Inspection on 24/03/06 for Laburnum Lodge

This inspection was carried out on 24th March 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Laburnum Lodge 10/10/08

Laburnum Lodge 22/02/07

Laburnum Lodge 11/01/06

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 Judith Stanley Unannounced Inspection 24th March 2006 09:30 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 Laburnum Lodge DS0000031082.V286793.R01.S.doc Version 5.1 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.V286793.R01.S.doc Version 5.1 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.V286793.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 11th January 2006 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 accommodation is provided on two floors in 34 single bedrooms. All bedrooms have washing facilities. A passenger lift provides access 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.V286793.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over a 3 ½ hour period on one day and was unannounced. In the absence of the Manager the Deputy Manager assisted with the inspection. Part of the time was spent in the office looking at residents’ records (care plans) and other documents the home needs to keep to run its business, and the rest of the time was spent talking with staff and residents as well a making a tour of the premises. What the service does well: What has improved since the last inspection? Extra staff are now on duty at peak periods of the day. With the help of the extra staff more activities can now be offered. Laburnum Lodge DS0000031082.V286793.R01.S.doc Version 5.1 Page 6 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. Laburnum Lodge DS0000031082.V286793.R01.S.doc Version 5.1 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.V286793.R01.S.doc Version 5.1 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): 3 The admission procedure ensures that all people receive a proper assessment prior to moving into the home in order to ensure that their care needs have been fully identified and that the home is capable of meeting those identified needs. EVIDENCE: The admission procedure is sufficiently detailed to guide staff in the actions to be taken to ensure that new residents needs are properly assessed and planned for. The pre admission assessment can take place at either the prospective residents home or at a place most convenient for them. Laburnum Lodge DS0000031082.V286793.R01.S.doc Version 5.1 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 and 10 The records show that the health, personal, and social care needs of the residents have been identified, were monitored, and were reviewed in a measured way. Residents could be confident that they would be treated with respect, and that right to privacy and dignity would be promoted. EVIDENCE: Three residents’ care plans were looked at to see if full consideration had been made for each resident’s health, personal, and social care needs. Records gave a brief outline of the individual person’s background, life/work history, family, interests and likes and dislikes. Care plans had been reviewed at least monthly, and more often if needed. Risk assessments were in place for all three residents, including those relating to moving and handling, and the prevention of falls. Again, each is reviewed on at least a monthly basis. Laburnum Lodge DS0000031082.V286793.R01.S.doc Version 5.1 Page 10 Staff have a good awareness of how to protect resident’s dignity and privacy. They were seen to knock on doors and wait for a response before entering. Some residents have their own keys to their rooms. It was observed that when staff were required to transfer a resident using the hoist, they did this in a manner that was reassuring to the resident, as quickly as possible and ensured that the residents dress was properly adjusted. Staff were seen to deal with individual residents in a supportive manner and assisting them as appropriate. Laburnum Lodge DS0000031082.V286793.R01.S.doc Version 5.1 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): 14 and 15 Residents are able to exercise as much personal freedom and choice as possible within a risk assessed framework and within the confines of the residents expressed interests, capabilities and choice. Meals at the home are good, are served in quantities suitable for residents, and offer choice and variety. EVIDENCE: Due to their condition, some residents may find it difficult to make choices about their day-to-day living arrangements, however one resident spoken with told the Inspector that with the help of staff she likes to go for walks to the shops, that she get up when she wants and it’s her choice of what time she goes to bed. It was observed that staff asked residents about what they would like to drink, and would they like the TV or music on. Menus were inspected and were found to be well balanced and nutritious. There is always an alternative to the main meal served. On the day of the inspection, for lunch there was a choice of steak and kidney pie, chipped potatoes and vegetables or the alternative of egg and chips, followed by Laburnum Lodge DS0000031082.V286793.R01.S.doc Version 5.1 Page 12 dessert. Meals are served on the separate units. Two residents spoken with expressed their satisfaction at the quality and quantity of the food served. The menus were displayed on a wipe board, however one resident likes to rub the board clean, an alternative suggestion may be to have smaller laminated menus on the wall, so that both residents and relatives are aware of the days meals and choices available. Laburnum Lodge DS0000031082.V286793.R01.S.doc Version 5.1 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): 16 and 18 Systems are in place with regard to the investigation of complaints and adult protection issues ensuring that residents were listened to and protected. EVIDENCE: A complaints procedure was in place. Two complaints had been made since the last inspection, one of which is still ongoing. The manager has informed the CSCI about both complaints and the outcomes to date. The home complies with the policies and procedures from Bolton Social Services with regard to the protection of Vulnerable Adults. Laburnum Lodge DS0000031082.V286793.R01.S.doc Version 5.1 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 25 The home is in need of some refurbishment ensuring that residents are provided with homely and safe place to live. EVIDENCE: On a tour of the premises it was noted that some areas of the home are looking ‘tired’ and in need of decorating and some furniture and flooring in need of replacing, this was discussed with the Deputy Manager who confirmed that work on the home was planned for April 2006. The water system requires attention. The temperature of the water was tested by thermometer in 2 bathrooms, in which one was registering at well below the recommended temperature of 43° and in another bathroom there was no water at all coming out the hot tap, therefore residents were unable to wash their hands. In one residents room the water was very hot and registering over Laburnum Lodge DS0000031082.V286793.R01.S.doc Version 5.1 Page 15 60°c, this could result in a resident being scalded. Pre set values must be fitted to ensure the water is regulated to the correct temperature of 43°c in all areas that residents have access to. Laburnum Lodge DS0000031082.V286793.R01.S.doc Version 5.1 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): 29 The homes recruitment procedures are robust and provide the necessary safeguards to protect residents living at the home. EVIDENCE: Some staff information is kept on site and other at the main personnel department at Bolton Social Services. The Deputy Manager confirmed that all new staff complete a written application and submits the names of 2 referees. New members of staff are only confirmed in post following the return of a Criminal Records Bureau check. All staff undertakes a new starters full induction programme. Laburnum Lodge DS0000031082.V286793.R01.S.doc Version 5.1 Page 17 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): 33 and 35 There are systems in place to audit the service provision, so that improvements are made, and any poor practice eradicate, in keeping with residents, best interests. The home has a satisfactory accounting system in place, which protects resident’s interests. EVIDENCE: Opinions are actively sought from residents through day-to-day communication. Relatives involvement and opinions are important to the running of the home and staff value their input. The home is audited and monitored by Bolton Council. Laburnum Lodge DS0000031082.V286793.R01.S.doc Version 5.1 Page 18 The home administers a number of personal allowances of which an income/expenditure sheet with a running total is maintained for each resident. Monies are kept separate and are securely stored. Receipts for any transactions are kept. Laburnum Lodge DS0000031082.V286793.R01.S.doc Version 5.1 Page 19 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 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x 2 x STAFFING Standard No Score 27 x 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 x 3 x x x Laburnum Lodge DS0000031082.V286793.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Yes 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. 2. Standard OP19 OP25 Regulation 23 23 Requirement The home is need of some refurbishment and decoration. There must be hot water in all areas that residents have access to. This must be checked and regulated to the correct temperature of 43°c. 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). The recommended ratio for caring for people with dementia is 1 member of staff to 5 residents. This is outstanding from the last inspection) Timescale for action 26/05/06 26/05/06 3 OP27 18 26/05/06 Laburnum Lodge DS0000031082.V286793.R01.S.doc Version 5.1 Page 21 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 Laburnum Lodge DS0000031082.V286793.R01.S.doc Version 5.1 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. 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