelines should include such information as when this medication is to be administered, how long for, and at what stage should further action be taken? All staff that are involved in the administration of medication receive accredited training that includes basic knowledge of how medicines are used and how to recognise and deal with problems that may occur. Medication is stored securely and given to people at the right time and full records are kept which show this. Medication information in care plans give details of current prescribed medication and include a risk assessment that describes possible side effects for each medication. The manager continues to develop a record of people’s wishes in the event of their death. The service now has a procedure with a flow chart for staff to follow in the event a sudden death occurs. Lorne House DS0000018509.V366535.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People have access to easy to understand information about how to complain and staff support people to express their views and any concerns they may have. There are suitable procedures in place for the management of complaints and to make sure that people who use the service are protected from abuse. EVIDENCE: Lorne House has a complaints policy and procedure in place which is made accessible to people who live at the home and their relatives. Staff support people should they wish to make a complaint. Survey responses show that people are aware of the complaints procedure and that no complaints have been made. The manager confirms in the AQAA that no complaints have been made to the service. The CSCI has not received any complaints about Lorne House. The service has a complaints book that records both compliments and any complaints that are made. Procedures are in place to guide responses to any allegations of abuse and how any complaints made about the service are managed. There are specific policies and procedures for the protection of vulnerable adults from abuse and ‘whistle blowing’ for staff. The manager said that staff ‘could do with more staff training’ in the protection of vulnerable adults and is looking for suitable training courses. A flow chart giving guidelines for staff to follow in the event of any allegation of abuse in the manager’s absence is to be produced. Lorne House DS0000018509.V366535.R01.S.doc Version 5.2 Page 18 People who use the service are supported in the management of their finances. We saw records where people have opened a post office bank account and successfully manage their own money. Lorne House DS0000018509.V366535.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live at Lorne House enjoy a comfortable and homely living environment. The home is spacious and is kept clean and well maintained. EVIDENCE: Lorne House is in a residential area of Kidderminster with access to shops, leisure centres and GP surgery locally. The service is provided in a three storey terraced house, with an enclosed garden to the rear. The property was originally two separate houses and has been combined to form one fully integrated house. Three of the bedrooms are on the ground floor and are easily accessed by people with mobility difficulties. The bedrooms are homely, spacious, and individually decorated and furnished. All bedrooms have en-suite facilities. Notices are displayed in all rooms written in signs and symbols to give information such as evacuation procedures in the event of a fire. Lorne House DS0000018509.V366535.R01.S.doc Version 5.2 Page 20 There are toilets and bathroom facilities on all floors, with separate laundry and kitchen facilities. The communal areas of the home are comfortable and well furnished, with adequate space for privacy or individual activities. There are two conservatories, one leading on from the other. People share their home with a dog, a cat and some rabbits. Lorne House is accessible, comfortable and provides a homely environment for the people who live there. A tour of the home was provide by one of the people living at Lorne House, and included all communal areas and the individual’s bedroom. We saw that rooms are very individually decorated and furnished. People confirmed their choices of décor in their rooms during the tour of the building. Lorne House is clean and tidy throughout. Policies and procedures for infection control are in place and staff are provided with disposable gloves and aprons. All cleaning materials are locked in the laundry room. Training records show that staff are trained in procedures for the control of infection and health and safety matters. The manager said that a schedule for routine maintenance and upkeep of the building is to be implemented. Lorne House DS0000018509.V366535.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. There are sufficient staff on duty with the right skills and knowledge to meet the needs of people who live at Lorne House. Staff are well supported and work together to provide consistent and good quality care. Staff receive relevant training to help them meet the needs of people who use the service. Recruitment policy and practices make sure that suitable staff are employed. All necessary checks are made to make sure that everyone living at Lorne House is kept safe. EVIDENCE: Lorne House has a committed and stable staff team and is now fully staffed. People commented in surveys that they were generally satisfied with the service and the staff. ‘Staff appear to be enthusiastic and well motivated’. Lorne House operates a recruitment policy and procedure where everyone is required to complete an appropriate application form. The service makes sure that suitable references are obtained including one from most recent employers. Appropriate criminal records and other checks are undertaken Lorne House DS0000018509.V366535.R01.S.doc Version 5.2 Page 22 before appointments are confirmed. All staff are required to work a probationary period. Staff records were examined for three people and all required information was seen including references and proof of identity. All staff now have their own folders with training records, supervision notes and include copies of individual training certificates. Files are numbered for ease of access and stored in the new cupboard that has been installed in the office. Copies of policies and procedures are included in individual files and staff sign and date to say they have read these. The storage of staff records was discussed with manager. The current arrangements give staff access to their personal files at all times, but does not protect confidentiality. The manager said that the storage and access arrangements would be changed to make sure confidentiality is maintained at all times. The induction programme includes an evaluation of understanding of the policies and procedures for people who have not yet started NVQ training. The induction programme includes pre-arranged dates for staff supervision sessions. Staff complete mandatory training such as infection control, health and safety, and fire safety. A record is maintained with dates of planned refresher courses identified on the training matrix. Training records confirm that six out of the team of seven staff has an NVQ qualification and the seventh person is currently completing their induction programme. Training planned for 2008 includes equality and diversity, manual handling, food hygiene, first aid, medication, infection control, and Person Centred Planning. Staff team meetings are held although the manager states in the AQAA that the service ‘could do with more frequent staff meetings’. Survey responses to staff training and skills included ‘staff are all very friendly’, and ‘treat everyone with dignity and respect’. Lorne House DS0000018509.V366535.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The service is well managed and staff receive the leadership and support they need. Health and safety procedures are in place to make sure that people are kept safe. EVIDENCE: The manager Gina Vaughan has many years experience working with people with learning disabilities. Gina is qualified to NVQ level 4, and has successfully completed her Registered Managers’ Award (RMA). Gina regularly completes training relevant to her position as registered manager of Lorne House. The manager said that the service operates ‘a positive and inclusive approach’. Surveys confirm that people are made welcome and are able to talk to the manager and staff at any time. Lorne House DS0000018509.V366535.R01.S.doc Version 5.2 Page 24 The Annual Quality Assurance Assessment (AQAA) was completed and submitted to the CSCI prior to the inspection visit. The AQAA is where the manager tells us about the service provided at Lorne House and the ways they plan to improve the service. The AQAA was informative and the manager was advised that this could be improved in the future by providing more detailed evidence about the service that is provided at Lorne House. Work continues to be done towards establishing a system that checks on the quality of the service being provided at Lorne House. The manager has compiled a portfolio for reviewing policies and procedures and intends to work through these as part of the service audit. The manager was advised to produce a summary of the findings that is completed each year. From this evaluation an action plan for the coming year should be developed. Records show that monthly checks of the fire safety system and equipment, water temperature and storage, fridge, freezers and electrical appliances are completed. Staff are undertaking all mandatory health and safety training topics. Generic risk assessments are in place. The manager states in the AQAA that ‘we promote health and safety by carrying out checks on fire safety equipment, drills and evacuations’. Fire records were checked and show that fire drills have been completed for new staff and residents. Fire drills were recorded in February and April 2008. Fire equipment was inspected 13/2/08. Generic risk assessments are carried out to ensure safe working practices. The records relating to accidents were seen. These are completed in full and are accurately maintained. The manager states in the AQAA that ‘we have policies and procedures to keep clients and staff safe’. The infection control policy was seen and some amendments are needed. This was discussed with the manager, as the policy contained references to ‘patients’ and ‘old people’ and the use of abbreviations such as ‘CCDC’ or ‘CICN’. It is not clear that staff will understand what these abbreviations mean. Surveys confirmed that people felt there was ‘no need for improvements’, their relative ‘is very happy so am I’. One relative commented on how well and how quickly their relative had settled into Lorne House. Lorne House DS0000018509.V366535.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 X 2 4 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 4 25 X 26 X 27 X 28 X 29 X 30 4 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 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 4 X 3 X X 3 X Lorne House DS0000018509.V366535.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard YA6 YA9 YA18 YA20 YA42 Good Practice Recommendations A more person centred approach to care planning should be developed. One recording system should be used so people are not at risk of becoming confused by a dual system. Staff should be trained in Person Centred Planning (PCP’s) to help develop a more person centred approach to the service at Lorne House. Guidelines should be developed for staff to follow when giving people medicine that is not needed all the time. The infection control policy should be amended to make sure it refers to the service provided at Lorne House. Lorne House DS0000018509.V366535.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Lorne House DS0000018509.V366535.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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