Care Home: The Lady Verdin Trust Ltd - Claremont

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What the care home does well Comprehensive information about people living in the home is available to staff so that they can ensure the care needs are being met. The information on each person`s care needs is kept in five separate files so they receive all the care that they need and staff know what to do to meet those care needs. Staff communicate well with relatives and healthcare professionals to ensure the needs of the people who live in the home are identified and met. The care needs of the people who live at the home are monitored regularly to make sure the care they are getting is still effective. The complaints procedure for the home is readily available for the people who live there, their relatives and others, so they can be confident their concerns and complaints will be listened to. Staff receive good leadership and direction to help them make sure that the needs of the people who live at the home are met in the way they prefer. The home, and particularly the garden to the rear of the home, is well maintained so that people who live there are in safe, comfortable and clean surroundings.The Lady Verdin Trust has provided a range of policies and procedures so that staff have the guidance they need to make sure that the people who live at the home stay safe and well. The daily options scheme, run by the Trust, gives the people who live in the home extra staff support so they can access community facilities and take part in their preferred activities. What has improved since the last inspection? The improvement to the way information on the care needs of each person who lives in the house is kept will help ensure staff are aware of how these needs are to be met. The work carried out on the garden at the rear of the home has greatly improved the choice of communal space available to the people who live in the home. CARE HOME ADULTS 18-65 The Lady Verdin Trust Ltd - Claremont Claremont 115 / 117 Valley Road Wistaston Crewe Cheshire CW2 8LL Lead Inspector Mr Val Flannery Unannounced Inspection 11 June 2008 09:00 DS0000006556.V362803.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 DS0000006556.V362803.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. DS0000006556.V362803.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Lady Verdin Trust Ltd - Claremont Address 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) Claremont 115 / 117 Valley Road Wistaston Crewe Cheshire CW2 8LL 01270 256700 01270 256900 www.ladyverdintrust.org.uk The Lady Verdin Trust Limited Susan Hilda Darken Care Home 4 Category(ies) of Learning disability (4) registration, with number of places DS0000006556.V362803.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1 This home is registered for a maximum of 4 service users in the category of LD (Learning disability) 8 June 2006 Date of last inspection Brief Description of the Service: Claremont (115/117 Valley Road) was originally two separate semi detached bungalows. The two bungalows were converted to provide a four-bed home for adults with a learning disability. Located in a residential area of Crewe the home is within easy reach of shops, pub and other local facilities and is on a bus route to the town centre. All the bedrooms are single and contain hand-washing facilities. Two toilets, one bath with a lifting aid and one shower are provided for the people living in the home. For those with mobility problems a walking frame, Zimmer frame and wheel chairs are provided. Communal space consists of one large lounge that opens onto the rear garden, one small lounge and a sensory environment room. The dining room is situated in the large kitchen. A secure landscaped garden is located to the rear of the home. Staff are on duty twenty-four hours a day to deliver care to the people that live there. Information on fees and other charges can be obtained from the manager. DS0000006556.V362803.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. This unannounced visit took place on the 11 June 2008. The visit lasted 4 hours in total and was carried out by one inspector. Feedback about the findings of the visit was given to the managers on 16 June 2008. The visit was just one part of the inspection. Before then the manager was asked to complete a questionnaire to provide up to date information about the service offered by the home. Other information received by CSCI since the home was last visited was also reviewed. During the visit various records and the premises were looked at. People who live in the home were spoken with. Staff were also spoken with during the visit and they gave their views about the service. These are included throughout the report. What the service does well: Comprehensive information about people living in the home is available to staff so that they can ensure the care needs are being met. The information on each person’s care needs is kept in five separate files so they receive all the care that they need and staff know what to do to meet those care needs. Staff communicate well with relatives and healthcare professionals to ensure the needs of the people who live in the home are identified and met. The care needs of the people who live at the home are monitored regularly to make sure the care they are getting is still effective. The complaints procedure for the home is readily available for the people who live there, their relatives and others, so they can be confident their concerns and complaints will be listened to. Staff receive good leadership and direction to help them make sure that the needs of the people who live at the home are met in the way they prefer. The home, and particularly the garden to the rear of the home, is well maintained so that people who live there are in safe, comfortable and clean surroundings. DS0000006556.V362803.R01.S.doc Version 5.2 Page 6 The Lady Verdin Trust has provided a range of policies and procedures so that staff have the guidance they need to make sure that the people who live at the home stay safe and well. The daily options scheme, run by the Trust, gives the people who live in the home extra staff support so they can access community facilities and take part in their preferred activities. 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. DS0000006556.V362803.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 DS0000006556.V362803.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 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. Information about the service is available so that people who may wish to live in the home can see how their needs would be met there. EVIDENCE: The three people currently living in the home have lived there for a number of years. During our visit records were seen for the last person who moved into the home. These showed that comprehensive information about the person, their background and current needs are available. Also included were assessments and other information from the placing authority (Social Services) and from healthcare professionals. Staff spoken with said it is the policy of the Trust that people who may wish to live in the home are able to visit for meals, overnight stays and to meet the other people living there and the staff. DS0000006556.V362803.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): 6, 7 and 9 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. Personal development plans used in the home reflect the actual care that needs to be provided for people so their needs are being be met. Staff are aware of the abilities of the people that live in the home so they can support them to be as independent as possible. EVIDENCE: The care records for one of the people who live in the home were seen during the inspection. The five files set out the Personal Development Plans for that person and contained a comprehensive range of information including their care needs and how these are to be met, how they communicate with others, how their finances are managed, the involvement of healthcare and other professionals and their weekly activity programme. The plans also contained risk assessments to ensure the safety of the person in the home and when out in the local community. Also seen during the inspection visit was a booklet called a Communication Passport. This DS0000006556.V362803.R01.S.doc Version 5.2 Page 10 contained a range of important information about the person and would accompany them if, for example, they had to go to hospital. A photograph of the person and their key worker is included in the Passport. Copies of reviews of the Personal Development Plans are kept on file. These showed that the person, their family and staff are involved in reviewing the care provided. Records of reviews carried out by the placing authority were also seen. During our visit staff were seen support the person with personal care and also encouraging them to make decision about where they wished to spend their leisure time. Although the people living in the home have restricted communication abilities, they were seen approaching staff requesting a drink, food and support with a board game. Staff spoken with during the inspection said they are aware of the care needs of the people who live in the home and know their individual ways of asking for help. DS0000006556.V362803.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): 12, 13, 14, 15, 16 and 17 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. The routines within the home allow for the people living there to have individual choices and wishes so they are able to exercise control over their lives. EVIDENCE: The home is in a residential area of Crewe and the appearance of the home is in keeping with the local community. Staff spoken with during the visit said they do not have any problems with the neighbours and are seen as part of the neighbourhood. The people who live in the home are supported by staff to visit local shops and other community facilities such as day care centres, drop in centres and leisure activities such as pubs, restaurants and discos. Each person who lives in the home has a weekly plan that sets out his or her preferred choice with regard to activities. The personal records seen during the visit showed that DS0000006556.V362803.R01.S.doc Version 5.2 Page 12 families and friends are able to visit the home and be involved in the lives of the people living there. Staff spoken with said there is no restriction on relatives and friends visiting the home. The daily routines for the people living in the home are governed by their planned activities. For example, on the day of our visit, one of the people was going to a day care centre, so staff gave support to make sure they were ready when the transport arrived. Another person was taking part in homebased activities that day, so was able to stay in bed until they chose to get up. The record of food offered to the people who live in the home was seen during the visit. Staff were also spoken with about menus and how the dietary needs of the people who live in the home are identified and met. The records showed that the individual likes and dislikes are identified and that every effort is made to ensure they are offered food they like. One of the people living in the home is on a weight loss programme. Evidence was seen to show that healthcare professionals have been contacted for advice and guidance on how best to set up that programme. Another person receives meals via a PEG feed, where meals are given directly to the stomach by tube. Staff said they received training from a qualified nurse on how to carry out this procedure properly. They also said they receive visits from representatives of the company that supplies the food supplements who offer them advice and guidance on PEG. DS0000006556.V362803.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): 18, 19 and 20 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. Care plans reflect the actual care that needs to be provided for people who live in the home, so their needs are being met. Staff maintain the dignity of the people who live in the home so they are being treated with respect. EVIDENCE: During our visit, the three people who live in the home were seen receiving support with personal care from the staff. This included dressing, using the bathroom, having their breakfast and preparing for their daily activity. The support was offered in a sensitive, caring manner that respected people’s dignity and privacy. For example, assistance with dressing and using the bathroom was carried out in the privacy of the bedrooms and bathrooms. The daily routines for the people who live in the home are dependent on their planned activities. One of the people was staying in the home that day so was able to have a lie in. On the day of our visit the people who live in the home could have received assistance with their personal care needs from a member of staff from the same gender. DS0000006556.V362803.R01.S.doc Version 5.2 Page 14 The records of the health care needs for one of the people who live in the home were seen during the visit. One of the five care files for that person contains comprehensive details on their healthcare needs and how these are to be met. This included input from doctors, nurses, psychotherapist, hospitals and other specialists involved in caring for that person. A record of the medication administered by staff was seen and was satisfactory. Staff spoken with during the visit said they receive training on medication as part of their induction and also receive refresher training from the Trust’s training manager. The person’s records seen during the visit showed that their medication and healthcare needs are regularly reviewed by health care professionals. DS0000006556.V362803.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): 22 and 23 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. There is evidence that complaints are dealt with adequately so people’s concerns are being listened to. Staff understand about safeguarding adults so people who live in the home are protected from harm and abuse. EVIDENCE: A copy of the Trust’s complaints procedure is kept in the home and includes details on how to contact the Commission for Social Care Inspection. The record of complaints showed that the home had received one complaint from the family of one of the people living there. This was dealt with satisfactorily by the home. A copy of Trust’s adult protection procedure is kept in the home. The manager said that no adult protection referrals have been made under the Safeguarding Adults procedures. The records showed that staff, including the manager, had received training on the ‘care protection and well being of all individuals’. A copy of ‘No Secrets’, the guidance on safeguarding adults from abuse, is kept in the home. The staff spoken with during the inspection said they would refer any complaints or concerns about the well-being of the people who live in the home to the senior member of staff on duty. DS0000006556.V362803.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): 24, 25, 27, 29 and 30 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. The environment, including the garden to the rear of the home, is very well maintained so that people live in safe, clean and warm surroundings EVIDENCE: During our visit a tour of the building was carried out. The areas seen included two residents’ bedrooms, the large communal lounge, small lounge and kitchen/dining room plus the garden to the rear of the home. Also seen were the bathroom, shower area and toilets. These areas were clean, comfortable and provided a safe environment for residents. The people who live in the home were seen moving freely between their bedrooms and the communal areas. Bedrooms were individually decorated and furnished and contained residents’ personal possessions. The bathing and toilet facilities contain lifting and mobility aids for the people who live in the home. On the day of the inspection the home was bright and free from unpleasant smells. DS0000006556.V362803.R01.S.doc Version 5.2 Page 17 The improvements to sections of the garden to the rear of the home has greatly enhanced this area so it now provides a pleasant, well laid out area for the people living in the home to use. It contains a water feature and resting areas. DS0000006556.V362803.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): 31, 32, 34, 35 and 36 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. Staff are aware of what’s expected from them in their role as carers so this helps ensure they are aware of how the care needs of the people who live in the home are to be met. EVIDENCE: During the inspection staff were seen caring for and supporting the people living in the home. It was evident that the staff were aware of the care needs of the people, how they communicated and their capabilities. The two staff spoken with said they are made aware of their roles and responsibilities and are aware of the policies and procedures of the Trust. The rota seen showed that there are normally two staff on duty, one of whom can be from the Trust’s daily options scheme. A member of staff sleeps in the home overnight to provide support and care to the people living there. The information we were sent by the manager before our visit showed that staff are expected to complete the Trust’s in-house induction programme and also have the opportunity to do NVQ training. DS0000006556.V362803.R01.S.doc Version 5.2 Page 19 A list of training carried out by staff from the home was provided. This included: moving/handling; medication; safeguarding vulnerable adults; food hygiene; First Aid and fire safety awareness. The Trust has policies and procedures in place on staff recruitment that includes Criminal Record Bureau checks, two references, formal interviews and probationary periods for new staff. This is to make sure that the staff are suitable to provide care for the people who live in the home. A record was seen that showed staff meetings are held and that staff are asked to contribute agenda items. Staff spoken with said they receive supervision and support from the home managers and other managers in the Trust. One of the staff on duty finished at 10am and went to the Trust’s main office for one to one supervision with their line manager. DS0000006556.V362803.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): 37, 39 and 42 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. Staff are receiving guidance to ensure they have the necessary skills to support the people living in the home live their lives as they wish. The home is well managed so it is being run in the best interests of the people who live there EVIDENCE: The current manager for the home has the required qualifications and experience to run the home. She also attends training sessions run by the Trust’s training section. These include Personal Development Plans, Challenging Behaviour and Communication, Assertiveness and Teamwork. DS0000006556.V362803.R01.S.doc Version 5.2 Page 21 Because of changes to the management structure within the Trust the current manager is moving to another post within the Trust and she is to be replaced by a manager who is managing other residential services within the Trust. The Trust seeks the views of the people living in the home and their relatives/other representatives about the quality of the care offered. This is done by questionnaires, in reviews and by general feedback. Comments received via the CSCI survey questionnaires showed that relatives are satisfied with the service offered to the people who live in the home and the overall management of the service. They said staff are very friendly and approachable and keep them informed of what’s going on Staff spoken with during the inspection said they receive support and supervision from senior staff in the home and from senior staff within the Trust. The information document completed by the manager before our visit showed what the service does well, what they could do better and what plans they have to improve services for the coming year. The Trust has a range of health and safety policies and procedures in place. A health and safety audit of the home was carried out on 10/01/08. The fire safety records seen during the visit showed that fire detection equipment is serviced annually, that drills/staff training sessions are held at least yearly and the fire alarms/emergency lights are checked weekly/monthly. A record of the tests carried out on portable appliances, dated 14/04/08, was also seen during the visit. Staff spoken with during the visit were aware of their responsibilities under health and safety, particularly in ensuring the safety and well-being of the people who live in the home. DS0000006556.V362803.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 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 3 26 X 27 3 28 X 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 X 34 3 35 3 36 3 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 X 13 3 14 3 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 3 DS0000006556.V362803.R01.S.doc Version 5.2 Page 23 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. Refer to Standard Good Practice Recommendations DS0000006556.V362803.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North West Region CSCI Preston Unit 1 Tustin Court Port Way Preston PR2 2YQ 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. 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