Random inspection report
Care homes for older people
Name: Address: Landemere Residential Care Home Inverary Close Off Grampian Way Sinfin Derby Derbyshire DE24 3JX one star adequate service 03/08/2009 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Claire Williams Date: 0 8 0 6 2 0 1 0 Information about the care home
Name of care home: Address: Landemere Residential Care Home Inverary Close Off Grampian Way Sinfin Derby Derbyshire DE24 3JX 01332272007 01332271224 maxine.smith@anchor.org.uk www.anchor.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Maxine Elizabeth Smith Type of registration: Number of places registered: Conditions of registration: Category(ies) : Anchor Trust care home 41 Number of places (if applicable): Under 65 Over 65 41 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is 41 The registered person may provide the following category of service only Care Home only PC To service users of the following gender Both Whose primary care needs on admission to the home are within the following category Old Age, not falling within any other category Code OP Date of last inspection 0 3 0 8 2 0 0 9 Care Homes for Older People Page 2 of 10 Brief description of the care home Landemere is a purpose built care home for Older People, was built in 1991, and provides accommodation for up to 40 Older People. It is situated close to local amenities and to bus routes serving Derby city centre. The accommodation is on two floors, with access to the first floor via staircases or via a shaft lift. All rooms are single occupancy, with en-suite facilities. Each room has the benefit of refreshment facilities and is fitted with a small refrigerator. Services include personal laundry, meals, and personal care designed to meet individual needs. The charges made for a room at Landemere Care Home were between £348 to £455 per week. Extras included some toiletries, private chiropody, private dentistry and hairdressing, a list of charges was on display in the hairdressing room. The manager provided this information. A copy of the last inspection report is available from within the service and on display in corridor areas. Further copies can be found by visiting www.cqc.org.uk Care Homes for Older People Page 3 of 10 What we found:
The purpose of this Random unannounced Inspection was to check compliance with the Care Homes Regulations 2001 in a narrow focus of Inspection activity and in preparation for the registration transfer under the Heath and Social Care Act 2008. We last visited this service to undertake a key inspection on the 3rd August 2009 when the current quality rating was made. We prepared for this visit by looking at all of the information we have received about this service. This included; The annual quality assurance assessment (AQAA) that was sent to us by the service. This is a self-assessment for providers, which is a legal requirement. This assessment gives the provider an opportunity to let us know about their service and how well they think they are performing. Surveys returned to us by people using the service and from other people with an interest in the service. Information we have about how the service has managed any complaints. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. Relevant information from other organisations. For this visit we was accompanied by an Expert by Experience. This is a person who, because of their shared experience of using services, and ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. The expert by experience spoke to people and visitors during this visit. We looked at the systems, records and evidence in place to ensure all previous requirements had been addressed, and to see if the service was meeting peoples needs. The registered manager was on duty and assisted us with this random inspection. At this inspection we case tracked two people who used the service. Case tracking is a method used to track the care of individuals from the assessments undertaken before they are admitted to a service through to the care and support they receive on a daily basis. Improvements had been made to address the previous requirements, and the files contained detailed pre- admission assessments and plans of care, which covered all areas of need applicable to the person. However we did identify some gaps in the documentation where the information had not been transferred from the pre-admission assessment. There was also no evidence in one file to support that the person had been involved in the development of their plan of care. Action was taken during our visit to address these issues. We was told an audit of the records for new admissions would commence to ensure all documentation is in place. The care plans were generally completed in a person centred detail. However in some areas such as social, emotional, and dietary requirements, some of the content was generic and not specific to the preferences and needs of the individual. We was informed that this would be addressed within the next two days, and further training would be provided to the staff team, in relation to writing care plans in a personalised way. This
Care Homes for Older People Page 4 of 10 will ensure individualised care is provided. There was evidence to support that the care plans were reviewed on a regular basis. The care plans contained the required risk assessments that should be undertaken to monitor peoples mobility, pressure areas, and nutrition and falls. A risk assessment was also in place for the use of bed rails, but the person had not yet signed the consent form in agreement to these being used. Action was taken during our visit to complete this record. All risk assessments were reviewed as required. The care records confirmed that contact with external health care services is routinely made. The medication practices were looked at and improvements have been made to address the previous requirement. There was clear records in place for receipt, storage, administration and disposal of medications held. The medication and records for the people case tracked were looked at and these demonstrated that they received their medication as prescribed. Internal and external audits have been undertaken since our last visit in order to monitor the standards in place and to identify and address any shortfalls. We did identify that the temperature of the medication fridge was not always monitored on a daily basis. Medication such as insulin and eye drops was stored in the fridge at the time of our visit. The expert by experience spoke with ten people and 3 visitors and this is what their findings were: People told the expert that they were treated with dignity and respect (including being bathed) and that they were happy living in this service. The expert observed the staff to be caring, but they encouraged people to be as independent as possible. People said there was activities available (with an Activity Co-ordinator) such as manicures, and an activities programme was in place and displayed in the foyer area. Bingo was the most popular activity, and people did say they would like more craft activities, singsongs and community activities. Three people said they would like a church service more often than once a month and a communion service included. People said the food was nutritious and there is a choice of meals with a menu always available. People told the expert they were satisfied with the service. The expert by experience observed that their flat-lets were well decorated, furnished and clean. People said they appreciated this. People and visitors did say they were not fully aware of the complaints procedure. However the minutes of the previous residents meeting demonstrated that this was discussed with people. We were told this would be re- visited to ensure people are fully aware of this procedure. People and their relatives said they were happy with the procedures in place for the safe keeping of their money. The service has had 4 safeguarding incidents since our last visit. These are in relation to thefts within the service. The service has followed the procedures in place and are currently working with the police to investigate. The service has received 11 complaints since our last visit. The issues raised include some of the following: Cleanliness of the building, odours, lost items in the Laundry, and an alarm pendent not working in areas of the building. All issues have been investigated and addressed and satisfactory records were in place to support this. During our brief tour of the building we found all areas to be clean, homely, warm and well lit. The physical environment was appropriate to the specific needs of the people who
Care Homes for Older People Page 5 of 10 currently live there. It was well maintained and had the required aids and equipment in place in order to meet peoples specific needs. We looked at the training records and the systems in place for recruiting staff. These demonstrated that staff have completed all of the required mandatory training. We found that the service undertakes all of the required checks to ensure the staff are suitable to work with vulnerable people. Discussions with staff members and the feedback from the surveys demonstrated that staff had regular training opportunities and were recruited appropriately. The staff members we spoke to, and the feedback in surveys told us they felt supported in their roles. The staff said they continue to have access to supervision, and team meetings. Comments from staff included: The people that live here are well cared for and have a say about the way the service is run. There is a good atmosphere in this service, and we all care about ensuring people receive a good standard of care. We have good training opportunities, and regular meetings. We all work as a team to ensure we meet peoples needs. The staff also told us about areas that could be improved and some of these comments included: Praise the staff more, sometimes we feel unappreciated and this can effect morale. More staff and not agency staff. Better communication. More activities and more support from family members. We was told that sufficient staffing was available in order to meet peoples needs. The dependency, and the staffing levels are reviewed weekly by the manager to ensure sufficient staff is on duty. The expert told us that people had said The staff numbers on duty were usually adequate, and a staff member would attend when they pressed the buzzer. A delegate of the provider continues to visit the service on a monthly basis to monitor the standards in place. Any issues raised are now part of an ongoing action plan to monitor progress in addressing issues and action taken in a timely way. Systems such as excellence audits and dip testing are in place to monitor standards in the service to ensure peoples needs continue to be met, and the records are up to date. Feedback is obtained from people, through the quality assurance surveys and regular meetings that are held. This ensures people are involved and consulted about the way the service is delivered. What the care home does well:
People are confident that the service is able to meet their needs because an assessment is completed with them, before they move into the service. This informs the staff about
Care Homes for Older People Page 6 of 10 the support they need and their individual preferences. People made the following comments in the surveys we received: I like living in this service, the routines were flexible and we can choose how we spend our day. The staff look after very well especially when we are poorly. There is always someone around so you dont get lonely. They look after us well, and provide good meals and regular baths. Look after us and meets our needs. Provide hairdressing. Regular visits to the chiropodist, and they provide activities. Good laundry service. People are supported by a trained staff team who are dedicated to ensuring peoples needs are met to a good standard. The staff spoken with demonstrated a good understanding of the needs of the people they supported. People are regularly consulted about the service and the suggestions they make are listened to and implemented which ensures the service is run in their best interests. The service has continued to be committed to providing a service thats meets peoples needs and the provider has continued to reinvest in the quality and fabric of the building and the staff who work there to support this aim. What they could do better: 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 2. Care Homes for Older People Page 7 of 10 Are there any outstanding requirements from the last inspection? Yes £ No R 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 10 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 Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement 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 2 3 7 All of the pre-admission records should be completed in full to ensure staff have access to this information The information in the social, emotional, eating and drinking care plans should be personlised and specific to the person and not generic in detail. This is to ensure the care plans reflect peoples actually needs and perferences. Handwritten medication instructions should be countersigned by two people to ensure they are validated. The temperature of the medication fridge should be monitored and recorded daily. This is to ensure medication is being stored at the correct temperature. 3 4 9 9 Care Homes for Older People Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 10 of 10 - 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!
