CARE HOMES FOR OLDER PEOPLE
Lake House Lake Walk Adderbury Banbury Oxfordshire OX17 3NG Lead Inspector
Carole Moore Announced Inspection 19th December 2005 10:00 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 Lake House DS0000013156.V259148.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. Lake House DS0000013156.V259148.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Lake House Address Lake Walk Adderbury Banbury Oxfordshire OX17 3NG 01295 811183 01295 811260 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) The Orders Of St John Care Trust Anna Hicks Care Home 43 Category(ies) of Past or present alcohol dependence over 65 registration, with number years of age (3), Dementia - over 65 years of of places age (18), Learning disability over 65 years of age (3), Old age, not falling within any other category (43), Physical disability over 65 years of age (12) Lake House DS0000013156.V259148.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The total number of persons that may be accommodated at any one time must not exceed 43. Admittance of one named resident under the age of 65 years. Date of last inspection 28th June 2005 Brief Description of the Service: Lake House is a purpose built residential home situated in the village of Adderbury, close to Banbury in Oxfordshire. Local shops and amenities are all within easy reach and the home is on a regular bus route between Banbury and Oxford. It is home to 43 older people, formerly a County Council home and now the responsibility of the Orders of St John Care Trust. The single storey accommodation provides individual rooms where residents are encouraged to decorate their rooms with personal possessions. The communal areas are pleasantly decorated and the lounge area accommodates a day centre for older people from the community in which residents may participate if they wish. The building is divided into five wings and accommodates the bedrooms. Each wing of the home has its own sitting and dining area. Three of the wings have there own small kitchen area. The home is set in attractive grounds with a courtyard in the centre of the building. Lake House DS0000013156.V259148.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an announced inspection and took place on Monday 19th December 2005. The inspector would like to thank all the residents and staff for their full cooperation on the day. Some of the key standards were assessed and met at the unannounced inspection in June 2005 and four standards 12,20,21 and 26 were reassessed at this inspection. The inspector toured the building looking at the communal areas and the five wings, talking to residents in their individual bedrooms as well as speaking to residents in the individual wing lounges. There had been many improvements made to the environment since the last inspection. Individual time was spent with the manager, care leader, senior carer and carers as well as the domestic team, the activities coordinator and the business administrator. The inspector sat in on part of the lunchtime handover and observed the afternoon activity, which was a Christmas quiz. A random selection of staff records and resident’s records were examined as well as discussions around the health and safety of residents. Feedback had been received from a number of GPs and favourable comments had been made in respect of the care residents received. There were some issues raised by the district nurses in relation to communication and the manager is to address these in the New Year Feedback from the residents and relatives was really positive. “Residents seem really happy,” “Staff are lovely,” “No grumbles,” “Plenty of choice” What the service does well:
Lake House has a committed well-organised manager who is keen to promote good communication between her staff, residents and relatives in order to provide her residents with the quality of care they need. There is a homely environment and generally happy atmosphere and residents spoken to were pleased with their overall care and had nothing but praise for the staff team. Lake House DS0000013156.V259148.R01.S.doc Version 5.0 Page 6 The manager has introduced a newsletter, which provides residents with all the information they require in relation to what is going on in the home as well as poems, quizzes and messages. Staff are working extremely hard to implement new working practices and record keeping to ensure that the residents needs are being met. What has improved since the last inspection? What they could do better:
Planned and regular supervision of staff is an area that needs to be further improved. Regular monitoring of the writing of care notes and care plans to ensure consistency and quality. Communication with the district nurses needs to be addressed. The manager needs to consult with the local fire officer about the resident’s bedroom doors remaining open during the day to ensure their overall safety. Lake House DS0000013156.V259148.R01.S.doc Version 5.0 Page 7 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. Lake House DS0000013156.V259148.R01.S.doc Version 5.0 Page 8 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 Lake House DS0000013156.V259148.R01.S.doc Version 5.0 Page 9 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 All prospective residents have an assessment of their care needs to ensure that the home, the resident and their family are clear that the overall needs can be met. EVIDENCE: All prospective residents are invited into Lake House for a full days assessment. This ensures that Lake House is able to meet the needs of the prospective resident and it is an opportunity for the resident and their families to meet staff and other residents and therefore help to make the transfer into the home more pleasant and personal for them. The inspector spent some time with the head of care and a senior carer looking at the dependency assessment they use for all prospective residents. These assessments were very comprehensive and gave detailed information about the individual’s overall care needs. This information then forms the basis of their care plans. Lake House DS0000013156.V259148.R01.S.doc Version 5.0 Page 10 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. The home meets the overall needs of the residents. EVIDENCE: A sample of three resident’s care notes were examined and all had the care needs clearly identified with actions on how they would be met. There was particular emphasis in relation to privacy and dignity, which is excellent practice. There were clear records of reviews being held and these were clearly documented. There has been training in relation to the writing of the care plans but further monitoring needs to take place to ensure a consistent approach with all the carers and to ensure the quality of the content of the notes. The inspector observed a staff handover of care, and it was evident during the course of this communication that the staff have a good understanding of the individual residents, their care needs and how these will be met.
Lake House DS0000013156.V259148.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. Residents are encouraged to join in social activities should they wish to do so. EVIDENCE: The home has employed another part time activities coordinator to complement the current part time post. This has enabled quality time to be spent with those residents who choose not to partake in joint activities. The inspector spent some time with one of the coordinators and viewed the programme that is currently in place over the Christmas period. There are group activities in the main lounge such as bingo, sing a long and quizzes as well as smaller wing activities such as craftwork and reminiscence. On the day of the inspection there was an afternoon Christmas quiz and the male voice choir was singing that evening. Several of the residents told the inspector how much they were looking forward to the choir and that there was plenty of choice of activities and games should they wish to take part. One resident told the inspector that they had visits from the Brownies and from Bell ringers.
Lake House DS0000013156.V259148.R01.S.doc Version 5.0 Page 12 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 key standards were assessed at the unannounced inspection in June 2005. EVIDENCE: Lake House DS0000013156.V259148.R01.S.doc Version 5.0 Page 13 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): 19,21 & 26. Residents have sufficient and suitable washing facilities. The home is clean, pleasant and hygienic and well maintained. EVIDENCE: The environment was bright, clean and fresh smelling and several areas of the home had been redecorated. There have been improvements made to the two bathrooms on Heather wing. One bath has been removed and a new shower put in its place and the shower room redecorated with appropriate non-slip flooring. The other bathroom has a parker bath, which staff are receiving training to use safely. There is now new lighting in the main lounge and a family room has been made available by moving the administration office to a new location. Lake House DS0000013156.V259148.R01.S.doc Version 5.0 Page 14 A new fire alarm system has also been installed. Cleaning was underway throughout the inspection and the housekeeping team work hard to maintain the cleanliness of the building. The inspector spent time with the housekeeping team and they are pleased with the new working practices allowing them to take responsibility for their own wings. This has certainly improved the look of Lake House and the housekeeping team need to be commended. Lake House DS0000013156.V259148.R01.S.doc Version 5.0 Page 15 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 Residents are protected by the home’s robust recruitment policy and practices. EVIDENCE: Three staff records were examined and the home have a clear recruitment procedure. There is a clear front sheet checklist thus ensuring that all the requirements of schedule 2 of the Care Homes Regulations 2001 are met. The only area of recommendation is in critically looking at the job history and identifying any gaps in employment. These gaps need to be checked and reasons for the gap documented on the staff file. Lake House DS0000013156.V259148.R01.S.doc Version 5.0 Page 16 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, 35 & 38. The home is run in the best interests of the residents, their financial interest is safeguarded and their health and safety protected. However advice needs to be sought from the fire officer in relation to resident’s bedroom doors being left open. EVIDENCE: Regular residents meetings are held where residents are able to discuss any day-to-day issues with the management team and minutes are taken of these meetings. Residents confirmed that they found these meetings useful and felt they could have a say in how the home is run. The inspector spent some time with the new business administrator and he manages the resident’s petty cash and handles all receipts and records of all transactions.
Lake House DS0000013156.V259148.R01.S.doc Version 5.0 Page 17 From the records and computerised systems seen, it was clear that financial records are well maintained. There is also a property file for those residents who wish their valuables to be kept safe. The health and safety of residents was assessed and met at the last inspection in June 2005 but at this inspection a majority of the bedroom doors were left open. The inspector would like the manager to consult with the fire officer as to the safety of the residents when their doors are left open and to ask the fire officer for a written statement in respect of their safety and to forward a copy of that letter to the Commission for Social Care Inspection. Lake House DS0000013156.V259148.R01.S.doc Version 5.0 Page 18 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 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X 3 X X X X 3 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 2 Lake House DS0000013156.V259148.R01.S.doc Version 5.0 Page 19 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 OP38 Regulation 23 Requirement The commission for Social Care Inspection would like notification from the fire officer that the bedroom doors can be left open during the day. Timescale for action 01/02/06 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 OP7 Good Practice Recommendations It is recommended that care notes continue to be monitored to ensure consistency and quality. Lake House DS0000013156.V259148.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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