Care Home: The Lady Verdin Trust Ltd - Crewe Road

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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 care needs are being met. The information on each person`s care needs is kept in four 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 the garden are well maintained so that people live in safe, comfortable and clean surroundings.There is a range of policies and procedures available 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 addition of a conservatory will provide more communal space for the people that live in the home. CARE HOME ADULTS 18-65 The Lady Verdin Trust Ltd - Crewe Road 552 Crewe Road Wistaston Crewe Cheshire CW2 6PP Lead Inspector Mr Val Flannery Unannounced Inspection 4 June 2008 08:20 The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V364451.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 The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V364451.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. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V364451.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Lady Verdin Trust Ltd - Crewe Road Address 552 Crewe Road Wistaston Crewe Cheshire CW2 6PP 01270 650897 01270 256900 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) www.ladyverdintrust.org.uk The Lady Verdin Trust Limited Patricia Mellor Care Home 4 Category(ies) of Learning disability (4) registration, with number of places The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V364451.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th June 2006 Brief Description of the Service: 552 Crewe Road is a care home for four adults with a learning disability. It is part of the Lady Verdin Trust which operates a number of facilities for adults with a learning disability in Crewe and Nantwich. Located in a residential area on the outskirts of Crewe, the domestic type bungalow is close to shops, pub and other local amenities. It is on the bus route to Nantwich and Crewe town centre. The trees and shrubbery to the front of the home ensure the privacy of the residents is protected from the busy main road. A secure well maintained garden is provided to the rear of the home. All the bedrooms are single and contain hand-washing facilities. Sufficient bathing facilities are provided for residents. Lifting aids are provided for residents with mobility problems. Communal space consists of one large open lounge and a dining room. Staff are on duty twenty-four hours a day to provide care for residents. Weekly fees for the home range from £1004.18 to £1407.08. For further information on fees and other charges please contact the manager The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V364451.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 4 June 2008. The visit lasted 6.5 hours in total and was carried out by one inspector. Feedback following the visit was given to the managers on the 9 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 service. Other information received by CSCI since the service 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 care needs are being met. The information on each person’s care needs is kept in four 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 the garden are well maintained so that people live in safe, comfortable and clean surroundings. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V364451.R01.S.doc Version 5.2 Page 6 There is a range of policies and procedures available 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. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V364451.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 The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V364451.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 are able to make an informed choice on how the home will meet their needs. EVIDENCE: The people currently living in the home have lived there for a number of years. The manager confirmed that the Lady Verdin Trust has developed policies and procedures for people who may want to come and live in the home. This can include visits to the home for meals, overnight stays and the opportunity to meet the people that already live there and the staff group. As part of the process to ensure the home can meet the person’s needs, assessments are undertaken that include talking with the person, their family and receiving copies of reviews/assessments from social workers and healthcare staff as appropriate. Information about the Trust and the range of services offered is made available to people who may wish to live in the home and their relatives/carers. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V364451.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, 8 & 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 personal development plans for one of the people that live in the home were seen during the visit. A comprehensive range of information is kept in four separate files for each person living in the house. The information seen included care plans on how the person was to be cared for, risk assessments on daily living and the support required by the person to use community facilities safely. For example, the plans seen during the visit showed that the person needed full staff support with dressing, bathing, eating and moving about the home. Information was seen that showed how the person communicated with staff and others and how they are able to make choices about their daily lives. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V364451.R01.S.doc Version 5.2 Page 10 One of the files contained a range of information about the healthcare needs of the person and a record of their prescribed medication. The staff spoken with during the visit told us they were aware of the needs of the people living in the home and how these were to be met. Staff were seen helping people with bathing, getting dressed and with their breakfast. They were chatting with the people who live in the home about activities and where they wished to go for a walk. Two of the people who live in the home were picked up by Social Services transport to go to a local day centre. One of the people was asked if they would like to help staff tidy the kitchen. The files included information on activities and the involvement of other health care professionals. Records were seen to show that the personal development plans are up dated and reviewed. However, these records were not dated or signed by staff and these involved in the review. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V364451.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, 15, 16 & 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 who live there to have individual choices so they are able to exercise control over their lives and still maintain their safety and well-being. EVIDENCE: The domestic appearance of the home and it location on the main Crewe to Nantwich road ensures that it is in keeping with the local community. During our visit, two of the people who live in the home were seen leaving the home to spend the day at a day centre run by Social Services. Another person who lives in the home was to be supported by a member of staff to use local shops. The care file seen for one of the people that live in the home showed that regular visits to local beauty spots, pubs and other community facilities are included as part of their weekly leisure activities. The staff we spoke with The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V364451.R01.S.doc Version 5.2 Page 12 during the visit said the home has a people carrier vehicle that is used for escorting people to activities, shopping and to doctors/hospital appointments. The personal development plans were seen for one of the people that live in the home. These showed that staff help the person to keep in regular contact with their relative. Visits by relatives and friends are welcome at any time as are phone calls and letters. The manager said they also arrange for the people who live in the home to visit their relatives, particularly if for any reason the relative is unable to visit the home. The daily routines within the home depend on the planned activities for the people who live there. The people going out to the day centre received support and assistance from staff to get ready for the arrival of the transport. The remaining two people were able to get dressed and bathed at a more leisurely pace. Although the people living in the home have some communication difficulties staff were seen responding to their requests for assistance. The staff we spoke with said they were aware of the needs of the people who live in the home and knew when they needed help and attention. A record was seen of the food offered to the people who live in the home. This showed that they are offered a choice of meals. On the day of the visit one person was having her breakfast in a leisurely and relaxed manner. One of the people living in the home receives food through a PEG feed. Staff spoken with said they have received training on how to carry out this procedure. The registered manager said a nurse from the company that supplies the equipment and food supplements provides additional help and support. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V364451.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 & 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 identify the care that needs to be provided for people who live in the home so their needs are met. Staff maintain the dignity of the people who live in the home so they are treated with respect. EVIDENCE: A separate healthcare file is kept on each of the people who live in the home. These files contain a comprehensive range of information on their healthcare history and current needs. This showed that their healthcare needs have been identified and are been met. Records seen also showed that medical advice and attention is sought from healthcare professionals as required. For example, one person who lives in the home is having problems and is receiving regular visits from the district nurse. Information seen showed that hospital appointments are arranged for people when they need them. The record of medicines administered by staff to one of the people who live in the home was seen and was completed satisfactorily. Individual people’s medication is kept in their bedroom in a locked cupboard. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V364451.R01.S.doc Version 5.2 Page 14 Plans of care seen during the inspection visit showed that people’s personal preferences about getting up, going to bed, bathing and eating are recorded under likes and dislikes in Personal Development Plans. The staff spoken with were aware of individual needs and how these were to be met. On the day of our visit staff were seen helping the people living in the home with dressing, eating and moving about the home. They also helped two of the people prepare for their visit to a local day centre. Staff assisted them in a respectful manner that ensured their dignity was maintained. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V364451.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 & 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. The records show that procedures are in place so complaints are appropriately dealt with and that people’s concerns will be 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 manager told us no complaints have been received since our last inspection visit. 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 seven staff (including the registered manager) had received training on the ‘care protection and well being of all individuals’. 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. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V364451.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, 26, 27, 28, 29 & 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 home is warm and clean so people live in comfortable and safe surroundings EVIDENCE: The domestic type bungalow provides a homely, comfortable and safe environment for the people who live there. The home is located in a residential area between Crewe and Nantwich Single bedrooms are provided for the people who live in the home. All the bedrooms were seen during the visit; they were well maintained and individually furnished and decorated. They contained personal possessions like ornaments, pictures and television/hi-fi equipment. Lifting aids and other equipment are provided for those who have severe mobility problems. Bedrooms are arranged to allow for easy access for staff when assisting the people with mobility problems. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V364451.R01.S.doc Version 5.2 Page 17 One adapted bath, with a lifting aid, is provided in the home. Doors have been provided between the toilet and bathing area. This will help ensure the privacy of people using these areas is protected. In addition to the lifting aids in the bedrooms, hoists and wheelchairs are provided for those with mobility problems. Since our last visit a conservatory has been added to the rear of the home. This has increased the amount of communal space available for the people living there and has added to the overall appearance of the home. A problem with access between the conservatory and the rear garden, identified during the visit, will be sorted out. The garden to the rear of the home is secure and accessible to residents. Problems with the general tidiness and appearance of the garden identified during the visit were addressed. On the day of the inspection the home was clean and free from unpleasant odours. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V364451.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): 32, 33, 34, 35 & 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. The good communication between staff and the management team means people who live in the home have their needs met in the way they prefer. EVIDENCE: The staff rota seen during our visit showed that there are normally two staff on duty when the people who live there are at home. One of the staff maybe from the Trust’s daily option scheme and are in the home to support individual people with a range of activities. One member of staff sleeps in the home during the night and will respond to requests for help from the people who live there. A senior member of staff is on call to provide support, advice and guidance for staff. Staff spoken with during the visit said the recruitment process was very thorough and that they had to complete a Criminal Record Bureau check before they started working at the home. They also said they receive regular support and supervision from senior staff in the Trust. The two staff on duty The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V364451.R01.S.doc Version 5.2 Page 19 said they had received ’very good’ induction training when they came to work for the Trust. A senior member of staff provided a record of the training programme for staff. This showed that staff had received training that included: moving and handling, First Aid, food hygiene, fire safety, medication administration and care planning. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V364451.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 & 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 receive the guidance they need to make sure they can support the people living in the home to live their chosen lifestyle. The routines of the home appear to be set up to suit the people that live there, so the home is being run in their best interests. EVIDENCE: The manager told us she has completed her NVQ Level 4 and is in the process of completing the Registered Managers Award. We spoke to the home manager and another manager from the Trust during the visit. They told us that changes are to take place within the management structure of the Trust. This included the current manager for the home transferring to other registered services within the Trust. A new manager will be appointed to manage this home and another of the Trust’s homes. Following our visit, we The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V364451.R01.S.doc Version 5.2 Page 21 received a letter from chief executive of the Lady Verdin Trust telling us about these proposed changes. The manager has provided information on how the service has improved, what they could do better and how they intend to develop the service in the future. Staff spoken with said they receive supervision, support and guidance from managers within the Trust. Records were seen during our visit to show that health and safety checks, including fire safety, are carried out in the home. Staff training records showed that staff receive training on manual handling, health and safety, first aid and food hygiene. The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V364451.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 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 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 3 3 X 3 X 3 X X 3 X The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V364451.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 The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V364451.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. Extracts may not be used or reproduced without the express permission of CSCI The Lady Verdin Trust Ltd - Crewe Road DS0000006505.V364451.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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