Inspection on 21/11/07 for Lynwood Residential Care Home

This is the latest available inspection report for this service, carried out on 21st November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Lynwood Residential Care Home 22/05/06

Lynwood Residential Care Home 26/10/05

Lynwood Residential Care Home 31/05/05

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Lynwood Residential Care Home 22/26 Grosvenor Road Paignton Devon TQ4 5DY Lead Inspector Stella Lindsay Key Inspection (unannounced) 21st November 2007 10:30 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 Lynwood Residential Care Home DS0000063555.V344645.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. Lynwood Residential Care Home DS0000063555.V344645.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lynwood Residential Care Home Address 22/26 Grosvenor Road Paignton Devon TQ4 5DY 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) 01803 551581 01803 527491 Lynwood Residential Home Limited Vacancy Care Home 22 Category(ies) of Dementia - over 65 years of age (22), Old age, registration, with number not falling within any other category (22), of places Physical disability over 65 years of age (22) Lynwood Residential Care Home DS0000063555.V344645.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate one service user (named elsewhere) under the age of 65 years in category DE. 23rd May 2007 Date of last inspection Brief Description of the Service: Lynwood Residential Home is registered to provide accommodation and care for a maximum of twenty-two men and women who fall into the registration categories of Old Age, Dementia over 65 years of age and Physical Disability over 65 years of age. Lynwood is in a residential area of Paignton and is within walking distance of the town centre and the railway and bus stations. There is a parking area at the front, and an enclosed garden at the rear. There are steps to the front door. Easier access is via sloping paths to the right of the house, with one step to enter the lounge. The homes fees range from £375 to £450 a week. There might be a discount for a couple sharing a double room. Additional charges are made for professional hairdressing, chiropody and a private telephone line, if required. The service providers have produced a written Statement of Purpose and Service Users’ Guide, both of which will be provided to prospective service users on request. Reports of previous inspections are available on the CSCI Website. The latest report is on display in the entrance hall at Lynwood. Lynwood Residential Care Home DS0000063555.V344645.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over two days in November 2007. The inspector was accompanied on the second day by an ‘Expert by Experience’, who made a tour of the premises with the Manager, met with three residents who normally stay in their room, met others in the lounge and shared a meal with them. The inspection also included discussion with the General Manager, the Responsible Individual for the company, four staff on duty, three other residents and two visiting relatives. Care records, staff files, health and safety records and the medication system were examined. Information had been provided by the Management prior to the inspection, and surveys were returned to the Commission for Social Care Inspection by staff, relatives, and health and social services professional staff who are in regular contact with the service. What the service does well: What has improved since the last inspection? A new Manager had been appointed, with the skills, knowledge and experience to introduce the improvements necessary to provide a good service to residents at Lynwood. He had already achieved a great deal in a short space of time. Staffing levels had been improved, to enable proper care and attention to be given to residents. A relative said in a survey returned to the CSCI, that ‘there are always staff around now to monitor situations…the feeling is better now, the environment is happier’. The recruitment system had been carried out with care, to assure the protection of residents. Lynwood Residential Care Home DS0000063555.V344645.R01.S.doc Version 5.2 Page 6 Care planning had improved, and records were properly kept. There is better observation and understanding of disease processes, and better access obtained to health care. Staff had been able to take residents out to meet friends and for other social engagements. Sit on scales had been purchased, and care plans now reflect monthly weight evidence and action taken where weight loss was identified. ‘Meals are better, people are always given food and drink they like and as much as they want whenever they ask for it’ – said a staff member in a survey returned to the CSCI. The new menus, with a choice at each main course, was being introduced at the time of this inspection. Hand towels and liquid soap had been provided in communal toilets and bathrooms, to prevent any spread of infection. Also, a new system for the safe disposal of clinical waste has been introduced. 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. Lynwood Residential Care Home DS0000063555.V344645.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 Lynwood Residential Care Home DS0000063555.V344645.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): 3 Quality in this outcome area is good. Residents are admitted after careful assessment of their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The management company have provided a concise assessment tool to be used before offering accommodation, which ensures that all aspects of care are considered in line with meeting standard three. The Manager is piloting a more person-centred version. Clients are invited to visit. Some had been for respite or day care before moving in. Lynwood Residential Care Home DS0000063555.V344645.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): 7,8,9,10 Quality in this outcome area is good. Care planning has improved significantly, and health care needs are being actively assessed and met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care planning and record keeping had greatly improved. Two were examined in detail. They started with a pen picture of the resident, to give the reader information about their previous life, their family and other important factors in their life. They gave information about particular needs with regard to medical history, communication, personal care, activities of daily living, any behavioural issues, emotional and spiritual elements, recreation and interests. One staff member paid tribute in a survey returned to the CSCI - ‘New care plans are much more informative!’ The Manager was planning to provide training for the staff on Person Centred Planning. Personal histories will be developed with help from families, if the resident agrees. Risk assessments had been carried out with regard to pressure vulnerability, moving and handling, and nutrition. Body maps had been compiled for all Lynwood Residential Care Home DS0000063555.V344645.R01.S.doc Version 5.2 Page 10 residents by the new Manager, which for some residents had led to the diagnosis and treatment of conditions that had previously gone unnoticed. Keyworkers had been appointed from the care team for each resident who will carry out monthly summaries with each resident. Some residents knew who their keyworker was, and were pleased that they could ask them for personal things. Staff are assigned to help certain residents each morning with regard to their skills and experience and the needs of the resident, and to complete their care records. Three of the residents who choose to remain in their rooms agreed to speak with the ‘expert by experience’. One maintained that they needed no help whatsoever and the others were totally content with the help available to them - all other residents concurred. Whilst there is a rota for baths, residents said they were able to have additional baths on request and they appreciated this facility very much. Residents reported that call bells are usually answered within a couple of minutes. One person said that once when they were worried in the middle of the night the carer talked through the problem and stayed by their side reading until they returned to sleep. A relative reported that they very much appreciate help from the Manager in taking a resident to hospital appointments, as it is so difficult by oneself. Also, they appreciated the Manager explaining everything properly to the resident, and treating them like ‘a proper person!’ A new policy on the safe administration of medication had been given to staff. It was seen to be detailed and specific to enable staff to ensure the correct medication is given to residents. Records were checked and seen to be accurate. Good training had been provided. Lynwood Residential Care Home DS0000063555.V344645.R01.S.doc Version 5.2 Page 11 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. Residents have choice in their daily routines, and opportunities for social activities. Meals are varied and nutritious. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All felt that they could choose when to retire – some added “within reason”. Rising time varied and the opportunity existed to “have a lie in”. Some residents are sufficiently independent to go out by themselves or with family. Recently carers have started to take people out. One had been to a garden centre, another to meet a friend not seen for years. Residents said they would like more outings for sightseeing and to local attractions. Several residents mentioned the recent firework party (with hot dogs), which they had enjoyed. The lounge had been decorated for Halloween, with pumpkins being carved. Recent visiting entertainers had included musicians and an exercise leader. A relative returning a survey said that their father has help from staff to use the telephone, to keep in touch. Mealtimes are subject to the constraints of the kitchen but “finger” food is available anytime. Breakfast is a “moveable feast” starting at 8.15am. Lynwood Residential Care Home DS0000063555.V344645.R01.S.doc Version 5.2 Page 12 Residents have two choices of main course for lunch and pudding. Large print menus were being provided for upstairs and down. Alternatives are available if people do not like what is on offer and for those with special dietary needs, and can be provided at short notice if a person changes their mind. The cook keeps a chart to record alternatives that have been eaten. Plenty of fresh vegetables were provided. On the day of the visit, diners were enjoying individual Sausage Toad in onion gravy with baked beans and sculptured mashed potato followed by either Apple Dumpling or fresh fruit. Ice Cream, fruit, or cheese and biscuits are always available. The meal was nutritious, suitably hot and very well presented. There is a four weekly menu cycle, which shows a good variety of traditional and popular dishes. Lynwood Residential Care Home DS0000063555.V344645.R01.S.doc Version 5.2 Page 13 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. Residents are protected by sound policies, and by good understanding on the part of the care team, who hear what residents say and act upon it. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure is included in the Service Users’ Guide, which is available in the entrance hall and given to new residents. A complaints form is available, should anyone wish to use it. No complaints had been received since the last inspection. One staff member said in a survey returned to the CSCI that the new Manager - ‘sorts everything out before problems happen’, and another that -‘people are encouraged and helped to ask for what they want’. The Safeguarding Adults procedure included action to be taken in the event of an allegation being made, so that staff would know what to do, and they had all been given a copy of the home’s Whistle blowing policy. Training in the Protection of Vulnerable Adults was provided in March 2007. More staff were on duty and available to protect residents from possible harm. Lynwood Residential Care Home DS0000063555.V344645.R01.S.doc Version 5.2 Page 14 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): 19,20,21,22,26 Quality in this outcome area is good. The residents benefit from living in a clean, safe and well presented home, but bathing facilities and access to the exterior should be improved. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was originally three large terraced houses. Residents’ accommodation is on two floors, with a passenger lift and stair lift. The kitchen and a staff office are on the lower ground floor and the laundry is separate. Refurbishment has continued through the year with seven bedrooms being decorated, carpeted, and with attractive washable new furniture. The toilet close to the dining room was in the process of being upgraded. The new Manager on arrival had checked the home for health and safety problems and booked a carpet fitter to correct any loose areas, and sunk a pipe to the washing machine in order to avoid a trip hazard across the garden path. There are steep steps to the front door. Access to the garden is via a step down over a threshold, and there is no grab rail. This is the most accessible exit from the building, and it is possible to get round the side of the house in a wheelchair. Lynwood Residential Care Home DS0000063555.V344645.R01.S.doc Version 5.2 Page 15 An Occupational Therapist had been booked to assess the building and advise on how to improve accessibility and provide a more enabling environment for residents. The main lounge on the ground floor is a comfortable, pleasant airy room without a television but with a CD player – in use and controlled by a resident at the time of the visit - and with access to the garden down one step. Residents said they had enjoyed the garden during the good weather. Chilled water is available from a dispenser in the hallway. The first floor lounge is smaller with a television and a small dining room attached. All residents have TV in their rooms. The ground floor bathroom has been fitted with a Jacuzzi bath that is suitable for use by people with physical disabilities, and residents said that they enjoyed using it. The upstairs bath has damaged enamel, and should be replaced. The home needs an accessible shower, to give choice in bathing facilities. This is important as some residents are unwilling to use a bath. Re-decoration is in progress with residents being invited to help in the choice of colour for their room. Windows on the rear elevation have recently been replaced. Plans are in hand to involve the residents in garden improvements. Hand towels and liquid soap had been provided in communal toilets and bathrooms, to prevent any spread of infection. A rolling programme was continuing to provide this in all bedrooms. There is a system in place to ensure that soiled laundry is not allowed to cause cross contamination, and staff were up-dated with this at a recent staff meeting. Lynwood Residential Care Home DS0000063555.V344645.R01.S.doc Version 5.2 Page 16 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. Caring and well-motivated staff are employed in sufficient numbers to meet the needs of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A written rota is kept, which shows that three carers are on duty from 8am until 8pm, with a shift co-ordinator appointed to allocate and check work and record keeping. The Manager is additional, generally on duty from 9 – 6 Monday to Friday. A cook is on duty from 9 – 2 each day, and the cleaner works from 9 – 12 Monday to Friday. This level of staffing was observed to be sufficient to meet the needs of residents. More staff had started working towards their National Vocational Qualification in Care. Of the twelve carers, nine had either achieved NVQ2 or equivalent or were engaged in working towards this. Four staff were working towards level 3. This shows very good progress in achieving a qualified workforce. Recruitment was taking place at the time of this inspection. It was seen that references were being taken up, proof of identity was being checked, and Criminal Bureau Clearances applied for. These had been obtained on behalf of overseas staff as required at a previous inspection. A person with learning disabilities had been working at the home for some time. It had recently been arranged that they should learn to help in the Lynwood Residential Care Home DS0000063555.V344645.R01.S.doc Version 5.2 Page 17 kitchen and support the cook. Their trainer was pleased with this new development. A full induction training was being introduced, and new starters are to have a weekly meeting with the Manager to ascertain progress and discuss any issues. A monthly training session is offered, recent topics being Infection Control, Moving and Handling, and Dealing with Challenging Behaviour. Training in Dementia care had started, and further training in the care of people with Alzheimer’s was planned. The Manager was in the process of producing a training matrix, to show staff achievements and outstanding training needs. Lynwood Residential Care Home DS0000063555.V344645.R01.S.doc Version 5.2 Page 18 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. The new Manager (not yet registered with the CSCI) has a clear vision of the good care to be provided at Lynwood, and is energetically driving forward the necessary improvements. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A manager, Mr Duncan Galbraith, had been appointed recently. He is a qualified Nurse (RGN) with experience of Senior post in a care home. He is registered with a training provider to work towards NVQ4 in care, and will apply to register with the CSCI in due course. He will undertake the Registered Managers’ Award and the Assessors’ Award. One staff member said in a survey, ‘things have changed a lot since our new Manager came to the home. He explains things to us before they are put into place, and works with us always checking to see if we understand.’ A resident told the inspector, ‘he is totally geared to making the residents happy’. Lynwood Residential Care Home DS0000063555.V344645.R01.S.doc Version 5.2 Page 19 He has been working with the Operations Manager of Personnel Solutions, the management company employed by the owners, to draw up and implement an action plan to address shortfalls that were evident at the time. He gave himself short deadlines and worked energetically to raise standards and improve the service to the residents. A staff meeting was held on the Monday before this inspection, and is to be a monthly meeting, to discuss good practice as well as enabling employees to express concerns or suggestions for improvement. Personnel Solutions have provided documentation for a quality assurance programme, to be carried out over the forthcoming year. The Manager does not deal with money on behalf of any resident. Some valuables are held for safekeeping. Some residents were able to keep their cash safely in their room, while others were supported by their relatives. Fire training had been provided on 5th November, to ensure staff know what to do in an emergency. The fire precaution system had been serviced professionally on 08/11/07. Fire risk assessments had been professionally carried out. The fire doors had been improved, and now shut properly as needed in order to keep the occupant safe in an emergency. All accidents and unexplained bruises were reported and recorded. A date had been agreed for the provision of First Aid training. Lynwood Residential Care Home DS0000063555.V344645.R01.S.doc Version 5.2 Page 20 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 2 2 X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Lynwood Residential Care Home DS0000063555.V344645.R01.S.doc Version 5.2 Page 21 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. 1. Standard OP21 Regulation 23 Requirement An accessible shower must be provided, to provide appropriate bathing facilities for all residents. Timescale for action 30/06/08 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 OP12 OP22 Good Practice Recommendations The team should enable more social activities for residents outside of the home. Safe access to the home should be improved, so that residents may use their front door, and get more easily to the garden. Lynwood Residential Care Home DS0000063555.V344645.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Lynwood Residential Care Home DS0000063555.V344645.R01.S.doc Version 5.2 Page 23 - 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. 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