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Care Home: The Lawns, Exmouth

  • 52 Salterton Road Exmouth Devon EX8 2EJ
  • Tel: 01395275382
  • Fax: 01395276845

The Lawns provides personal and supportive care for 10 residents with learning and physical disabilities. The house is a detached three storey building in a residential area of Exmouth. All bedrooms are single with en-suite facilities. There is a large lounge, dining room and kitchen. Additional communal rooms are provided for games and relaxation. There are pleasant secure gardens to the front and rear of the property including level patio areas. The home has been adapted to meet the needs of residents with physical disabilities. The providers, Voyage Ltd are a large organisation with a number of registered homes throughout the region. Fees range from £1350 to £1650 per week. Additional charges are made to service users for the use of the home`s transport at a cost of £50 per month. The Service User Guide states that CSCI reports are available upon request to the manager.

  • Latitude: 50.619998931885
    Longitude: -3.3970000743866
  • Manager: Miss Melissa Joyce Lindley
  • Price p/w: £1500
  • UK
  • Total Capacity: 10
  • Type: Care home only
  • Provider: Voyage Ltd
  • Ownership: Private
  • Care Home ID: 16082
Residents Needs:
Physical disability, Learning disability

Previous Inspections

This may not be the latest inspection for this service as we are having techinical problems updating from CQC - please check directly on the regulators website for the most recent report; bestcarehome hopes to be back to regular updates shortly.

For extracts, read the latest CQC inspection for The Lawns, Exmouth.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Lawns, Exmouth 52 Salterton Road Exmouth Devon EX8 2EJ The quality rating for this care home is: three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Michelle Oliver Date: 1 3 0 8 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 39 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (20092008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 39 Information about the care home Name of care home: Address: The Lawns, Exmouth 52 Salterton Road Exmouth Devon EX8 2EJ 01395275382 01395276845 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Voyagecare.com Voyage Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 10 Number of places (if applicable): Under 65 Over 65 10 10 0 0 learning disability physical disability Additional conditions: The maximum number of service users who can be accommodated is 10. The registered person may provide the following category of service only: Care home providing personal care only- Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability- Code LD Physical disability- Code PD Date of last inspection A bit about the Care Homes for Adults (18-65 years) Page 4 of 39 care home The Lawns provides personal and supportive care for 10 residents with learning and physical disabilities. The house is a detached three storey building in a residential area of Exmouth. All bedrooms are single with en suite facilities. Care Homes for Adults (18-65 years) Page 5 of 39 There is a large lounge, dining room and kitchen. Additional communal rooms are provided for games and relaxation. There are pleasant secure gardens to the front and rear of the property including level patio areas. Care Homes for Adults (18-65 years) Page 6 of 39 The home has been adapted to meet the needs of residents with physical disabilities. Fees range from #1350 to #1650 per week. Additional charges are made to service users for the use of the home’s transport at a cost of #50 per month. Care Homes for Adults (18-65 years) Page 7 of 39 The Service User Guide states that CSCI reports are available upon request to the manager. The providers, Voyage Ltd are a large organisation with a number of registered homes throughout the region. Care Homes for Adults (18-65 years) Page 8 of 39 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 9 of 39 How we did our inspection: This is what the inspector did when they were at the care home This unannounced inspection took place over 5.5 hours on Thursday 14th August 2009. During the inspection 3 people were case tracked. This involves looking at peoples individual plans of care, and speaking with the person and staff who care for them. This enables the Commission to better understand the experience of everyone living at the home. As part of the inspection process the Care Quality Commission likes to ask as many people as possible for their opinion on how the home is run. We sent questionnaires out to all people living at the home, 3 health and social care professionals (including GPs and care managers) and 5 Care Homes for Adults (18-65 years) Page 10 of 39 staff. At the time of writing the report, responses had been received from 6 people living at the home, 2 health and social care professionals and 3 staff. Their comments and views have been included in this report and helped us to make a judgement about the service provided. People living at the home have limited verbal communication skills, and as we are not skilled in their other methods of communication it was difficult for us to have any meaningful communication with these people. However, the interaction between the people living at the home and those who care for them was closely observed. We also spoke with 3 staff and the manager General information about fees and fair terms of contracts can be accessed from the Office of Fair Trading web site at /www.oft.gov.uk . What the care home does well The staff team work hard to encourage and support people to live their lives as they wish. The atmosphere is warm, friendly and fun. It is clear there are good relationships between staff and the people living in the home. We saw staff being caring and respectful, offering choices and supporting people in a kind manner. Care Homes for Adults (18-65 years) Page 11 of 39 People living in the home lead an active life, using local and surrounding communities to obtain social and educational facilities. The meals at the home provide a varied diet and take into account peoples likes and dislikes. Relatives are welcomed at the home and there appears to be good communication with families. Relatives are encouraged to be involved and participate in the care planning and reviewing process. Care Homes for Adults (18-65 years) Page 12 of 39 Concerns and complaints are taken seriously and people are protected from abuse or harm by well informed staff and good reporting procedures. Peoples finances are protected by rigorous systems. People are supported by a team of staff who are competent, qualified and well supervised. The health, safety and welfare of people living at the home is promoted and protected. Care Homes for Adults (18-65 years) Page 13 of 39 Comments made by staff and people living at the home include the home promotes a caring homely environment offering choice and dignity within a safe environment for very vulnerable people, we are committed to encouraging individual living skills and offering a range of activities and very friendly staff create a welcoming atmosphere. Very caring and friendly happy relationship between staff and residents. The records kept in the home help staff assess, understand and monitor peoples needs and risks. Good policies, procedures and practices ensure people and staff are kept safe, this includes good recruitment, health, safety and financial practices. Good systems are in place to assess and monitor all practices, seek views of people, staff and outside professionals, to ensure the home is run in the best interests of the people living there. Care Homes for Adults (18-65 years) Page 14 of 39 What has got better from the last inspection What the care home could do better No requirements were made as a result of this inspection. Two recommendations have been made, one relating to making sure there are always enough staff on duty to allow people living at the home to take part in activities when they choose, Care Homes for Adults (18-65 years) Page 15 of 39 And the other relating to the service producing more appropriate complaint formats for people with limited communication needs, which might help them to express when they are unhappy. . If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Michelle Oliver 33 Greycoat Street London SW1P 2QF 02079792000 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Adults (18-65 years) Page 16 of 39 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 17 of 39 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 18 of 39 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People considering making The Lawns their home will benefit from the assurance that their aspirations and needs can and will be met at the home before a decision to live there is made. Evidence: All the people living at the home have done so since the service opened in December 2004.We were told that a comprehensive detailed assessment of peoples needs was undertaken to ensure the home were able to meet their individual needs before a decision was made for them to make The Lawns their home. We were told that staff from the Lawns visited people on a number of occasions prior to their admission to ensure a full assessment was completed and they were confident the home could meet the people individual needs. The manager told us that if the service were to admit a new person to the home it would only be following a full assessment of their needs, after they had visited the home a few times, or as many as needed and had spent a short introductory stay. A Care Homes for Adults (18-65 years) Page 19 of 39 Evidence: permanent place would only be offered if they were happy with this and all other parties were happy with the service. Each person living at the Lawns has been provided with Terms and Conditions of occupancy, which ensures that those living at the home, or their representatives, know what services will be provided within the fee structure. Information about the service is included in a Statement of Purpose and a Service User Guide. Both of these documents have been produced in a pictorial version and are always available in the lounge and in peoples private rooms. Since the last inspection the service has produced an audio version of both of these documents so that people can listen to them. The Care Quality Commission obtains information from the service prior to inspections being carried out. Information received before this inspection confirmed that all necessary policies and procedures are in place and are up to date and that all equipment is well maintained regularly. Care Homes for Adults (18-65 years) Page 20 of 39 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home can be confident that they will be involved in decisions about their lives, in the planning of their individual care and that their wishes and needs are considered when plans are completed. Evidence: All people living at The Lawns have individual comprehensive plans of care based on an assessment of need. They include detailed information about their individual health and social care needs and what actions staff are to follow to ensure each need or goal is met and monitored. They include reference to equality and diversity and focus on the individuals strengths and personal preferences. Other information includes, for example, who or what is important to them, how they keep safe, their goals and aspirations, skills and abilities and how they make choices in their lives. People living at The Lawns have limited communication skills and a limited understanding of care plans and are therefore unable to easily contribute to their formulation or reviews. It was clear through observations made that the staff team work hard to meet peoples needs and have a good knowledge and understanding of the care plans and any associated risks. Care Homes for Adults (18-65 years) Page 21 of 39 Evidence: All plans of care looked at included detailed information in relation to all aspects of individuals care and how best these needs can be met by the individual and staff at the home. The plans provide short term goals, how they will be met, assessments of risk and good monitoring. Daily records are kept of all areas of need, including health care appointments, activities, and achievement of the goals in care plans. Staff support and enable people living at the home to take responsible assessed risks and care plans include assessments of risks that may cause danger to the individual or make it unsafe for them to do certain things. Assessments of potential risks to individuals through general health, needs or activities, are undertaken and clear action required to be taken to minimise or reduce any risks is recorded. We spoke to staff during this inspection, all of whom had a good understanding of such risks and described what they should do to reduce them. Each person living at the home has a key worker, who provide one to one support, keep the care plan up to date and makes sure that other staff always know the persons current needs and wishes. During this inspection we spoke to several members of staff all of whom had excellent knowledge and understanding of the needs of all living at The Lawns and who were committed to supporting people to lead purposeful and fulfilling lives as independently as possible. We saw staff communicating well will all people living at the home, being kind, affectionate and respectful. The ethos of The Lawns is to ensure that all those living at the home are enabled and supported to make decisions in all areas of their lives. For example, they are involved in the recruitment of staff and would be involved in introductory visits of perspective residents at the home. All decisions made on behalf of individuals living at The Lawns are agreed and discussed with relatives and care managers, particularly those that may infringe upon individuals freedom of movement or privacy. Good records of such decision making processes are recorded and reviewed regularly. Staff confirmed there is a high level of staff training at the home, directed at the needs of people living at The Lawns, thereby ensuring their needs are met appropriately. Care Homes for Adults (18-65 years) Page 22 of 39 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at The Lawns can be confident that they will be supported to make choices about their lifestyles, will be provided with choices of well balanced meals and will be treated respectfully and consulted in all decisions about their lives. Evidence: All staff spoken to during this inspection confirmed that people living at The Lawns live their lives as they wish and undertake meaningful activities when they choose. When we arrived at The Lawns we were greeted by a senior support worker and a person who lives at the home. Some people were sitting in the light and airy entrance hall, others in a comfortable lounge watching TV and others were enjoying breakfast in the dining room. The atmosphere was comfortable and happy and a lot of laughter and affection was seen throughout the inspection. People moved around the home with no restrictions, although there was always a support worker close by if needed. We were told that staff at The Lawns enable people to experience a wide range of leisure activities and support them to continue with existing activities. Staff also Care Homes for Adults (18-65 years) Page 23 of 39 Evidence: provide opportunities for them to be involved in the local community, have access to vehicles, are given a choice of external activities brought into the home, provide the support for people to have annual holidays of their individual choices and to go on day trips. We saw well maintained records of activities undertaken by all people living at The Lawns. Photographs taken during several outings and holidays are displayed around the home. Recent outings include a trip to Alton Towers and to Exmouth Pavillions Recent outings include a trip to Alton Towers and to Exmouth Pavilions, and holidays include Disney World Paris and Centre Parks. A time table of organised activities is displayed in the kitchen at The Lawns so people can see what is planned. We were told that people living at the home take part in planned activities and in whatever they choose to do. Individual care plans included information about people enjoyed doing, for example one person enjoys swimming and daily monitoring sheets and staff confirmed this took place. Daily records confirmed the activities that people take part in are their own choices. The Lawns has 2 vehicles, which are used to take people out and also for taking people to their family homes for weekend stays. One of the vehicles is a mini bus that takes 2 wheelchairs and the other provides seating for 7 people. During this inspection a group of people were taken in the homes transport, to the seaside, an outing that was not planned but enjoyed by all who took part. Other people went out individually for walks with staff. An activities therapist is employed at the home and undertakes 2 sessions a week. During these sessions people take part in art and musical sessions. These sessions usually take place in the homes Snoozelum but time is spent with people individually also. The Snoozelum is a quiet, relaxing room where people go to chill out, take part in activities or listen to music, and is equipped with visual and sensory equipment that works towards achieving this. We were told that one person frequently goes to this room for a snooze where they lie on the floor on a soft, comfy mattress. Activities are not limited to just during the day, we were told that people go out to the pub discos, clubs or to the cinema. People also enjoy massage therapy, reflexology, manicures and visits from a hairdresser. We were told that people had recently enjoyed going to a local nightclub to celebrate a 21st birthday. We received responses to surveys sent prior to this inspection from 6 people living at The Lawns. All were very satisfied with the care, support and environment provided at the Lawns. However, 4 people, in reply to what could the home do better told us that activities and outings could be improved. Some of the comments included Have a more varied choice of activities that I can join in, I have no problems, perhaps go out more, I would like to go out on some more trips and outings and it would be nice to have a few more activities and sometimes we need more staff to access these. We discussed this with the manager who told us that currently the service is recruiting Care Homes for Adults (18-65 years) Page 24 of 39 Evidence: staff, when additional staff have been recruited the rota will reflect this and shift times will be increased to ensure that activities can be undertaken as people choose. People living at The Lawns are encouraged and supported to maintain close contact with their families and it is clear when looking at care plans that this is achieved. Visitors are welcome at the home at any time and people living at The Lawns are supported to welcome visitors in private or in a chosen communal area. Family and friends are also encouraged to participate in daily routines with the agreement of the person concerned. Pictures are used to display menus of food on offer at the home and menus we saw showed that a varied and healthy diet is offered to people living at the home. We saw a wide choice of dishes available and we were told these have been suggested by people living at the home as they are their favourite meals. During lunch we heard staff offering people a choice of food at breakfast one person was shown a selection of cereals to choose from, even though they confirmed they always chose the same one. Records of meals eaten by people are maintained and show a healthy, well balanced diet is provided and encouraged. During lunch we saw support workers assisting those who needed it, discreetly in an unhurried manner. Lunch was a leisurely communal event and seemed to be enjoyed by all, in a comfortable atmosphere. Care Homes for Adults (18-65 years) Page 25 of 39 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples dignity and privacy is fully respected and people benefit from their health needs being closely monitored. Medication practices protect peoples health and welfare. Evidence: Personal care and support is provided by staff that have a good knowledge of how people prefer to receive personal care. We saw detailed information included in care plans relating to peoples preferences, likes and dislikes and staff have a good knowledge and understanding of the information in the care plans. Health care needs are assessed and monitored regularly with health professionals involved when necessary. Responses, to surveys sent prior to this inspection, from two health professionals confirmed they felt the home meets health needs well. One commented that the home always contact me if they have concerns and are always open and approachable for discussion or visit. Always sensitive to difficult issues, always supportive of one another, they work as a team and another that the service represent the need of the individual and support them and work with outside agencies. Care Homes for Adults (18-65 years) Page 26 of 39 Evidence: Good records of peoples health care needs and how they are monitored are maintained at the home. There was good evidence that such monitoring takes place, including records of routine well person health checks being undertaken, consultations with speech and language and behavioral therapists and annual flu vaccinations being given. People living at The Lawns are encouraged and supported to attend medical appointments. Details of appointments with opticians, dentists and chiropodists were seen in care plans and records of the outcome of appointments. This ensures that peoples health care needs are met. During this inspection a person went to the accident and emergency department at the local, close by, community hospital, because they had injured their toe. Also, the manager received a phone call from a doctors surgery offering people living at the home their annual flu vaccination. Staff spoke to us about how they respect peoples privacy and dignity when offering support for personal care. They told us they always knock on bedroom doors and wait to be invited before going in or, in some instances wait a reasonable amount of time and then go in if the person is not able to invite them in. Staff are very aware of peoples rights in relation to their privacy being respected at all times. Medication storage and records of administration were accurate and up to date. All staff that administer medication have received appropriate training and their competencies are assessed by the manager to ensure they understand the training they have received and remain safe to administer medication. Detailed, individual information sheets are included in the medication administration file that include relevant information about medication and an agreement, signed by a GP, agreeing to any non prescibed medicines that mey be given to individuals. For example paracetamol. This means that people are protected from being given medicines that may not be suitable for them. We saw a support worker giving medication to one person at breakfast. They explained what they were doing and were aware of the way the person liked their medication given. Good information was recorded about when and how emergency medication should be given and results are monitored. Care Homes for Adults (18-65 years) Page 27 of 39 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are assured they are listened to and complaints are dealt with appropriately. There are good systems in place to ensure people are protected from abuse or the risk of harm. Evidence: Neither The Lawns nor the Care Quality Commission has received any complaints about the service since the last inspection. People living at the home were not able to tell us what they would do if they were unhappy about anything at the home, and staff said their knowledge of the people living in the home helps them to recognise when someone if unhappy and they then try and resolve the problem. If a visitor or relative made a complaint to a member of staff we were told they would report it to the manager or deputy. The complaints policy is currently not in a format suitable to the communication needs of the some people living in the home. The manager told us that the service plans to develop policies in more formats to meet a wider range of needs and to develop a national service user forum to enable people who use services to share their views, concerns and ideas to senior managers within the company. During the last 12 months people living at The Lawns have been provided with an accessible version of letting Us know what you think and information relating to Safeguarding Adults procedures. Care Homes for Adults (18-65 years) Page 28 of 39 Evidence: All staff have received training in the protection of vulnerable adults and staff spoken to during this inspection demonstrated a good awareness of types of abuse and knew what to do if witnessed poor practice. Peoples finances are managed well. The manager holds small amounts of pocket money for some people living at the home; we saw detailed records of these finances together with receipts for any outgoings, all of which were accurate and up to date. Care Homes for Adults (18-65 years) Page 29 of 39 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with clean, safe and comfortable surroundings that meet their needs. Evidence: The Lawns provides an accessible, homely, clean, hygienic, safe, well maintained, and comfortable environment to meet the needs of people living and working there. The home is well located with easy access to local facilities and transport. Peoples bedrooms are personalised, decorated in their favourite colours and themes, reflecting their interests and with furnishings to suit their needs. Furnishings, fittings and decoration throughout the home are a good standard. The garden area to the front of the building is paved and used mainly as a car parking area. The area to the rear of the property is paved with seating and areas where people living at the home can take part in games including basketball. The home has a number of communal areas, including a large entrance hall, lounge, which has a large flat screen TV and music system, dining room and kitchen as well as a Snoozelum or sensory room. This enables people to get away from each other if they choose but still have the same facilities. The standard of decorations and furnishings create a warm, friendly and homely atmosphere.Staff have recently redecorated several areas within the home. Care Homes for Adults (18-65 years) Page 30 of 39 Evidence: All bedroom doors are fitted with key pad locks, some of which have been personalised to enable people to access their rooms independently whenever they wish. Other bedrooms remain locked to prevent people living at the home entering the rooms uninvited. Staff told us this does not mean that people cannot go to their rooms whenever they wish and described how people, who always needed support to enter their rooms, let staff know when they want to go to their rooms. We were told that since the last inspection these issues have been discussed within a multi-disciplinary setting with A Good Practice Committee. The Committee consists of independent professionals who advise on such issues and look at what is in the best interests of people using services. All bedrooms have ensuite facilities, which are kept unlocked following risk assessments undertaken to establish whether individuals would be safe if left in their en suite unsupervised. Toiletries and electrical equipment, which could potentially make it unsafe for some people, are stored in locked cabinets in en-suites to prevent the room being unsafe. People living at the Lawns are able go into the kitchen under supervision but the door is locked when no staff are actually in the kitchen to supervise people. A separate laundry is provided for people at the home. This was clean and well organised at the time of this visit. Care Homes for Adults (18-65 years) Page 31 of 39 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at The Lawns are supported by caring staff, trained staff to meet their needs and are protected by robust recruitment procedures followed at the home. Improvements in the number of staff available to fully meet peoples social needs would further promote person centred care and meet the diverse needs of people living at The Lawns. Evidence: The manager is usually on duty 5 days a week between 9 am & 5pm, and aims to have 5 support workers on duty at the home from 8am to 8.30pm, including a senior or deputy manager. We were told that this number has dropped to 4 on occasions recently as the service is currently seeking to recruit 2 additional members of staff. Two waking staff are on duty between 8.30 pm to 8am. We were told that staff would be asked to work past 8.30 pm if people living at the home wanted to go out during the evening and additional staffing would be available for an event planned in advance. Support staff also undertake domestic duties at the home including cooking, cleaning and management of laundry. We received response to surveys sent prior to this inspection, from 5 people currently living at The Lawns and 5 members of staff. Four people living at the home thought Care Homes for Adults (18-65 years) Page 32 of 39 Evidence: that they would like to have more staff available to enable them to go out more and have more varied activities. (please refer to Lifestyle section of report) Staff also thought that more staff were needed at times. Comments included More care hours to enable more staff at all times including the weekend, more care hours, staff on duty to provide better level of support and more staff working at weekends. A support worker told us that staff meeting are held at the home 3 monthly and all staff speak up as the atmoshere is open and not intimidating and the meetings are great, everyone has good ideas. They also said it is a pleasure to come to work. Recruitment procedures protect people living at The Lawns from the risk of potential abuse. Appropriate checks are made prior to someone working in the home, in including police checks. Interviews are carried out in the home where potential staffs are introduced to people living at the home, which gives the manager the opportunity to see how they interact. A structured Induction training is provided by the organisation and the manager to ensure new staff understand health & Safety issues and working with people with a learning disability. The induction training is linked to the Learning Disability Award Framework (LDAF), which is a nationally recognised standard expected to be achieved by staff that work in this kind of setting.One staff member spoken with on the day of the inspection told us they had received a good induction and described what they had learned and how it had helped them to meet peoples needs safely. Staff demonstrated a good understanding of peoples needs, health & safety issues and told us about training they had received and what they had learned from it. Training undertaken during the last 12 months includes management of medication, total communication, manual handling, first aid and safeguarding adults. This means that peoples needs and welfare are met and protected by appropriately trained staff. The manager told us that during the last 12 months the company has appointed a regional training and development manager and regular, updated training programme has been implemented Care Homes for Adults (18-65 years) Page 33 of 39 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home continues to be run in the best interests of people who live there and to protect their health, safety and welfare. People living at The Lawns benefit from excellent systems to review, develop and improve the home. Evidence: Mr. Adam Ferris, who was registered as manager of The Lawns in June 2007, has spent his whole career working within care settings, which has included working with the elderly client group, people with mental health needs and substance misuse and people with learning disability. He said that although he has enjoyed his other posts the work he has undertaken with people with learning disabilities have been the ones he has enjoyed the most. Mr Ferris commenced work at The Lawns in 2004 initially as one of two deputies at the home and when the manager left he applied for the post and his application was successful. Care Homes for Adults (18-65 years) Page 34 of 39 Evidence: Mr Ferris has completed a Nationally recognised qualification, NVQ, at level 4 in Care and the Registered Managers Award, is an NVQ assessor and told us he uses the internet, managers meetings and courses to keep up to date with developments. Staff spoke very highly of the manager and said they felt well supported and received clear direction and leadership. The manager and staff are very focused on meeting the health and social care needs of all people living at the home and work hard to make sure The Lawns is run in the best interests and needs of those people. We saw this throughout this inspection and this has been reflected throughout this report. Care managers and other professionals provided positive feedback of the manager and the home in general. Comments made included The Lawns represents the need of individuals and supports them and the service works with outside agencies, always contact me if they have concerns and are always open and approachable for discussion or visits. Always sensitive to difficult issues and supportive of one another, they work as a team and I have been impressed with their endeavours always. The manager has excellent systems in place to review and monitor the care delivered to people living at the home. This includes reviews of how peoples needs are met, health reviews, staff meetings, and supervision with staff, appropriate training, reviewing of policies and procedures. Voyage Ltd also completes monthly inspection visits and quality audit reviews. The inspector was told that satisfaction questionnaires are sent to people living at the Lawns, where appropriate, to relatives and outside stakeholders. Not all of the information has been collated or acted upon yet. The manager told us work is being undertaken to make the outcomes of the surveys accessible to people living at the home and expects this work to be completed soon. Staff at the Lawns receive training annually in the use of safe ways of moving people and objects that avoid injury to people living at the home or staff. All staff have undertaken training in first aid since the last inspection. This means that there is always a member of staff on duty who is able to carry out first aid in the case of an accident or an emergency. All staff currently employed at the home have undertaken a period of induction training and several hare now undertaking or completing a Nationally recognised qualification (NVQ) The Care Quality Commission obtained information from the service prior to undertaking this inspection. Information included indicated that all equipment at The Lawns is well maintained regularly and confirmed that all necessary policies and procedures are in place and are up to date. These were not inspected during this inspection but the information is used to help form a judgement as to whether the home has the correct policies to keep people living there, and staff, safe. Risk assessments are reviewed regularly and are up dated where necessary, to ensure they are appropriate and reduce risks to people living at The Lawns and staff. One person living at The Lawns told us I am looked after and kept safe. Care Homes for Adults (18-65 years) Page 35 of 39 Evidence: Care Homes for Adults (18-65 years) Page 36 of 39 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 37 of 39 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 22 More appropriate complaint formats for people with limited communication needs might help them to express when they are unhappy. 2 33 The registered person should review staffing shifts to ensure the home is able to meet social needs at all times of the day and evening, including weekends. Care Homes for Adults (18-65 years) Page 38 of 39 Helpline: Telephone: 03000 616161 or Textphone : or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 39 of 39 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!

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