Inspection on 10/06/10 for Lee House

This is the latest available inspection report for this service, carried out on 10th June 2010.

CQC 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.

Similar services:

Coppermill Care Centre

Abbey Care Complex

Victoria House

Compton Lodge

Conifers The

Coplands Nursing Home

Coombe Hill And Blenheim Lodge Nursing Home

Heatherwood Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/06/2011.

Key inspection report Care homes for older people Name: Address: Lee House 2 Lancaster Avenue London London SW19 5DE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Emma Dove     Date: 1 0 0 6 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial 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. 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: Lee House 2 Lancaster Avenue London London SW19 5DE 02089460369 02089474791 t.mclaughlin@abbeyfield.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): The Abbeyfield Society Name of registered manager (if applicable) Type of registration: Number of places registered: care home 21 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The Maximum number of service users who can be accommodated is 21 The registered person may provide he following category/ies of service only: Care home only - Code PC, to service uses of the following gender: Female, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category- Code OP Date of last inspection Brief description of the care home Lee House is a registered care home providing care and accommodation for up to twenty one older ladies. Sixteen ladies are currently living there. Lee House is owned and managed by The Abbeyfield Society. Lee House is situated in a private cul-desac, five to ten minute walk from shops, public transport and amenities in Wimbledon Village. The home is a two-storey house which was extended in 1991. Accommodation includes two lounges, a dining room, three laundry rooms, one assisted bathroom, one Care Homes for Older People Page 4 of 26 Over 65 21 0 Brief description of the care home walk in shower room and one accessible toilet. All bedrooms are single with an en-suite bathroom, and they have a small fridge, two electric cooking rings, a microwave, a kettle and toaster. Two lifts and a stair lift serve all floors. People have access to a large well-maintained established garden. Garden furniture is provided, awnings have been fitted to windows giving protection from the sun. Parking is available at the side of the home and in the road. The current fees are from £720.00 per week. 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: two star good 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 is the first key unannounced inspection of Lee House since it was taken over by the Abbeyfield Society. The inspection was carried out over five hours on the 9th and five hours on the 10th June 2010. One inspector visited, spoke with people who use the service, staff, the manager and looked at records. Surveys were sent to people who use the service and staff. We received fifteen surveys from ladies who live at Lee House and three members of staff, comments from these are included thoughout this report. We received an annual quality assurance assessment. This gave us good information about the service, what it does well and areas that will be developed over the next year. We looked at other information received from the service during the last year. Care Homes for Older People Page 6 of 26 Care Homes for Older People Page 7 of 26 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 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 service understands the importance of having sufficient information when choosing a care home. The Service Users Guide contains clear information about the services provided, staff and accommodation at Lee House. Assessments are completed before admission, to ensure the service can meet the individuals needs. Intermediate Care is not provided. Evidence: There is a detailed Statement of Purpose and Service Users Guide which include information about the organisation, the home, who the service is for and detail the routines, mealtimes including a sample menu, cleaning, laundry and activities. These documents also cover some key policies with information on how to make a complaint, visitors, fire safety, confidentiality and medication. Fifteen ladies told us in surveys that they had enough information to help them make the decision to move in. In surveys, twelve ladies told us they have a contract with Care Homes for Older People Page 10 of 26 Evidence: the home and three were not sure if they have a contract of residence. We saw case files contain assessments completed before a lady moves into the home. 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. Ladies receive personal and health care support in a person centred way. They are supported and helped to be independent and can take responsibility for their personal care needs. Staff respect privacy and dignity and are sensitive to changing needs. Medication is well managed. Evidence: We saw care plans in place, which are reviewed every month with an annual review of care. Abbeyfield have a new care plan format which is being introduced to the service. The new format is more detailed and includes more space for staff to detail individuals needs and what they can do for themselves. This is very important to ensure ladies are able to maintain their independence. Care plans cover areas around social contact, health and physical needs, psychological and mental health needs, personal care, tissue viability, mobility and preference for time to get up and go to bed. Three ladies told us in surveys that they always and twelve ladies said usually get the care and support they need. During our visit ladies said staff help them as needed. Ladies said staff protect thier privacy and dignity and any support with personal care Care Homes for Older People Page 12 of 26 Evidence: is appropriate. Three members of staff told us in surveys that they always have up to date information to ensure they can meet ladies needs. Records are kept of health appointments and staff or volunteers are available to support ladies with attending GP and hospital appointments. Records are kept of any actions required and changes to medication. Eight ladies said the home always and four said usually make sure they get the medical care they need. This section was blank on three surveys. Appropriate medication policies and procedures are in place. Some ladies self medicate and appropriate risk assessments are completed. Staff complete training in medication administration. Medication Administration Record Sheets (MARS) are up to date and signed by staff. Medication in blister packs are labelled as MARS. The count of one medication for two ladies balanced, with the amount recieved, number of tablets administered and tablets remaining being correct. One medication for one lady had one tablet too many. We were told that this is due to receiving one tablet from the local pharmacy which had not been recorded. One of the deputies is responsible for medication and completes random audits. The records of these audits showed no issues with medication. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The organisation is commited to enabling ladies to maintain their independent living skills. Some activities take place on a regular basis with a number of social events and outings planned, depending on the ladies interests. A varied menu is provided and medical or religious dietary needs are met. Evidence: The manager said they provide some regular activities including a film afternoon, flower arranging, painting, a weekly exercise group, visiting pets and daily coffee or tea in the lounge. There are regular outings for ladies, recent trips have included a day at Bognor Regis and to a musical at the local theatre. The service has a folder with photographs of trips and events held at the home. Two ladies told us they always, six said usually and seven said sometimes have enough to do. Some ladies maintain links with clubs and groups they attended before moving into Lee House. Ladies are able to go out in the local community. Visitors are welcome at the home and may visit in communal areas or ladies bedrooms. Ladies have an intercom system in their room, enabling them to let their visitors in. A new seasonal varied menu is provided and the service now offers three meals a day, although ladies do not have to go down to the dining room for breakfast or their Care Homes for Older People Page 14 of 26 Evidence: evening meal. Ladies comments about the food ranged from it is excellent to some of it is inedible with some saying the quality of the food has deteriorated since Abbeyfield have been involved while others think the food has improved. One lady said they always, seven said they usually and sometimes like the food. 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. The service has developed a clear complaints procedure which is included in the Service Users Guide given to all ladies when they move in. Systems are in place to safeguard ladies who live at the home. These include staff attending training to ensure they are aware of their responsibilities and actions they should take if they are concerned and appropriate recruitment checks being completed before someone starts work. Evidence: The complaints procedure is included in the Service User Guide and displayed around the home. Thirteen ladies said they had someone they could speak to informally with concerns. Twelve ladies said they are aware of how to make a complaint. One lady indicated they did not know who to complain to and this section was blank in two surveys. Ladies we spoke with during our visit did not have any concerns or issues and felt they would be listened to and any complaints responded to appropriately. We saw records of complaints received with details of actions taken and outcomes. A number of issues have been raised recently about the changing needs of some of the new ladies. These are being addressed by the manager using the complaints procedure. Three members of staff told us in surveys that they are aware how to respond to concerns and complaints. We have not received any complaints or concerns about the service in the last year. Care Homes for Older People Page 16 of 26 Evidence: We saw that staff have recently completed training in safeguarding and are aware of the procedure to follow if they have concerns. 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 physical environment is generally appropriate for the ladies who live there. The organisation is in the process of developing a fully accessible dining room on the ground floor and installing a new passenger lift that serves the ground and first floors. Bedrooms are single with ensuite bathroom. All areas were seen to be clean and fresh. Evidence: The home has been developed and extended over the years to meet the needs of the ladies who live there. Bedrooms are single with an ensuite bathroom. They also have small kitchen facilities to enable ladies to make their own drinks and light snacks. We saw bedrooms have been personalised to individuals taste and most ladies have brought their own furniture, pictures and ornaments. There are two lounges, a dining room and a large garden. Work is currently underway to develop a new dining room on the ground floor which will be more accessible to all the ladies. The organisation is also having a new lift installed that will access the ground and first floor. Ladies told us they have all they need in their rooms. Some issues were raised about the hairdressers facilities which are in a temporary room due to the building works. The manager is aware of these concerns and working with ladies during this time of change. There is a fully accessible bathroom and shower room for ladies who need them. Care Homes for Older People Page 18 of 26 Evidence: Heating and lighting is appropriate throughout the home. We saw all areas of the home to be clean and fresh. Most areas are maintained and decorated to a good standard. Some areas are in need of attention due to the current building works. The manager said these areas will be improved once the building work is complete. Eleven ladies told us in surveys that the home is always and four said it is usually clean and fresh. 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. Ladies have confidence in staff who care for them. Staff levels are sufficient to meet ladies needs. Staff have access to appropriate training to help them carry out their role. Good systems are in place to recruit staff safely. Evidence: The staff rota showed four staff work in the morning and three staff in the afternoon plus the manager five days a week. Currently they have one waking night staff and one member of staff asleep but on call at the home at night. The manager told us they are planning to have two waking night staff at night to prepare for the changing needs of ladies who are moving into the service. In surveys, four ladies said staff are always, ten said usually and one said sometimes available when required. One member of staff said there are always, one said usually and one said sometimes enough staff to meet the ladies needs. We saw staff levels be sufficient to meet the needs of the ladies currently living at Lee House. Two ladies said staff always, eleven said usually and two said sometimes listen and act on what they say. We saw staff offer appropriate support and assistance to ladies. We saw some good interactions and staff demonstrating good knowledge of ladies and how to meet their needs. Three staff surveys said they had appropriate checks before starting work. We saw Care Homes for Older People Page 20 of 26 Evidence: staff files contain a completed application form, two written references and proof of the individuals identity. One staff file contained confirmation that a clear enhanced Criminal Records Bureau (CRB) check had been completed. One file identified the CRB check had been requested although not yet received. The manager confirmed that this member of staff is only working under supervision. The manager told us they are looking at ways to involve the ladies in the recruitment process. Two members of staff said their induction covered all they needed to know very well and one said mostly. Three staff said they have relevant training. Two staff said the training helps them understand peoples needs and keeps them up to date. One member of staff said training gives them enough knowledge about health care and one said it did not. We saw records confirming staff have completed training in safeguarding, manual handling and working with people with Parkinsons. We saw the list of future training for staff to include sessions on risk assessment, continence care, infection control and medication administration. One member of staff said they always, one said usually and one said sometimes have enough support, experience and knowledge to meet peoples needs. 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 manager has the required qualifications and experience to run the home. They continually work to improve services. There is a focus on person centred planning and care. Good systems are in place for quality assurance. The annual quality assurance assessment contained good, clear, relevant information that is supported by evidence. Health and safety is well managed. Evidence: The manager has been at the home for one year and is in the process of applying to register with the Care Quality Commission. The manager has lots of experience working with older people and was previously deputy manager at another home owned by the organisation. She has completed NVQ to level 4 and the registered managers award. Good systems are in place to monitor the quality of services provided at the home. A visit is completed every month with an action plan developed for work required to improve the services. We saw that this action plan is checked each month to ensure Care Homes for Older People Page 22 of 26 Evidence: improvements are made. The manager has developed an action plan which is being worked to. The organisation carries out an annual survey and sends feedback to the home. We saw that the manager has passed this information to ladies so they know their comments are listened to and actions are taken. The manager told us they have regular meetings ladies to keep them informed of progress with the building plans and to give them the opportunity to comment on the care and support they receive. Ladies confirmed they attend meetings with the manager and are informed and involved in decision making. Two members of staff told us in surveys that they see the manager regularly and one staff said they see the manager often. Staff told us they feel supported to do their job. Health and safety is well managed with checks on the gas safety, electrical supply, portable electrical appliances and the lifts up to date. 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 1 7 Work on the new care plan format should continue to ensure good information is available to staff to ensure they can meet ladies needs. Work should continue on developing the programme of activities available to ladies to ensure their social and leisure needs are met. 2 12 Care Homes for Older People Page 25 of 26 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 non-commercial 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 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!