Inspection on 25/09/08 for Laywell House Ltd

This is the latest available inspection report for this service, carried out on 25th September 2008.

CSCI found this care home to be providing an Good 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

Laywell House Ltd 06/06/07

Laywell House Ltd 15/11/06

Laywell House Ltd 29/11/05

Laywell House Ltd 07/06/05

Laywell House Ltd 18/01/05

Laywell House Ltd 09/06/04

Laywell House Ltd 02/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

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 29/01/2009.

CARE HOMES FOR OLDER PEOPLE Laywell House Ltd Laywell House Summer Lane Brixham Devon TQ5 0DL Lead Inspector Rachel Proctor Key Unannounced Inspection 25 September 2008 9:45 X10015.doc Version 1.40 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 Laywell House Ltd DS0000018384.V367179.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 Older People. 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. Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Laywell House Ltd Address Laywell House Summer Lane Brixham Devon TQ5 0DL 01803 853572 01803 853572 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) Laywell House Limited Mrs Vera Dorothy Caunter Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30), Physical disability over 65 years of age of places (30) Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP 2. Physical disability aged 65 years or over on admission - Code PD(E) The maximum number of service users who can be accommodated is 30. 16th October 2007 Date of last inspection Brief Description of the Service: Laywell House is a large extended detached residence that has two stories and stands in its own grounds. The home offers 24-hour residential care for up to 30 persons in the category of Old Age and Physical Disability over the age of 65 years. The home has available three separate communal lounge areas and a dining room. There are 28 single rooms and 1 double, 12 of the single rooms have on suite facilities. Two vertical lifts are provided and bathing and toileting aids are available for persons with mobility issues. At the front of the building there is a hard standing car park, which has the capacity to take several vehicles. At the rear of the home there is a large well-tended garden, which has views of the surrounding area. There are also productive vegetable and fruit plots that supply the home. Access into the building is by a single step; a folding ramp is available for use when required, all other entrances into the building are level. The weekly fees payable are: lowest £340.00 and the highest is £412.00. The statement of purpose was available in the office of the home. Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This was a key unannounced inspection, which took place over two days in September 2008. During the visits a tour of the home was completed. People living at the home and staff were spoken to and some records were inspected. Three of the people living at Laywell House had their care followed as part of this inspection. Their records of care were seen; the individual rooms they occupied were visited. The people whose care was followed were spoken to about their experience of care where this was possible. Information received from the home since the last inspection was reviewed, this included the AQAA (Annual Quality Assurance Assessment). Three people living at Laywell House two relatives and two staff members returned survey forms prior to this inspection. Some of the comments in the surveys and comments made during the inspection have been incorporated into this inspection report. All required core standards were inspected during the course of this inspection. What the service does well: What has improved since the last inspection? Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 6 All the Requirements made at our last inspection had been met. The manager has a new pre admission assessment process for people who wish to stay at Laywell House. This was being followed up by a comprehensive assessment of their health; personal and social care needs following admission to the home. People’s individual care plans include risk assessments and their plans of care provide clear information about how the persons care needs should be meet and what was important to them. This should ensure people have the care they need provided in a way they expect. The registered manager has ensured that all staff that administers medication in the home have received training from a recognised trainer. This should ensure medication practices are safe. The registered manager has set up a system to ensure that all care staff receive formal supervisions a minimum of six times per year. Staff spoken to confirmed they regularly meet with the manager to discuss work issues. This should ensure that staff know what is expected of them. The registered manager has ensured that monthly reviews are carried out on all care plans. People spoken to confirmed that a senior member of staff discusses their care needs with them on a regular basis. This should ensure any changes in their care needs are recorded and people have their current care needs meet. The training information for new staff shows that they have received basic instruction in fire safety, manual handling, health and safety. Staff spoken to confirmed they had regular up dates for manual handling and fire safety in the home. This should ensure staff have training that enables them to work safely and protect the people they are caring for. The registered manager provided a copy of the quality assurance report completed. This was available for people who live in the home and their representatives. The manager was able to show how she monitors quality in the home. This should ensure that people are aware of how the home is being run, and demonstrates that the management of the home listens and acts on what people who live and visit Laywell House say. What they could do better: Two good practice Recommendations have been made as a result of this inspection. These relate to reviewing risk assessments separately to the care plan review and medication management for people admitted for respite. Any improvements the manager makes will improve on the already good practices observed at Laywell House. Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 7 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. Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6. Quality in this outcome area is good. People are given sufficient information about Laywell House to make an informed choice about whether the home can meet their needs. People can have confidence that a staff team who have their best interests at heart will assess their care needs. People are given the opportunity to be involved in their assessment and influence the way their care is provided. This means that people living at Laywell House receive person centred care. The home does not provide intermediate care, however they can provide planned respite for people. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People are given sufficient information about Laywell House to make an informed choice about whether the home can meet their needs. The statement of purpose was available in the office of the home. Individual people spoken to were aware of what the home could offer. Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 10 The manager confirmed that people are only admitted on the basis of a comprehensive assessment being completed to ensure an appropriate service can be provided to meet those needs. The new assessment process adopted by the manager provides clear information about the persons health and personal care needs. The assessments also include the things that are important to the person. Such as the food they like to eat the activities they enjoy and who was important to them. The assessments had been followed up with a plan of care, which addressed the care needs for the individual person. One person admitted to the home recently spoken to said the manager had discussed what they needed with them and asked them about the things that were important to them. One person whose care was followed had been given the opportunity to go home for a day before they made the decision to stay at Laywell House permanently. Their representative said this had enabled them to make a difficult decision more easily. The person said they had been helped to settle at Laywell House, staff were helpful and they liked their room. Laywell House does not provide intermediate care. However they do provide planned respite care for people. The manager advised that she had adopted a different assessment process for people admitted for respite. One of these was seen completed for a person whose care was followed. The assessment and care plan followed checklist style documentation. The assessment had been personalised to reflect the care needs the person had. When this person was spoken to they said they were satisfied with the caring attention the staff were giving them. Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11.Quality in this outcome area is good. The person centred care planning approach adopted by the manager means that people have the care provided in a way they would do themselves if they were able. People receive the health and personal care they need from a staff team who understand them. Medication practices are safe People living at Laywell House are treated with respect and dignity and their needs and wishes are taken into account when is provided. People are encouraged to be involved in their care planning process. This ensures that care is provided in a person centred way. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three people had their care followed as part of this inspection. This included looking at their care planning information and assessments, meeting and speaking to the person in private where possible. The rooms these people occupying in the home were also visited. The care planning information for the Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 12 three people whose care was followed was comprehensive. The new care planning process the manager had introduced provided clear information for staff about the care needs of the individual and how they should be met. The care planning process included how the person could be involved in their care and what they were able to do for themselves. Two of the people whose care was followed said their care needs had been discussed with them. They said theyd been asked about what was important to them and what their likes and dislikes for food, music and other entertainments were. The care plans were an up to date working tool used by the individual person where possible and staff. The care plan could be easily used by staff who are not familiar with the individual to deliver personalised and consistent person centred care. One person whose was care was followed had had a fall earlier in the year. The information regarding the action taken to reduce the risk of falls were clearly recorded in the persons care plan and in an accident record. The person said since they had returned to the home following the fall their ability to walk was not as good as it had been. They said the home staff were working with them to help them maintain as much independence with the mobility as they could. The persons plan of care included manual handling assessment. The care plan had been reviewed monthly and changes recorded. However the manual handling plan had not been reviewed separately following the hospital admission. The manager advised that the person still required the same amount of help although they were not able to walk as far as they used to. One person whose care was followed was not able to communicate by speaking. The care plan clearly indicated how staff should involve the person in their care and ensure they understood what was happening. The manager advised that the speech and language therapist had provided an alphabet board and pictures to use with the person. She also said that staff had become accustomed to the expressions and gestures the person made when they wanted something. This person was spoken to in the privacy of their own room they were able to indicate that they were satisfied with the care they were receiving in the home. The staff observed providing care for this person appeared to understand what they wanted. They were friendly respectful and helpful to the person as they tried to understand what it was they wanted. The way the person was responding to the staff indicated they were used to being listen to and given time to express themselves. Another person whose care was followed had been admitted for a short respite stay to give them a break. They had chosen to stay in the privacy of their own room. They said they had been given the opportunity to go to the lounge or dining room with other people if they wished or take part in the activities provided. The person had drinks easily available to them in their room. A call bell had been placed within easy reach, the person said that staff responded quickly when they used to call bell. They also commented that staff were very kind and helpful to them. Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 13 The care plans for people whose care was followed had a record of the involvement of the multidisciplinary team including the persons GP. Where professional had made recommendations regarding the care of a person these have been followed up in that persons care plan. The manager advised that she used the district nurses and other nurse specialists for advice and support when caring for people living at Laywell House. The way this information was provided shows that people have access to the health care they need. The key principle of Laywell House was that people living there are in control of their lives and they direct the service. Staff are fully committed in supporting individuals to be as independently as possible. People living at Laywell House are encouraged to make their own informed decisions. The care plans are person centred and focuses on the individual’s personal preferences. The medication records of three people whose care was followed were reviewed with the manager during the inspection. People had a record of the medication given, which the staff assisting them had signed. One person whose care was followed he was receiving respite care had their medication in a dose box. However the name and the dose of the medication had not been recorded on this. The manager advised that the pharmacist had been asked to prepare a blister pack for this person’s medication. This had been provided by the second day of the inspection. The manager confirmed that only staff who had received training for medication were given responsibility for assisting people with their medication. A record of medication return to the pharmacist was being kept. This had been signed and dated. The way medication was being stored showed that the manager had achieved good stock control and only medication people were currently using was being stored. Medication for return to the pharmacist was being stored in a separate area in the locked cupboard. The manager confirmed that information about the medication people were taking was available for staff. The controlled drugs record book was checked against the stock for one person as correct. Where control drugs had been returned to the pharmacy this had been recorded in the control book, signed and dated. The staff observed providing care were doing so in a friendly respectful way. People spoken said the staff are very kind and they were well looked after. The care planning information provided indicates that the people who live at Laywell House are at the centre of care practices. This means that people who live at Laywell receive person centred care. Discussion took place with the manager regarding the care of people who became terminally ill. She advised that she was aware of the Liverpool care pathway for the care of people at the end of life. She also advised that she had good support from the district nurses who visited the home on a regular basis. The manager was aware that the hospice provided training for staff for Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 14 end of life care. She advised that it was her and the staff teams aim to provide a home for life for people where this was possible. Although the manager and the staff team were not caring for anyone at the end of life at the time of this inspection. The way care planning was organised and the attention to person centred care would mean people’s needs and wishes at this time are met. Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. People who live Laywell House are given the opportunity to take part in activities they enjoy. Staff listen to people and try to ensure the activities they like are available to them. People are encouraged to maintain contact with family and friends who live in the local community. People visiting Laywell House feel welcome. Mealtimes are a pleasant experience for people who live Laywell House. They are given choice and encouraged by staff to make mealtimes a sociable occasion for everyone. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Six people living at Laywell House was spoken to during the inspection. Some were seen in the privacy of their own rooms others were spoken to in one of the communal lounges. People gave positive feedback about what it was like to live at Laywell House. One person spoken to in their own room said, I know there are lots of activities available that I can take part in but I prefer to stay in my own room. Another person spoken to said they really look forward to the exercise classes that the staff did with them on a regular basis. During the inspection a member of staff was encouraging people to exercise their arms Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 16 and legs was sitting in the chair. The people taking part were laughing with each other and the staff member. The manager provided two record folders, which showed the activities that people had taken part in. One folder contains a record of the entertainment or activities that have been provided by outside agencies and the other contained a record of the activities staff provided with individual people. This showed that people had access to a variety of activities. The three people whose care was followed had a record of the activities they enjoyed. Staff appeared to understand what was important to individuals and what they enjoy doing. Two people spoken to in the lounge said the staff were very good and enjoyed being able to choose what they took part in. One person said they look forward to having a manicure and fresh nail polish. They said a member of staff provides this on a regular basis for those who want it. Visitors were coming and going throughout the inspection. The manager advised that visiting isnt restricted unless the person has requested not to receive visitors or there are health reasons why they shouldnt receive them. Three visitors spoken to during the inspection said they were always made welcome by the staff and the manager. All said that the manager and staff always keep them informed about things that are important. The way individual care plans are recorded shows that people are given the opportunity to exercise choice and control over their daily lives. Individual likes and dislikes are clearly recorded in the care plan. The individual rooms people occupying had been personalised with items of their choice. The manager advised that when the person was able their care plan was discussed with them and they can sign this to say they agree. Two examples of this were seen during the inspection. All the people spoken to during the inspection said they really look forward to mealtimes and enjoyed their meals. There was a spacious dining room for people to sit comfortably and eat their meals. The lunchtime meal observed appeared to be a pleasant experience for the people living at Laywell House. Meals are very well balanced and highly nutritional and cater for varying cultural and dietary needs of the people living at Laywell House. The three people spoken to during a lunchtime meal said they always know whats for lunch each day and staff speak to them in the morning about whats on offer for the lunchtime meal. One person said they really enjoyed curry. People were being given the choice of cottage pie or chicken curry. Very little wastage was seen at the lunchtime meal and people were being offered second helpings if they wished. One relative who visited over a lunchtime period was provided with a cup of tea and offered something to eat while they waited for their relative to finish lunch. Menus are available in the kitchen. The manager advised that these are change seasonally. Staff assisting people to eat their meals were doing so in a friendly supportive discreet way. People were able to choose to eat their meals in their own rooms as they wished. Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is Good People who live at Laywell House can have confidence that any concerns they have will be dealt with promptly by the staff team who are caring for them. People are cared for by a staff team who understand them and know how to protect their interests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has ensured that there was a robust complaints policy and procedure available for people who live at Laywell House. Information regarding how to complain was displayed in the reception area of the home. This included the contact details for the Commission. All those spoken to during the inspection who were visiting or living at Laywell House were clear how to raise concerns if they had any. Two visitors commented that the manager deals with any concerns they have had promptly and they did not have any concerns at present. Both commented that they were impressed by the way the manager and staff put the people living at Laywell House first and always tried to ensure their wishes were taken into account. One person spoken to in the privacy of their own room said staff were always polite and friendly and listen to them. The manager advised that people living at the home are always put first and any concerns they have are always dealt with as quickly as possible. Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 18 Information was available for staff in relation to protection of vulnerable adults from abuse. The staff spoken to were clear about how any disclosures or concerns they had should be dealt with. The manager confirmed that staff have received training in protection of vulnerable adults and had access to information packs if they needed them. Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26. Quality in this outcome area is Good. People who live at Laywell House have a well-maintained, clean, fresh environment to live in, which meets their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the home was completed with the registered manager. Some individual peoples rooms were entered in each area where people were living. During this tour some people who had chosen to stay in their own rooms were spoken to in private. All the areas seen during the inspection were being kept fresh and clean. The maintenance and redecoration of individual peoples rooms and communal areas has continued since the last inspection. The manager advised that rooms are redecorated and re-carpeted as needed when the rooms become vacant. The manager advised that the lounge and kitchen area that had been part of the annex had been converted into two large en suite rooms for individual Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 20 people. These rooms had almost been completed at the time of the inspection. The manager advised that people using the rooms in this area had been using one of the three communal lounges close to the entrance of the home. People spoken to in each of the three lounge area said they like to be where things were going on. Two people were sitting in the smaller quiet lounge during the first day of the inspection. They said they like sitting there as they could have a chat and not disturb other people. The manager advised that one of the bedrooms that was currently used for respite would be put to alternative use once the new en suite bedrooms had been completed. People spoken to in the privacy of their own rooms said they liked the rooms they were in the two said they really enjoyed the view of the garden. During the inspection a gardener was working in the grounds. Disabled access bathrooms and toilets are available for people who need them. The manager confirmed that hot water temperatures are regulated and the maintenance man does regular checks to ensure hot water temperatures are kept within safe limits. A variety of manual handling aids and equipment were available for staff to use to assist people. The manager had provided information about the service of this equipment. Different peoples rooms entered were being kept at different temperatures. The manager advised that the temperature could be adjusted to suit the needs and preferences of the individual living in the room. The home has a laundry, which was sited away from individual peoples rooms and the kitchen of the home. They were separate areas in the laundry room for clean and dirty laundry. The manager had provided a bolt to the outside of the door to ensure people’s safety when a member of staff wasnt in the laundry. A hanging rail was provided for peoples clothes as well as individual baskets. The manager advised that peoples individual clothing was return to their rooms by staff after its been laundered. Discussion with the housekeeper revealed that they ensure the home was always kept fresh and clean for the people who live there. Cleaners were working in the home on both days of the inspection tidying and cleaning individual people’s rooms, bathrooms and communal areas. Staff have access to gloves and aprons for use when providing personal care for people. The home has an infection control policy provided for staff use. Staff observe providing care for following good infection-control practices. Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is good. The manager ensures that the numbers and skill mix of the staff provided to care for people are able to meet their care needs in a way they would do themselves if they were able. People living at Laywell House are protected by the robust recruitment procedures in place, which protects them from unsuitable staff. People are cared for by a knowledgeable staff team who try to ensure people receive the care they need in a way that respects their individuality as well as meeting their needs and wishes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager provided a rota, which showed how many staff were on duty each shift, and in what capacity they were employed. In addition to care staff the home employs kitchen, domestic and maintenance staff. Two staff were spoken to individually and three staff were spoken to together. All said they had sufficient staff on duty each shift to meet the needs of the people they were caring for. Two commenting that work was arranged around the people living at the home. One carer said some people prefer to have a bath in the morning others prefer this in the afternoon. They said were possible peoples individual choice was respected. People were getting up at different times during both days of the inspection. Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 22 The pre inspection information AQAA (Annual Quality Assurance Assessment) indicated that 14 of the 20 care staff had achieved an NVQ level 2 or above in care and a further 2 staff were working towards this qualification. Staff spoken to said the manager had encouraged them to attend training and they had access to training that helped them do their jobs well. The manager confirmed that all new staff have an induction that covers the important aspects of care including health and safety. An example of the induction programme used was provided for inspection. Two staff files were seen during the inspection. These contained application forms, references, proof of identity and a record that a satisfactory police check had been completed. The manager advised that new staff are not confirmed in post until all their pre employment checks are returned. One member of staff who had started work at the home since the last inspection confirmed that they had all the pre employment checks completed prior to starting work at the home. Staff files were being kept securely in the office of the homes office, which was separate to the office used by the manager. All the staff spoken to during the inspection said they enjoyed working at the home. They said the manager was firm but fair and ensured that they had access to information and training they needed to do their jobs. People spoken to who were living at Laywell House said staff were very helpful and understood what they needed. One person went on to say staff helped them with the things they were unable to do themselves and encouraged them to do the things they could. Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38. Quality in this outcome area is good. People living at Laywell House have benefited from improvements in the management of the home introduced by the registered manager in the last twelve months. The home manager has introduced a person centred approach to care. This ensures that Laywell House has continued to be run in the best interests of the people who live there. This approach means that people’s individuality is respected and promoted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has several years experience in care and has the required qualifications was competent to run the home. The manager has a clear understanding of the key principles and focus for Laywell House she has work Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 24 hard to improve people’s experience of care. This has increased the quality of life for people by focusing on dignity, respect and fairness. There was also a focus on person centred care. People living at Laywell and their representatives being encouraged to influence what was provided for them. The results of a recent quality audit were provided for inspection. These showed that the manager has involved the people living at Laywell House and their representatives when making changes. People visiting the home said they were kept informed and the manager provided them with all the information they needed. People living at Laywell said they thought the home had improved since the new manager had started. Laywell House has policies and procedures, which the manager has reviewed and updated. These were provided in the office of the home. The staff spoken to during the inspection were aware of the policies and procedures for the home. Staff said that they regularly receive feed back from the manager about their work. The Requirements and Recommendations set at the last Key inspection had been fully met. The manager advised that she and the staff team had worked together to address the shortfalls identified at the last inspection. The manager has a system for securely storing and recording money held for individual people in the home. The records of expenditure and receipt were checked for one person as correct. The manager advised that money held for individual people at their requested was stored in a separate envelope in a locked safe. A chart showing when staff received supervision was being kept in the manger office. She advised that she had arranged the date and time of supervision in advance to give staff the opportunity to plan for this. Staff spoken to during the inspection confirmed they met regularly with the manager or senior person in the home either formally or informally. The staff reported the manager was very approachable and they knew what was expected of them. The manager confirmed that all staff have regular up dates for mandatory training for fire, manual handling and health and safety. A record of the training staff had received and copies of certificates for training were being kept in staff files. Information relating to COSHH (Control of Substances Hazardous to Health) was available in the office of the home for staff use. Chemicals used in the home were being stored securely or out of reach. The dates when equipment was services and electrical and gas boiler checks were completed was provided with the AQAA (Annual Quality Assurance Assessment) information prior to the inspection. The records for one service equipment check were seen at the home during the inspection. The manager confirmed that an environmental assessment had been completed for the Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 25 home. She also advised that the maintenance man had taken responsibility for checking hot water temperatures in the home. Staff were receiving a fire training lecture during the inspection from a recognised trainer. Staff confirmed they received regular training for manual handling and health and safety. The manager was keeping a record of accidents. This showed the incident and what had been done following this to reduce the risk. One person whose care was followed was identified as at risk of falls. They had a clear plan of care, which identified how staff should reduce the risk for this individual. Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 4 X X X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 3 X 3 Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 27 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 2 Refer to Standard OP8 OP9 Good Practice Recommendations The manager should review individuals risk assessment separately to the care plan review. This should ensure they accurately reflect the person’s current risk. The manager should ensure that people admitted for respite; where possible have their medication prepared for dispensing in blister packs by the pharmacy as other people in the home do. Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Laywell House Ltd DS0000018384.V367179.R01.S.doc Version 5.2 Page 29 - 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. 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