Inspection on 05/08/08 for Lobswood House

This is the latest available inspection report for this service, carried out on 5th August 2008.

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

Lobswood House 29/09/05

Lobswood House 20/05/05

Lobswood House 15/12/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Lobswood House 16 Fitzalan Road Littlehampton West Sussex BN17 5JR Lead Inspector Sheila Gawley Unannounced Inspection 5th August 2008 09:00 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 Lobswood House DS0000014615.V369229.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. Lobswood House DS0000014615.V369229.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lobswood House Address 16 Fitzalan Road Littlehampton West Sussex BN17 5JR 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) 01903 715055 lobswood_house@hotmail.com Dr G S Kalkat Mr G S Nijjar Mr James Muldoon Care Home 26 Category(ies) of Dementia - over 65 years of age (26), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (26) Lobswood House DS0000014615.V369229.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One person under the age of 65 years n the category of Dementia can be accommodated until they no longer reside in the home. 24th July 2006 Date of last inspection Brief Description of the Service: Lobswood House is a care home that is registered to accommodate up to 26 residents in the category of dementia and mental disorder in older people. The property is located in an easily accessible area of Littlehampton, opposite a wooded green and near to the sea. It is a large, detached, older style property covering three floors with a passenger lift accessing all floors. The home has a secure secluded garden to the rear of the property, which includes a patio and a raised water feature. Apex Healthcare privately owns the service, and the registered Manager is Mr. J. Muldoon. The responsible person operating on behalf of the company is Dr. G S Kalkat. The fees currently being charged are £410 to £580. Lobswood House DS0000014615.V369229.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 3 stars. This means the people who use this service experience excellent quality outcomes. This site visit as part of the inspection process was carried out on 05/08/08. Prior to the visit the service file was reviewed as were any comments received by the Commission for Social Care Inspection. Four people who use the service were case tracked during the inspection. Staff were spoken to on the day. We were in receipt of comments from surveys we had sent to people who use the service. Staff spoken to on the day stated that the home had a happy atmosphere and that the registered manager is approachable. The home had sent us their Annual Quality Assurance Assessment for the inspection, which gave us the information we needed on the home. The premises were toured. The registered manager facilitated the inspection and any documents required on the day were made available. People who use the service receive a good level of care from well trained staff all of the outcome groups assessed today were rated as good or excellent. What the service does well: Needs are assessed prior to admission and the required information is given to prospective admissions. Care needs are assessed, reviewed, recorded and met with respect. Medicines are handled safely There is excellent activities provision and nutritious meals are served in a pleasant and unhurried manner. The home is well managed, staffed and maintained. Lobswood House DS0000014615.V369229.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Lobswood House DS0000014615.V369229.R01.S.doc Version 5.2 Page 7 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 Lobswood House DS0000014615.V369229.R01.S.doc Version 5.2 Page 8 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): 1, 3, Standard 6 is not applicable People who use the service experience good quality in this outcome area because needs are assessed and information needed to make an informed choice is available. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who use the service have their needs assessed prior to admission. In the care plans inspected these assessments were seen and were comprehensive including mental and physical health, personal and social needs. Surveys received from people who use the service all stated that they received sufficient information on the home. Care management plans were also seen in care plans in which social services detailed the care needs they wished to see being met. Lobswood House DS0000014615.V369229.R01.S.doc Version 5.2 Page 9 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): 7-9,10 People who use the service experience excellent quality outcomes in this area as all needs are assessed and met, set out in a plan and residents are treated with respect. Medicines are handled safely. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a sustained track record in delivering good care and in managing improvement. All residents had a plan of care. Four people who use the service were case tracked and their care plans were inspected and they contained information on health, personal, nursing and social need. The care plans were drawn up following an assessment of these needs and were individualised and person centred. These assessments included mental, physical and social need, nutritional assessments, mobility, hygiene, continence, and pressure areas, and risk assessments. The risk assessments covered, moving and handling, nutrition and pressure Lobswood House DS0000014615.V369229.R01.S.doc Version 5.2 Page 10 area risk. There were daily records and evidence of monthly review, fluid intake, nutritional need and weight is monitored. There is a key worker system in place, staff spoken to demonstrated knowledge of how this system benefits people who use the service in that they can act as advocates and ensure changing needs are communicated and recorded. Staff spoken to confirmed that the home is supportive in meeting all training needs so they can offer up to date care and best practice to people who use the service. Access to specialist health support is available as required including general practitioner and community mental health team. Those eligible for chiropody at the local medical centre are taken there, for the others a chiropodist visits the home. A letter received by the Commission expressed extreme pleasure with the care received by a person who uses the service. Her daughter stated that her mother’s condition improved dramatically following admission to Lobswood House. The health and personal appearance of two new admissions has improved with evidence of improved asthma control in one the other is being monitored by GP to establish if Parkinson’s disease is present as there was not clarity on this from the previous care home. The specialist equipment required to meet the needs of people who use the service is in place. There is evidence of staff training to ensure staff can meet assessed need and staff turnover is low with a mix of male and female staff to meet the preferences of people who use the service, this helps ensure equality and diversity needs are met. Surveys are in place for people who use the service, relatives and health professionals so the home can ensure it is still meeting need and preferances. Medicines are received, administered and stored, correctly. Medicine Administration Charts inspected were up to date, and all had a photograph. There are not any people who use the service self-medicating at present. One staff member is responsible for auditing and reordering medicines; this aspect of quality assurance ensures compliance with the homes medicines policies. The home is not overstocked with medication. Staff were observed offering care in a respectful and encouraging manner and surveys received people who use the service commented that they are treated with respect. They also all commented that care is offered as assessed. One person who uses the service commented, “The staff are always helpful and cheerful” Another commented “ This is a very happy home and residents laugh and talk freely to nurses and visitors” Lobswood House DS0000014615.V369229.R01.S.doc Version 5.2 Page 11 Lobswood House DS0000014615.V369229.R01.S.doc Version 5.2 Page 12 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): 12-15 People who use the service experience excellent quality in this outcome area because the lifestyle in the home meets their expectations. Activities and events provided satisfy social, cultural and recreational needs. There is a variety of nutritional food on offer. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is an activities programme in place and comments in the surveys received expressed satisfaction with this. One comment was “ Great efforts are made at Christmas and Easter”. Music and exercise is provided every Tuesday morning. There is a musician who visits weekly and a theatre group visits every three months. A carer is employed to involve people who use the service in activities every afternoon from 2pm to 5pm. This involves board or floor games or to take people who use the service out for walks on rotation. A Client Information Questionnaire is filled up by a prospective clients relative/representative which gives the home a better understanding of their past and preferences which helps in providing individual care for people who Lobswood House DS0000014615.V369229.R01.S.doc Version 5.2 Page 13 use the service in terms of their interests and needs. There is a list of regular activities showing which ones people who use the service enjoy. The AQAA states that a balanced, nutritious diet is provided. Evidence of this was seen in the kitchen and food stores. There is a menu in place offering choice. The food seen being prepared and served was as advertised. There were ample fresh and dried food stores with fresh fruit and vegetables. People who use the service are served a fruit smoothie mid morning to increase their fruit intake as the majority of them can take fruit more readily in this format. People who use the service are encouraged to maintain contact with friends and relatives. Those who have families living abroad can contact can have contact via email and relatives can also arrange to communicate via use of the web cam, the home also also sends regular emails and pictures. Families are involved in all activities. People who use the service have choice in where they sit and some chose to go back to their rooms during the visit. Staff were observed interacting with people who use the service in a respectful manner. Lobswood House DS0000014615.V369229.R01.S.doc Version 5.2 Page 14 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): 16,19 People who use the service experience good quality in this outcome area because complaints are listened to, and people are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The AQAA stated that the home has a complaints procedure. This was seen on display in the hallway. It needs to be updated with the current contact details of the Commission. It is also made available in the Statement of Purpose and Service User Guide. Comments in surveys received included “ manager always available”, another commented 2 staff and management always attentive and positive in all actions” There have not been any complaints about the service. There are safeguarding procedures in place and staff spoken to were aware of the processes to follow. All are aware when an incident needs to be referred to the local authority. Staff files contained evidence of safeguarding training. Staff are also trained in managing challenging behaviour. The home communicates well with the Commission and all incidents are notified according to the regulations. Lobswood House DS0000014615.V369229.R01.S.doc Version 5.2 Page 15 Lobswood House DS0000014615.V369229.R01.S.doc Version 5.2 Page 16 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): 19,20, 22, 24,26 People who use the service experience good quality in this outcome area because they live in a well-maintained environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The building was toured. The home externally and internally is decorated to a good standard. There are two lounges and a dining room. It was neat, clean and free from offensive odours. It has comfortable homely furnishings. Radiators are covered. There is a well-maintained courtyard garden area with seating where people who use the service can sit. Lobswood House DS0000014615.V369229.R01.S.doc Version 5.2 Page 17 The specialist equipment required to meet the needs of people who use the service is in place. There are sufficient wheelchairs and hoists and grab rails are in place. There is a passenger lift, which accesses all floors. A new call bell system has been put in place. Bedrooms are comfortable with contemporary furnishings. The bedrooms are personalised according to the wishes of people who use the service. The proprietor has been purchasing specialist beds to maintain the safety and comfort of those nursed in bed. The home was neat, clean and free from offensive odours on this occasion. All taps have thermostatic controls. There are sufficient assisted baths to meet the needs of people who use the service one of which is a Jacuzzi. The footplate of the bath hoist in one ground floor bathroom was worn but the registered manager stated that this bathroom and adjoining toilet are to be refurbished; he had the quotes in the office. There are suitable laundry facilities sited away from areas of food storage and preparation. Washing machines have the required programmes. Lobswood House DS0000014615.V369229.R01.S.doc Version 5.2 Page 18 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): 27-30 People who use the service experience excellent outcomes in this outcome area because needs are met by suitably numbers of qualified staff. Staff training is beyond basic requirements. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff rota showed staffing levels were sufficient to meet the needs of residents. There are generally four carers on duty, 2 domestics, 1 chef and a bed maker in addition to the registered manager and deputy manager. There are robust recruitment procedures in place and staff files inspected contained all the documentation required to ensure the protection of people who use the service. There was evidence of application forms with employment history. Criminal Records Bureau Clearance and POVA check, two references, identity documentation, and photograph were all in place. The comments received on surveys received were positive indicating that people Lobswood House DS0000014615.V369229.R01.S.doc Version 5.2 Page 19 find the staff helpful. One person who uses the service commented, “This is an excellent home, staff and management are always attentive”. There is a staff-training programme in place, provided by an external organisation, which staff spoken to confirm they attend. Training records were seen in staff files. The training provided includes food hygiene, moving and handling, fire, infection control, first aid and health and safety. There is also ongoing training on dementia, coping with confusion, nutrition, death bereavement and loss, palliative care, aging process, communication, caring for those with sensory loss, and medication. Ten of the sixteen carers have achieved the National Vocational Qualification Level 2 in Care, which puts the home well above the 50 minimum. Five have NVQ Level 3 and two have NVQ Level 4. It is planned for two staff to commence the Registered Managers Award. Staff spoken to confirmed that they work in a very supportive environment and that requests for training are all dealt with favourably. All staff complete an induction this was confirmed by a member of staff spoken to and the registered manager stated that new staff can be slotted into training sessions at a sister home to ensure they receive all training in a timely fashion. Lobswood House DS0000014615.V369229.R01.S.doc Version 5.2 Page 20 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): 31,33,35,36,38 People who use the service experience good outcomes in this area because the home is run in the best interests of people who use the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is a Registered Nurse in mental health and has been at Lobswood House for six years. He is registered with the Commission and attends training to maintain registration with the Nursing and Midwifery Council. He has clear responsibilities and is supported by the proprietors who respect his decisions. Staff spoken to stated that there is an open culture in the home and that their opinions are listened to. Lobswood House DS0000014615.V369229.R01.S.doc Version 5.2 Page 21 We received the AQAA and it contained the information we required. The AQAA states that quality assurance systems are in place. Evidence of this was seen in the home. Surveys are in place for people who use the service, relatives and health professionals. The results of these surveys are collated and issues identified are acted on. Relatives were asked if they wished to have meetings but declined. Comments received in surveys sent to the Commission were very favourable, “The manager is very approachable”, “Manager meets often to give support”, “Manager is always available”. The home does not manage any financial affairs for people who use the service and people have their own bank accounts, managed with famly or solicitor help if necessary. A small cash amount is held for one person who uses the service. This is to help him manage his cigaretts. Staff supervision is in place, evidence of supervision was seen and staff also confirmed that this takes place. The registered provided ensures the health, safety and welfare of people who use the service by the provision of mandatory training. The home meets the requirements of the local Fire Authority and Environmental Health Department. Substances hazardous to health are stored securely. Lobswood House DS0000014615.V369229.R01.S.doc Version 5.2 Page 22 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 4 3 3 X 3 X 3 X 3 STAFFING Standard No Score 27 4 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 4 X 3 Lobswood House DS0000014615.V369229.R01.S.doc Version 5.2 Page 23 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. Refer to Standard Good Practice Recommendations Lobswood House DS0000014615.V369229.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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