Inspection on 11/01/06 for Laburnum Lodge

This inspection was carried out on 11th January 2006.

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

Laburnum Lodge 10/10/08

Laburnum Lodge 22/02/07

Laburnum Lodge 24/03/06

Laburnum Lodge 17/02/05

Laburnum Lodge 12/10/04

Laburnum Lodge 27/02/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Laburnum Lodge Breightmet Fold Lane Breightmet Bolton BL2 6PP Lead Inspector Stuart Horrocks Unannounced Inspection 09:30 11 January 2006 th 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 Laburnum Lodge DS0000031082.V273226.R01.S.doc Version 5.0 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. Laburnum Lodge DS0000031082.V273226.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Laburnum Lodge Address Breightmet Fold Lane Breightmet Bolton BL2 6PP 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) 01204 337837 01204 337838 Bolton Metropolitan Borough Council Mrs Pauline Crank Care Home 34 Category(ies) of Dementia - over 65 years of age (34) registration, with number of places Laburnum Lodge DS0000031082.V273226.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Staff numbers to be calculated in accordance with the Residential Forum Care Staffing Guidance (Older People) by 1 April 2004 The service should at all times employ a suitably qualified and experienced manager who is registered with the National Care Standards Commission. 17th February 2005 Date of last inspection Brief Description of the Service: Laburnum Lodge is owned by Bolton Council and is run by the Social Services Department. The home is purpose built with four care units, Greengate and Bright Meadows on the ground floor, Bannister and Ashes Farm care units on the first floor. The home is situated near a main road in a residential area of Breightmet approximately two miles from Bolton town centre and is close to bus stops, pubs and local shops. Laburnum Lodge is pleasantly sited in its own grounds with surrounding gardens and there is some car parking to the front of the building. The accomodation is provided on two floors in 34 single bedrooms. All bedrooms have washing facilities. A passenger lift provide acess to the upper floor. There is a dining room and lounge on each wing and each floor is provided with toilets and bathrooms. The home also has seating area near to the entrance and there is an activities room. There is a central courtyard with a garden and patio area that can easily be reached from the ground floor. Laburnum Lodge DS0000031082.V273226.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was started at 9.30am.It took place on one day and it lasted for about five and a half hours. The time was split between talking to the Care Supervisor and checking records, and looking around the home, watching what was happening and talking to residents and other staff. Six residents and four staff were spoken with. What the service does well: What has improved since the last inspection? What they could do better: Staffing levels need to be checked to make sure that enough staff are on duty to see to the residents needs. Laburnum Lodge DS0000031082.V273226.R01.S.doc Version 5.0 Page 6 The inspector suggests that the staff should continue to look for different ways of providing the less able residents with fulfilling and stimulating activities. 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. Laburnum Lodge DS0000031082.V273226.R01.S.doc Version 5.0 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 Laburnum Lodge DS0000031082.V273226.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The above key Standard 3 was not examined at this inspection. The outcome for this Standard will be checked at the next inspection. Laburnum Lodge does not provide intermediate care services (key Standard 6). This standard does not therefore apply. EVIDENCE: Laburnum Lodge DS0000031082.V273226.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8 and 9. Proper arrangements are in place that ensures the residents health care needs are monitored and met. Individual care plans are also in place, which were up to date, regularly reviewed and provided the staff with the information they needed to give a good standard of care. The medication arrangements are properly managed thus ensuring that residents receive their medicines as prescribed. The above key Standard 10 was not examined at this inspection. The outcome for this Standard will be checked at the next inspection. EVIDENCE: The care files of four residents were looked at. These contained care plans that had been kept up to date monthly as is required. The care plans are well laid out and they are easy to read and follow. Each plan contained details of health, personal and social care needs for the resident. Laburnum Lodge DS0000031082.V273226.R01.S.doc Version 5.0 Page 10 The staff said that they knew each residents needs by reading the care plans, which are readily available to them. Talking to residents, the manager and the staff and looking at records showed that the resident’s health care needs are taken care of and that when necessary health workers such as doctors, nurses and opticians are called. A number of risk assessments are in place; all of these had been reviewed regularly with the information being up to date. Records also showed that the weight of the residents’ is also regularly checked. Suitable equipment is available for the treatment and prevention of pressure sores although the inspector was told that no resident had such sores at the time of this inspection. The staff are aware that should anyone develop this condition the treatment and progress of the ailment must be properly written down. The home’s medicines are provided in pre-filled blister packs with pre-printed prescription/recording sheets also provided. Medicines are safely and securely stored, and the staff have been given training about how to give out and deal with medicines. Up to date records are kept of medicines received, given out and disposed of by the home therefore ensuring that medicines are handled properly. Laburnum Lodge DS0000031082.V273226.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 13. The home offers a number of leisure activities, which help to keep some of the residents interested and stimulated. The visiting arrangements are flexible thus enabling residents to have good contact with family and friends as they please The above key Standards 14 and 15 were not examined at this inspection. The outcomes for these Standards will be checked at the next inspection. EVIDENCE: Due to their condition many of the residents have a limited ability to make decisions and choices about their day-to-day living arrangements. In discussion the staff said that they try to assist the residents with this by offering them choices about such things as what clothing to wear, when to rise and retire and helping to choose from the menu. The inspector confirmed this when he spent some time in one of the residents lounges where the staff were seen to be asking the residents what they wanted to drink and which television programme they wished to watch. The home provides a number of recreational and stimulating activities (e.g. exercises, a social evening every Saturday, outings, crafts, visiting entertainers and armchair aerobics) that the residents are encouraged to join in with. Laburnum Lodge DS0000031082.V273226.R01.S.doc Version 5.0 Page 12 However, the staff told the inspector that due to their condition, a number of residents are either unable or are unwilling to take part in the above activities. The home should continue to look for other forms of stimulation for those residents who are less able. The staff also said that due to their caring duties that they had only a limited amount of time to spend in providing the residents with social activities and they felt that with more staff they would be able to become more involved in providing such activities. A programme of activities displayed around the home. From talking with residents and staff the inspector confirmed that the visiting arrangements are flexible with these being described in the resident’s information guide. Those residents spoken with said that they “were able to see their visitors wherever they wanted to”. They described taking visitors to their bedrooms for privacy or seeing them in the main lounge. The residents said that visitors are made welcome and that they (the visitor) can have a warm drink if they so wish. Laburnum Lodge DS0000031082.V273226.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The above key Standards 16 and 18 were not examined at this inspection. The outcomes for these Standards will be checked at the next inspection. EVIDENCE: Laburnum Lodge DS0000031082.V273226.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Laburnum Lodge care home provides safe, clean, comfortable, homely and friendly surroundings for the people living there. EVIDENCE: Laburnum Lodge is well maintained both to the inside and to the outside. A lounge has been refurbished, some bedrooms have been redecorated, new carpets have been fitted in some lounges and a new floor has been provided in a sluice room and shower room has been re-tiled. There is a well-kept secure and peaceful central garden area that is easily accessible to the residents which is provided with seating. The home has acted upon any recommendations made by the local fire service and environmental health department thus everyone’s ensuring safety. The home has a properly equipped laundry and information regarding the control of infection is available. Residents clothing is marked to enable easy Laburnum Lodge DS0000031082.V273226.R01.S.doc Version 5.0 Page 15 identification and the residents had no complaints about the laundry service provided by the home. At the time of this inspection the home was generally clean and tidy apart from one bedroom, which had a noticeable malodour. The staff are well aware of this situation with the carpet being cleaned every two days. The inspector suggests that this carpet may need to be renewed if regular cleaning proves to be ineffective. Laburnum Lodge DS0000031082.V273226.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 28. Staffing levels must be reviewed therefore ensuing that the assessed needs of the residents can be met. The home has met the requirement to have at least 50 of the care staff trained to NVQ Level 2 or above by 2005 so making sure a good standard of care is provided. The above key Standards 29 and 30 were not examined at this inspection. The outcomes for these Standards will be checked at the next inspection. EVIDENCE: A number of the staff have worked at the home for a considerable time. This helps provide continuity and a good standard of care for the residents. The residents said that the staff were “easy to get along with” and that they were helpful and considerate. Staff morale was good with staff saying that “we work together well as a team, they also said that they “get on”(together) and that there is a “good team spirit”. Looking at staff rotas showed that staff are regularly available throughout the day and the night. However the Care Supervisor and other care staff said that in their opinion there wasn’t always enough staff on duty to do the work required of them. Laburnum Lodge DS0000031082.V273226.R01.S.doc Version 5.0 Page 17 The staff felt that one more worker is required throughout the daytime period. They felt that such an additional person would allow them to be better able to supervise the residents, to cover the residents lounges during staff breaks and to provide more activities for the residents and to generally meet the residents care needs more effectively. The inspector therefore requires that the staffing levels at the home be reviewed. Of the 26 care staff employed at the home 10 have got a National Vocational Qualification at Level 2 and four at Level 3. Eight staff are presently undertaking NVQ assessment at Level 2 and six other staff are due to start this training at the end of January 2006. The home manager has completed the Registered Managers Award (NVQ Level 4). Laburnum Lodge DS0000031082.V273226.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 and 38. The manager of the home provides strong leadership; guidance and support to the staff therefore making sure that the home is run in the best interests of the residents. Procedures and practices within the home promote and safeguard the health, safety and welfare of the people living and working in the home. The above key Standards 33 and 35 were not examined at this inspection. The outcomes for these Standards will be checked at the next inspection. EVIDENCE: The manager of the home (who was not on duty at the time of this inspection) has considerable experience of managing care home settings is also is well experienced in the care of older people. The manager has recently successfully completed the Registered Managers Award (NVQ Level 4). Laburnum Lodge DS0000031082.V273226.R01.S.doc Version 5.0 Page 19 Both residents and staff said that the manager was approachable and would listen to any suggestions and comments. A number of residents said that she was “OK” and the staff said that the manager “would listen” and that “her door (to her office) is always open” to them. Looking at records and maintenance certificates showed that these were up to date and the examination of paperwork and conversations with staff also confirmed that they had been provided with the necessary training so that they can work safely. The home is safely maintained with fire precautions tests done weekly and details of accidents are properly written down. Hot water temperatures at sinks are controlled in such a way as to prevent accidental scalding and upper floor opening windows are made so as to avert falling accidents. Laburnum Lodge DS0000031082.V273226.R01.S.doc Version 5.0 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 3 Laburnum Lodge DS0000031082.V273226.R01.S.doc Version 5.0 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 OP27OP12 Regulation 18 Requirement The Registered Person must review the adequacy of staffing levels to ensure that sufficient staff are provided to meet all of the assessed needs of the residents (including social needs). Timescale for action 17/03/06 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 Refer to Standard OP12 Good Practice Recommendations The registered person should continue to look for different ways of providing the less able residents with fulfilling and stimulating activities. Laburnum Lodge DS0000031082.V273226.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG National Enquiry Line: 0845 015 0120 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 Laburnum Lodge DS0000031082.V273226.R01.S.doc Version 5.0 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. 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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