Care Home: The Lawrence

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What the care home does well The person centred documentation is good and show that people are fully involved with assessing their care needs and developing and reviewing their own care plans. The daily records and record of activities show that people are supported to live as ordinary a lifestyle as possible and are encouraged to use ordinary community based healthcare and leisure services. One person said that they like going shopping into Wakefield with their girlfriend. Another said that they like going to college to learn how to cook. Another said that they go to the centre to meet their friends. One said that they have chosen to go to Blackpool next year for their holidays. Throughout the visit people were observed being treated with dignity and having their wishes respected. The daily records, the minutes of the service user meetings and quality assurance surveys show that people have a say in the running of the home and the quality of the services provided. Discussion with people using the service found that they are very happy with life in the home and the support and care provided. This was confirmed by the returned quality assurance surveys. People are safeguarded by the way staff are recruited and selected as records show that police and POVA Checks are carried out before people are employed.Staff records also show that people using the service are involved in staff selection process and are included on the interviewing panel and a say in who is employed. What has improved since the last inspection? To make sure people are protected and remain well, the way medicines are administered is checked more regularly and all staff giving medicines have been trained to do so correctly and safely. To protect people from any kind of abuse all staff working in the home have attended POVA (Protection of Vulnerable Adults) training since the previous inspection visit. A new assertive protocol for dealing with healthcare services has been introduced and this along with training for staff is to ensure that people`s healthcare needs are appropriately met. What the care home could do better: It is acknowledged that people have a say in the running of the home and make decisions about their daily lives. However, the daily records do not contain descriptive words to reflect and show peoples choices, preferences or any decisions they make on a day-to-day basis. CARE HOME ADULTS 18-65 The Lawrence 316-318 Bradford Road Wrenthorpe Wakefield West Yorks WF2 0QH Lead Inspector Tony Railton Key Unannounced Inspection 27th December 2007 11.00 The Lawrence DS0000006195.V357040.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 Lawrence DS0000006195.V357040.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 Lawrence DS0000006195.V357040.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Lawrence Address 316-318 Bradford Road Wrenthorpe Wakefield West Yorks WF2 0QH 01924 369164 01924 383811 north.office@craegmoor.co.uk www.craegmoor.co.uk Johnston Care Limited 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) Care Home 14 Category(ies) of Learning disability (14), Physical disability (3) registration, with number of places The Lawrence DS0000006195.V357040.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th December 2006 Brief Description of the Service: The Lawrence continues to provide personal care and accommodation for up to 14 people who have a learning disability. Set back in its own grounds these two joined very large period terrace houses provide accommodation on three floors. There are two small gardens to the front one extending around the side and there is parking provided to the rear. The main entrance is also found at the back of the home. There is a large lounge to the rear and a smaller quiet lounge to the front. There is an adjoining dining room to the larger lounge next to the office. All accommodation offered is single, however, there are no en-suite bedrooms and the washing and bathing facilities are shared. The care provided by the home is underpinned by ordinary living principles and there is an expectation that residents do as much for themselves as possible in the pursuit of living an ordinary lifestyle and to maintain their independence. There are only a few local shops nearby including a public house. On the 27th December 2007 the acting manager said that the weekly fees for the service ranges from £395 to £445, for further information about the service and the role of the CSCI please contact the home or visit the homes web site on www.craegmoor.co.uk The home is on a main bus route and is only a few minutes journey from the centre of Wakefield and all services and amenities. The home is also close to the M1/M62 link roads. The Lawrence DS0000006195.V357040.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit to the home commenced at 11.00 and ended at 14.00. During the visit there was the opportunity to speak to people using the service, the acting manager and care staff. Six peoples case files were seen and included assessments, care plans, reviews, medical, financial and daily records. Six staff files were seen and included, references, police and POVA (Protection of Vulnerable Adult List) checks and training records. The medicine and financial administration systems was also checked. The homes returned quality assurance surveys were seen and the annual quality assurance report. Other information considered included the service history, previous inspection visit report, the minutes of Safeguarding Meetings and the Regulation 37 ‘Notifiable incident’ reports. Other records included the complaints book, staff supervision records and health and safety checks and maintenance records. Te inspector would like to take the opportunity to thank the people using the service and the acting manager and her staff team for their hospitality and cooperation throughout the visit. What the service does well: The person centred documentation is good and show that people are fully involved with assessing their care needs and developing and reviewing their own care plans. The daily records and record of activities show that people are supported to live as ordinary a lifestyle as possible and are encouraged to use ordinary community based healthcare and leisure services. One person said that they like going shopping into Wakefield with their girlfriend. Another said that they like going to college to learn how to cook. Another said that they go to the centre to meet their friends. One said that they have chosen to go to Blackpool next year for their holidays. Throughout the visit people were observed being treated with dignity and having their wishes respected. The daily records, the minutes of the service user meetings and quality assurance surveys show that people have a say in the running of the home and the quality of the services provided. Discussion with people using the service found that they are very happy with life in the home and the support and care provided. This was confirmed by the returned quality assurance surveys. People are safeguarded by the way staff are recruited and selected as records show that police and POVA Checks are carried out before people are employed. The Lawrence DS0000006195.V357040.R01.S.doc Version 5.2 Page 6 Staff records also show that people using the service are involved in staff selection process and are included on the interviewing panel and a say in who is employed. 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 Lawrence DS0000006195.V357040.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 Lawrence DS0000006195.V357040.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 using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. To make sure peoples needs are met these are assessed before they are offered a service. EVIDENCE: Samples of six peoples records show that there care and support needs are assessed before they are offered a service. The acting manager who said that they go out to assess peoples personal and healthcare needs before people are invited into the home confirmed this. One persons assessment shows that they had the opportunity visit and to ‘test drive’ the service before choosing to live in the home. The person cantered documentation is good and there is evidence of people taking part in completing their own assessments, including their choices and preferences and choosing their own ‘keyworker’. The Lawrence DS0000006195.V357040.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 & 9 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. People’s personal care needs are written down and they are supported to make decisions and to take risks as part of living an ordinary lifestyle. EVIDENCE: The acting manager said that people are fully involved in completing their own person centred plans. Some people using the service are very able and the records show that they have signed their assessments and care plans to say that they agree with them. The acting manager said that the care provided by the home is based on ordinary living principles and that people are supported and encouraged to live as ordinary a lifestyle as possible. This is supported by the homes Statement of Purpose and Service User Guide The reviews, minutes of residents meetings and quality assurance surveys show that people have a say in the running of the home and what happens to them. The daily records show that people participate in every aspect of daily life within the home. However, the daily records do not contain descriptive words to reflect people’s choices and preferences. Throughout the visit people were The Lawrence DS0000006195.V357040.R01.S.doc Version 5.2 Page 10 observed being treated with dignity at all times and having their wishes respected. One person using the service said that they like to help in the “kitchen and doing they’re cleaning”. Another said that enjoy “interviewing staff”. Another said that they like going into Wakefield “shopping” and that they and their girlfriend have chosen to get engaged. Another said that they like living in the home and have “chosen their own keyworker” The homes returned quality assurance surveys show that people feel part of the home and that they have a say in how they live their lives. Risk assessments in people’s records show that they are supported and encouraged to take risks as part of living an ordinary lifestyle. The Lawrence DS0000006195.V357040.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 and 17 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. People enjoy living an ordinary lifestyle and are offered a varied and balanced diet. EVIDENCE: One person said that they enjoy going to college to learn how to cook. They said that they have made some good meals and when asked what they liked best about going to college they said, “eating the meals they have made”. One person said that they like going to the day centre and “seeing all their friends”. The daily records show that people enjoy going to the local shops and public houses. One person said that they “like going shopping with their girlfriend into Wakefield”. The acting manager said that some people are very able and travel independently to local pubs and shops. However, some require support and to assist people to use ordinary community based leisure services the home has acquired a minibus. The Lawrence DS0000006195.V357040.R01.S.doc Version 5.2 Page 12 One person said that they like going on holiday with their have chosen to go to Blackpool for their holidays this year. The menus show that people are offered a varied and balanced diet and that they have a choice of menu. The homes returned quality assurance surveys show that all fourteen people using the service said that they are happy with the meals provided. People said on the day of the visit that they enjoy the meals and that they can choose what menu they would like. The Lawrence DS0000006195.V357040.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 using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. People’s personal and healthcare needs are met and they are protected by the way medicines are dealt with. EVIDENCE: The homes returned quality assurance surveys show that people using the service feel that their healthcare needs are met. The acting manager said that people are encouraged and supported to have their personal healthcare needs met by ordinary community based health services. A sample of six peoples medical records confirmed this and also showed that the Community Learning Disability Team Nurses and specialist Social Workers also support some. To make sure people receive the care and support that they need some care plans showed evidence of ‘joint working’ between the home and the community specialists. A report into how the home supported someone requiring medical attention who was seriously ill and subsequently passed away was discussed with the acting manager. The acting manager said that the homes staff responded appropriately. However, to further protect people using the service, further The Lawrence DS0000006195.V357040.R01.S.doc Version 5.2 Page 14 training has been provided for staff there is a new ‘assertive’ protocol in place for dealing with healthcare services. The acting manager said that the way medicines are given and recorded has improved and as it is checked more regularly to make sure that people using the service are safe. A sample of three peoples medicines were checked and found to be correct. To make sure people continue to be protected, staff training records show that people giving out medicines have been trained to do this properly and safely. The Lawrence DS0000006195.V357040.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 using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. People know how to complain and they are protected from self-harm and abuse. EVIDENCE: The acting manager said that the home has not received any complaints since the previous inspection visit. The record of complaints and service history confirmed this. The minutes of the residents meetings and the returned quality assurance surveys show that people using the service have the opportunity to comment on the quality of care provided. The daily records show that people do make comments on a day-to-day basis and that their concerns are listened to and acted upon. Five people said that they know how to complain, however, they also said that they have never had to make a complaint. To help people who may want to complain an easy read version of the complaints policy and procedure is displayed around the home. It was also noted that everyone has a copy of the Service User Guide that also contains an easy read complaints policy procedure. To make sure people are protected from abuse the minutes of one Safeguarding Meeting was discussed with the acting manager who said that to make sure people remain safe one staff is still suspended from duty pending an investigation. It was noted from the Regulation 37 (reportable incident report), that one staff member had acted inappropriately when dealing with someone using the service. The staff training records shows that all staff have received training in how to protect vulnerable adults from abuse within the past year. The Lawrence DS0000006195.V357040.R01.S.doc Version 5.2 Page 16 The Lawrence DS0000006195.V357040.R01.S.doc Version 5.2 Page 17 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 and 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. People live in a home that is comfortable and safe. EVIDENCE: A tour of the premises found people relaxing in a well decorated and well maintained home that is comfortable and homely. One person said that they like living in the home because it is “nice”. Another said they liked their bedroom as they have everything they need and have it “how they want it”. The homes returned quality assurance surveys and quality assurance report shows that people are very happy with the home and the services provided. People enjoy living in a home that is clean, as all areas of the home were observed and found to be clean and free from any unpleasant odours. Discussion with the acting manager and a short tour of the premises found that there have been a number of improvements to the environment, which included new carpets and new lounge furniture. To keep the premises looking The Lawrence DS0000006195.V357040.R01.S.doc Version 5.2 Page 18 homely for people using the service, the manager said that funding has been obtained to completely refurbish the bathrooms. People live in a safe environment as the maintenance records show that regular health and safety checks are carried out. The Lawrence DS0000006195.V357040.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34, 35, and 36 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. Peoples care needs are met and they are protected by the way staff are selected and employed. EVIDENCE: On the day of the visit there appeared to be enough staff on duty to meet the needs of people in a relaxed and unhurried manner. The acting manager said that there are enough staff planned to be on duty to respond to peoples care and support needs. The duty rota confirmed this. One person said that they are involved in interviewing new staff and sit as a member of the interviewing panel. The acting manager and staff recruitment records confirmed this. People’s care needs are met by staff that are trained as staff training records show that staff receive training in First Aid, Moving and Handling, Infection control, Food Hygiene and Health and Safety. People are also protected from abuse as records also show that staff receive induction training that includes the complaints policy and procedure and POVA (Protection of Venerable Adults) training. The Lawrence DS0000006195.V357040.R01.S.doc Version 5.2 Page 20 The staff recruitment and selection process further safeguards people as staff records include Police and POVA list checks, references, and proof of identity and employment history. To make sure that people’s needs are appropriately met staff receive regular line management supervision to discuss the work that they do and the training they require. Peoples care and support needs are met by qualified staff as staff training records show that nearly all staff have a NVQ (National Vocational Qualification) Level or above. The Lawrence DS0000006195.V357040.R01.S.doc Version 5.2 Page 21 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 using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including this visit. People have a say in the running of the home and their health and welfare is promoted and protected. EVIDENCE: People live in a well managed home, as the care plans, assessments, reviews and daily, medical, financial and health and safety records show that peoples needs are met, and they live in a home that is run in their best interests. The minutes of the residents meetings, quality assurance surveys, reviews and daily records show that people have the opportunity to comment on the running of the home and the quality of the services provided. The acting manager said that the quality assurance surveys had not been given to relatives or other visitors this year. Peoples financial interests are safeguarded as a sample of three people’s monies were checked and found to be correctly administered. The Lawrence DS0000006195.V357040.R01.S.doc Version 5.2 Page 22 Peoples health, safety and wellbeing is promoted and protected as staff training records show that they receive health and safety training, and the maintenance records show that there are regular emergency systems checks. The acting manager said that they are going to make an application to register with the Commission for Social Care Inspection, as the law says that the home must have a registered manager. The Lawrence DS0000006195.V357040.R01.S.doc Version 5.2 Page 23 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 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 3 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 2 X 3 X X 3 X The Lawrence DS0000006195.V357040.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA7 Good Practice Recommendations The daily records would benefit from an increase in the use of descriptive words to show and reflect people’s choices, preferences and any decisions they make about their lives on a day-to-day basis. The views of people’s relatives and other visitors on the quality of service provided by the home should be actively sought. 2 YA39 The Lawrence DS0000006195.V357040.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND 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 Lawrence DS0000006195.V357040.R01.S.doc Version 5.2 Page 26 - 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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