Inspection on 13/01/09 for Landscore House

This is the latest available inspection report for this service, carried out on 13th January 2009.

CSCI found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Landscore House 21/03/06

Landscore House 27/09/05

Landscore House 12/01/05

Landscore House 21/09/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Landscore House 3 Landscore Road Teignmouth Devon TQ14 9JU     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: Sue Dewis     Date: 1 3 0 1 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. that people have said are important to them: They reflect the things 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 Older People 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 Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Landscore House 3 Landscore Road Teignmouth Devon TQ14 9JU 01626770340 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): npiwebb@tiscali.co.uk Penelope Webb,Nicholas Alan Webb Name of registered manager (if applicable) Penelope Webb Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Landscore House is situated on a hill about half a mile from Teignmouth town centre. The home is registered to care for up to fourteen people aged sixty-five and over. Two bedrooms are large enough to be double, but all bedrooms are currently in single occupation. All bedrooms have an en suite WC and some have a shower. Some of the windows have lovely views across Teignmouth. There is a stair lift, but no passenger lift. There is a large lounge and adjoining conservatory.on the ground floor and also a dining room, which is also used for some office duties. There is a south facing terrace and garden, and a sizeable car parking area. The registered providers live on the premises. Fees range from 370 to 450 pounds per week. A copy of the last inspection report is available in the hallway. Care Homes for Older People Page 4 of 26 0 Over 65 14 care home 14 Care Homes for Older People Page 5 of 26 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 Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced visit took place over 7.5 hours, one day towards the end of January 2009. The home had been notified that a review of the home was due and had been asked to complete and return an AQAA (Annual Quality Assurance Assessment). This shows us how the home has managed the quality of the service provided over the previous year. It also confirms the dates of maintenance of equipment and what policies and procedures are in place. Information from this document was used to write this report. Although only one inspector undertook this visit, throughout the report there will be reference to what we found and what we were told. This is because the report is Care Homes for Older People Page 6 of 26 written on behalf of the Commission for Social Care Inspection. During the visit 3 people were case tracked. This involves looking at peoples individual plans of care, and, where possible 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 CSCI likes to ask as many people as possible for their opinion on how the home is run. We sent questionnaires out to some people living at the home, some visiting health care professionals and some staff. At the time of writing the report, responses had been received from 6 people living at the home, 2 staff and 3 health care professionals. Their comments and views have been included in this report and helped us to make a judgement about the service provided. During the visit 11 people living at the home were spoken with individually as well as observing staff and people living at the home throughout the day. We also spoke with 2 staff and the owners. A tour of the building was made and a sample of records was looked at, including medications, care plans and staff files. All key standards were inspected. We were joined for this inspection by an Expert by Experience. Experts by Experience are people who have used or visited the type of service we are inspecting. Their role is to bring a different and independent view to the inspection process by working alongside inspectors, observing and gaining the views of people who use the service. The Expert by Experiences background knowledge of services enables them to ask different questions and explore different themes. They are able to pick up on and note details, such as care practices, accessibility within the home, interaction and nonverbal communication between staff and people who use the service. People who use the service are able to talk openly and differently to the Expert by Experience and this makes them feel valued. Following the visit the Expert by Experience sent us a report on their findings. Information from this has been included in the main report. What the care home does well: What has improved since the last inspection? 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 4. 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 Older People Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. The admission procedure ensures that there is a proper assessment prior to people moving into the home, and that individuals can be assured that their care needs can be met. Evidence: All rooms have a red file which contains copies of the homes Statement of Purpose, Service Users Guide, menus and the complaints procedure. The files of three people now living in the home were looked at and all contained evidence that a pre-admission assessment had been completed. The owners told us of the procedure they follow when an enquiry has been made about a vacancy. They told us that they encourage people to come and see the home and are given a copy of the homes Statement of Purpose, Service Users Guide and Care Homes for Older People Page 10 of 26 Evidence: Inspection report. The owners said that people often know quite a lot about the home before they come to look around. Following on from the initial meeting the owners complete an assessment of the individual. People are written to by the owners to confirm that the home either can or cannot meet their needs. Although people are usually admitted on a trial basis, we were told that they often make up their minds to stay straight away. The home does not provide intermediate care. Care Homes for Older People Page 11 of 26 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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. Everyone who lives at the home has a care plan which provides staff with some information to enable them to meet peoples health and social care needs on a day to day basis. The management of medication is good and helps ensure people are protected from the risk of not receiving their prescribed medication. Evidence: The care plans of three people living at the home were looked at. They contained a good assessment of peoples health and social care needs, and two contained good details of how staff should meet these needs. It was clear through discussion with staff that they knew what peoples needs were and how they should be met. There was evidence that detailed risk assessments have been completed where necessary and in particular there were risk assessments relating to falls and moving and handling needs. There was evidence that the care plans had been reviewed regularly, there was also Care Homes for Older People Page 12 of 26 Evidence: evidence that the individual or their representative had been included in the care planning process. Care staff told us that they can have access to care plans at any time and that they are always kept informed of any changes. The owners make daily recordings when something particular has changed to the way care is to be given. Staff are directed to the changes via a note in the diary. Changes to the system of recordings were discussed,to ensure that people who wanted to see information written about them would not be able to see information written about other people. There was evidence on file that peoples health care needs were being met, and that a range of health care professionals visited the home, including GPs and District Nurses. It was possible to see where a health problem had been identified, the GP called and medication obtained. One visiting district nurse commented via a survey form that, myself and my colleagues are very impressed with Landscore House........If I had a relative needing a care home it would be my first choice. There is a policy and procedure for the administration of medicines and people are supported to look after their own medicines if they wish to. All medicines were seen to be stored securely and staff were seen administering them appropriately and signing the MAR (Medication Administration Record) as needed. Medication is stored in a location which may not be ideal with regard to temperature, the owners are looking to find a more suitable storage area. Everyone was satisfied with the arrangements for washing, bathing, or showering and they were confident that they receive any necessary assistance at a time of their own choosing. All people we saw during this visit looked well cared for and were treated with respect by the staff and their right to privacy was upheld. Personal care was seen to be offered in a discreet manner. Staff told us how they respect peoples privacy when helping them with personal care and we heard staff speaking with people in a kindly, friendly way. There was an obvious affection between staff and the people they care for. Care Homes for Older People Page 13 of 26 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. 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. An excellent selection of activities, entertainments and outings are available, and there is good daily variation and social interaction for people living in the home. Evidence: There is a wide variety of activities and outings available to people living at the home. Two people said that they took no part in any activities, preferring to remain in their rooms saying, I am happy with my own company and At my age (90 years) I am content to remain in my room and read or watch television. Other people said they took part in drawing and painting sessions or played Scrabble and other games. An accordionist visits fortnightly for a sing song and people told us they enjoy singing and playing tambourines. A clergyman visits fortnightly and gives Holy Communion. Several people said that the owner frequently takes people out in his car, not only for medical appointments but also for social trips to a nearby Garden Centre, the bars at the local Golf Club and Rugby Club, Church on a Sunday and Well, anywhere we want to go said one person. Enquiries revealed that no charge is made for transportation or for the staff time spent waiting at medical appointments. When the weather is good, people said, We take Care Homes for Older People Page 14 of 26 Evidence: advantage of the garden and its beautiful views. Most people had a copy of a daily newspaper. The owners and staff told us that they offer people as many choices as possible and involve people in the running of the home as much as they wish to be involved. A newsletter is now being produced that asks people for any suggestions for the menu, and informs them of any forthcoming events. On the day of the visit some people were receiving hand massages that were paid for by the owners as part of their Christmas present to people living at the home. We were told by the owners, individuals and staff that visitors are encouraged and made welcome at any time. Everyone we spoke with was of the opinion that they chose when to get up and go to bed with or without assistance. One person added Its a bit of mutual agreement with the carer. Some people choose to rise just in time for lunch. Without exception, people were very complimentary about the food saying, Food is excellent and the cook knows what I like and dislike, The vegetarian meals are very good, Food wonderful and Anything you do not like they dont give to you. A dated menu for four weeks is contained in the Service Users Guide in each bedroom and this shows a good variety of meals with several roasts each week. Although there is no choice shown, at the head of each menu the reader is invited to ask for an alternative if the days meal is not to their liking. A cooked breakfast is available at the weekends. The teatime menu has a huge variety of items which can be pre-ordered an hour or so before the meal. People said that late tea/snacks were available for them returning from visits out or if they felt hungry in the evening. The plated lunch on the day of the visit consisted of roast chicken with stuffing, roast potatoes, cheesy leeks, carrots, cabbage and swede. The meal was well presented, hot, tasty and nutritious, peaches and ice cream followed. Four people chose to eat in the pleasant dining room with the remainder eating in their bedrooms. A carer was seen to gently encourage someone who was reluctant to eat. Care Homes for Older People Page 15 of 26 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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. There is a clear and simple complaints procedure and people can be confident that their concerns will be listened to. Procedures are in place to ensure that people are protected from abuse. Evidence: There is a clear and simple complaints procedure in place to help people who wish to raise concerns. There is a copy of the procedure contained in the red files in peoples rooms and displayed in the hallway. The owners told us that they try to deal with all concerns and issues as soon as they become aware of them. Some people living at the home who were spoken with during this visit were unable to tell us whether they knew about the homes complaint procedure or whether they would feel comfortable making a complaint. However, those who were spoken with were able to tell us who they would speak with if they were unhappy about anything. Records show, and staff told us that they had received training in Protection Of Vulnerable Adults (POVA) issues. Both staff that we spoke with were able to discuss different forms of abuse and said that they would report any suspicions they had to the owners. They felt that any concerns would be dealt with straight away, but were also clear about who they would report any concerns to, outside of the home if they Care Homes for Older People Page 16 of 26 Evidence: needed to. Care Homes for Older People Page 17 of 26 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, 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. 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. The home provides a pleasant, comfortable and safe environment for those living in, working at and visiting the home. Evidence: The home owners live on site, and deal immediately with any maintenance issues that arise. All parts of the home seen were warm, bright and welcoming. A full tour of the communal areas of the home was made and some of the bedrooms were looked at. The communal areas of the home were light and airy with a comfortable homely feel. They were nicely decorated and comfortably furnished in a domestic style. Peoples bedrooms contained many individual items and reflected the personality of the occupant. People told us that they had been able to bring things from their home when they had first moved in. The house was clean and free from unpleasant smells. There have been many improvements to the environment including 2 small bedrooms being demolished and six new rooms built to a high specification with full disabled access and shower/en suite facilities. All communal areas have been redecorated as well as some bedrooms. Some carpets have been replaced and some new furniture purchased. The conservatory has been rebuilt and new blinds and a heater have been Care Homes for Older People Page 18 of 26 Evidence: installed so that the room can be used in both sunny and cooler weather. There is a range of aids and adaptations around the home to help staff meet the needs of people who have limited mobility. These include standaids, a mobile hoist, fixed bath hoist and grab rails. Staff told us that they had received training in moving and handling and people had a moving and handling risk assessments in their care plans. Radiators throughout the home are covered which helps reduce the risk of people suffering burns from falling against them. Windows above ground floor level are fitted with restrictors which minimises the risk that people may fall from them. Thermostatic valves are fitted to the hot water system to ensure people are protected from burns from water that may be too hot. Staff said that they had received training in infection control matters and were seen following good infection control procedures. Disposable gloves and aprons were readily available around the home. The laundry is located in the basement and only the owners access this area. The laundry was clean and tidy and has an impervious floor covering to help prevent cross contamination from soiled articles. The washing machine has the ability to meet disinfection standards. Care Homes for Older People Page 19 of 26 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. A wide range of training is provided and the numbers and skill mix of staff on duty are sufficient to meet the needs of people currently living at the home. People are protected by recruitment procedures that ensure people who may be unsuitable to work with vulnerable people are not employed at the home. Evidence: On the morning of the visit there were 3 care staff on duty plus the owners, and a cook. Care staff are also responsible for cleaning at the home. At night there is one staff awake from 8pm - 8am with the owners on call. People said that the call bells were always answered in less than 5 minutes and often within 2 minutes both day and night. They were confident that there were enough staff on duty to meet their needs commenting, They really care about you here, Staff helpful, Friendly and helpful. One person said, There is a good repartee between residents and staff. Staff were seen to be polite and caring in a genuine manner. The staff spoken with enjoy working at the home and staff morale appears to be high. The owners work alongside their staff and are very much involved in providing and monitoring the care provided. Care Homes for Older People Page 20 of 26 Evidence: Three staff files were looked at. All the files contained all the required information including a satisfactory CRB (Criminal Records Bureau) check, two written references and proof of identity. Training has a high priority at the home with the owners providing much of the training themselves using the BVS training system. Records show and staff confirmed that they receive a wide variety of training including a comprehensive induction for all new staff. Other training includes Fire procedures, Moving and Handling, Food Hygiene, First Aid and Infection Control. Staff are also encouraged to work for NVQs (National Vocational Qualifications) and currently 7 staff have or are working for NVQ level 2 or above. Care Homes for Older People Page 21 of 26 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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. The home is well managed resulting in practices that promote and safeguard the health, safety and welfare of people who live and work in the home. Evidence: Mrs Webb, one of the Registered Providers, is also the registered manager of the home. She has worked at Landscore House for over thirteen years, and is experienced and knowledgeable about this client group. She has continued to undertake training, and has completed the Registered Managers Award and NVQ 4 in care. Mr Webb has also completed the Registered Managers Award and is working for an NVQ 4 in care. Staff that we spoke with during the visit told us that they felt supported and encouraged by the owners to do a good job. Comments received via survey forms include Penny and Nick are very approachable, can discuss anything with them, they are very supportive with work and if any problems at home. Care Homes for Older People Page 22 of 26 Evidence: There is a formal quality assurance system in place at the home. Questionnaires are sent out to everyone connected with the home and any suggestions implemented. The information from these questionnaires is collated into a report, which is made available to everyone at the home with a copy being given to us during the visit. No monies are managed on behalf of people living at the home. The AQAA (Annual Quality Assurance Assessment) submitted prior to the visit, provided evidence that Landscore House complies with health and safety legislation in relation to maintenance of equipment, storage of hazardous substances, fire precautions, health and safety checks and risk assessments. Policies and procedures are not always inspected during the visit but the information provided on the AQAA helps us form a judgement as to whether the home has the correct policies to keep people living and working at the home safe. Information provided by the home, evidenced that policies and procedures are in place and along with risk assessments are reviewed regularly and updated where necessary, to ensure they remain appropriate and reduce risks to people living and working at the home. So that the risk of burning from hot surfaces is minimised, radiators within the home are covered and so that the risk of burning from hot water is minimised temperature controls are fitted to taps. Restrictors are fitted to windows above ground floor level to minimise the risk of anyone falling from these windows. Care Homes for Older People Page 23 of 26 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 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, 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 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 Care Homes for Older People Page 25 of 26 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 Older People Page 26 of 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. 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!