Inspection on 22/03/06 for Lake View Nursing Home

This inspection was carried out on 22nd 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

Lake View Nursing Home 06/03/07

Lake View Nursing Home 26/09/05

Lake View Nursing Home 23/02/05

Lake View Nursing Home 21/06/04

Lake View Nursing Home 26/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Lakeview Nursing Home Chorley Road Withnell Chorley Lancashire PR6 8BG Lead Inspector Anne Taylor Unannounced Inspection 22nd 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 Lakeview Nursing Home DS0000025566.V278912.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. Lakeview Nursing Home DS0000025566.V278912.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lakeview Nursing Home Address Chorley Road Withnell Chorley Lancashire PR6 8BG 01254 831005 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) European Care (UK) Limited Mrs Margaret Parker Care Home 51 Category(ies) of Dementia (26), Old age, not falling within any registration, with number other category (25), Physical disability (4) of places Lakeview Nursing Home DS0000025566.V278912.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 51 service users to include: Up to 25 service users in the category of OP (Old age not falling within any other category). Up to 26 service users in the category DE (Dementia) 2. 3. Up to 4 service users in the category of PD - (Physical Disability) The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided at all times to meet the dependency needs of service users and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. 26th September 2005 Date of last inspection Brief Description of the Service: Lakeview is a residential and nursing home providing 24-hour care and accommodation for fifty one residents of either sex over the age of sixty-five. The registration includes a specialist unit for residents suffering from mental health problems associated with dementia and four residents with a physical disability over the age of fifty. At the time of inspection fifty residents were living at the home. Lakeview is owned by European care (UK) Limited, whose headquarters are based in London. Responsibility for the day-to-day running of the home is that of the registered manager, Mrs Margaret Parker. There is an area manager who visits the home regularly to provide managerial support. The home is located near the village of Withnell, in a rural area requiring transport to reach the nearest shops and other facilities such as the post office, local pubs, and other town amenities. The home is set in extensive grounds with woodland views and views of a lake owned by a different company. The home provides accommodation on two floors, served by a passenger lift. All rooms are single and thirty-one have an en-suite facility. Lakeview Nursing Home DS0000025566.V278912.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that started at 9.30am and lasted six hours. The inspection involved discussion with the people who lived and worked at the home and visitors, examination of records, policies and procedures and a tour of the premises. As part of the inspection process the inspector used “case tracking” as a means of assessing some of the National Minimum Standards. This process allows the inspector to focus on a small group of people living at the home. All records relating to these people are inspected along with the rooms they occupy in the home. They are invited to discuss their experience of the home with the inspector, however this is not to the exclusion of other people living at the home. What the service does well: What has improved since the last inspection? Lakeview Nursing Home DS0000025566.V278912.R01.S.doc Version 5.1 Page 6 Since the last inspection some bedrooms and communal areas in the home have been refurbished so that residents continue to live in a well-maintained and comfortable environment. The amount of training available to staff has increased so their knowledge and skill base is broader and enables them to continue to provide a good standard of care. The range of activities and social events has increased and a new DVD player has been bought, all of which have improved the activities available to residents. 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. Lakeview Nursing Home DS0000025566.V278912.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 Lakeview Nursing Home DS0000025566.V278912.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 A thorough pre admission procedure ensured that prospective residents could be involved in the process and their individual wants and needs properly assessed. EVIDENCE: Standard 6 was not assessed, as Lake view does not provide intermediate care. Pre admission assessments carried out by the home and or social workers involved prospective residents and or their relatives. This helped residents to know what sort of care they should expect to receive when they came to live at the home. The assessments were detailed and showed the individual needs of each client. The assessments were used to develop a plan of care for each resident that showed how the home would meet individual needs. The manager said that she or another registered nurse usually carried out pre Lakeview Nursing Home DS0000025566.V278912.R01.S.doc Version 5.1 Page 9 admission assessments for prospective residents. This meant that both the home and any prospective resident could be sure that an appropriately trained person had done the assessments and residents had the opportunity to meet someone from the home before they came to stay there. Lakeview Nursing Home DS0000025566.V278912.R01.S.doc Version 5.1 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): 10 Staff were sensitive to the needs of residents and made sure that residents’ rights to privacy and dignity were upheld. EVIDENCE: Records showed that induction training included instruction on privacy dignity and respect so that staff had knowledge and understanding of this before they started to give care to residents. Staff spoken to were able to discuss how they put into place the home’s policies and procedures relating to maintaining the privacy and dignity of the people they cared for and how this helped to make sure that residents felt respected. Staff were seen to be providing care in a sensitive and caring manner, which promoted residents’ dignity. People living at the home say staff maintained their dignity and treated them respectfully. They commented, “staff are kind and friendly, always polite” and “When the doctor comes he sees me in my own room and the nurse makes sure the door is closed and the curtains are shut before he examines me”. Lakeview Nursing Home DS0000025566.V278912.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): 12,15 The daily routines were flexible and residents supported to make choices about their lifestyle. Residents benefited from the positive and proactive approach to social activities. The importance of providing a well balanced diet was recognised by the home and residents were able to eat healthily and given a choice about what they ate. EVIDENCE: Residents spoken to said that they were able to exercise choice about what time they got up and went to bed and what clothes they wore, giving them some control over their lifestyle. For residents unable to make such choices, personal preferences were recorded in care plans. When asked how they helped residents to exercise choice staff said, “we ask if they want to get up and what they want to wear every day, what they want to eat and what they plan to do today”. Records showed that a lot of attention was given to helping residents to take part in valued and fulfilling activities that were already established or developed in the home so that the lifestyle experienced by residents met their Lakeview Nursing Home DS0000025566.V278912.R01.S.doc Version 5.1 Page 12 expectations and preferences as much as possible. The activity organiser produced a monthly newsletter, which informed residents of forthcoming events, activities and the dates of religious services to be held in the home. Particular attention was paid to providing suitable activities for people in the dementia unit and they benefited from the one to one interaction with the activities organiser. Some of the people spoken to preferred to spend time in their rooms and were happy that they were not forced to participate in the activities provided. They said, “there is lots to do if you want it but I like doing my own thing, I like to garden and go outside in the summer” and “I like to stay in my room and read or watch television, I could join in other things but I don’t want to”. Records were kept of individual likes and dislikes and staff were aware of residents’ dietary needs and personal preferences, which ensured that those living at the home received a nutritional diet in accordance with their needs. The lunchtime meal was relaxed and unhurried with staff available to assist if needed. Some residents had chosen to eat in the dining room, others in their bedroom. One resident said, “I have some meals in my room and some in the dining room it depends really”. Residents spoken to were generally satisfied with the range and quantity of food available to them. When asked one resident said, “The food is fine, I don’t suppose you can please everyone all the time but I have no complaints”, and “There is a choice, the staff ask me what I want and if I don’t like the menu they will get me a sandwich or salad or something like that”. Lakeview Nursing Home DS0000025566.V278912.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 The management of any complaints was good and helped residents to know that their concerns would be listened to and acted upon. EVIDENCE: A complaints procedure was in place and residents spoken to know how and who to complain to. The home had received two complaints since the last inspection both of which had been managed in line with the home’s policy and subsequently resolved. Resident’s spoken to knew how to complain and felt that they were encouraged to raise any concerns they might have about the home and that they would be listened to and action would be taken on any issues raised. One resident said, “I would tell the nurse or matron if I was really unhappy but I’m not, everything is good”. Staff were able to discuss how they would respond if a resident complained to them and realised how important it was to make sure residents felt able to raise concerns and be sure they were listened to. Lakeview Nursing Home DS0000025566.V278912.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, 25, 26 The standard of accommodation was good and provided an environment that was suitable for it’s stated purpose. EVIDENCE: The home was accessible to all residents. Ramps allowed easy access to the outside and the grounds were tidy and well maintained, providing a pleasant area for residents to enjoy if they wished. Residents spoken to were generally happy with their private accommodation and some had personalised their rooms so that they felt more at home. One said, “My room is fine I can see squirrels and sometimes deer and the lake”, and “some of my things are here and there is still enough room”. A programme for maintenance and refurbishment was in place so that furnishings, fittings and décor in all parts of the home could be renewed and kept up to date when needed. A number of radiators were unguarded and did Lakeview Nursing Home DS0000025566.V278912.R01.S.doc Version 5.1 Page 15 not have a guaranteed low surface temperature. Unprotected radiators present a possible health and safety risk to residents. However, the manager had carried out risk assessments, which were regularly reviewed and the organisation was seeking advice about how the central heating system could be improved. The programme to cover exposed pipe work was complete and the risk from hot water pipes therefore reduced The home was clean and free from offensive odours. One resident said, “ Someone cleans my room every day so it is always clean and tidy”. One visitor said, “ it’s always clean and tidy, it never smells or anything”. Policies and procedures were in place that identified infection control measures in place at the home. Staff were able to discuss infection control procedures so the risk of cross infection between residents was minimised. Lakeview Nursing Home DS0000025566.V278912.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): 28,30 The approach to training was good and made sure that appropriate training was provided for new and existing staff that helped make sure they were competent do their jobs and able to practice safely. EVIDENCE: Training records showed that new staff received induction and ongoing training that provided them with the basic skills needed to carry out tasks allocated to them. Staff spoken to said that training opportunities were good and that they had received training in fire safety, moving and handling and other health and safety topics so that they were kept up to date about safe working practices. National vocational training (NVQ) was available to care staff and a significant number of carers had already obtained level two or three so the home exceeded the fifty per cent ratio needed to meet the national minimum standard. Discussion with the manager showed that she had a positive and proactive approach to training. The development of a training and development programme added structure to the process and made sure all staff continued to receive the training they need to keep up to date with any changes in legislation and best practice. Lakeview Nursing Home DS0000025566.V278912.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): 31, 38 The home was well managed by a responsible person who discharged her responsibilities fully and made sure that the health; safety and welfare of residents were promoted and protected. EVIDENCE: Records showed that the registered manager is a first level registered nurse who has kept up to date with clinical areas of practice and management issues so that she can meet the professional registration requirements of the Nursing and Midwifery Council and fulfil the responsibilities of her job. The manager is in the process of completing a recognised management qualification. When this is achieved the national minimum standard can be considered fully met. Lakeview Nursing Home DS0000025566.V278912.R01.S.doc Version 5.1 Page 18 Discussion with staff showed that the manager provided leadership and direction so that every one knew what their role was and what was expected of them. Residents and visitors spoken to were satisfied with the way in which the home was managed and found the manager to be approachable and helpful. One visitor said, “I can ask the manager anything and she will always try to find an answer and help, the home runs well and I am very satisfied with the way in which my relative is being cared for”. Certificates were inspected which confirmed that regular servicing had taken place in relation to systems and equipment used by the home to make sure they were safe to use. Discussion with the manager and staff demonstrated a clear commitment to health and safety issues and a number safe working practices were verified at the time of inspection. Training in relation to health and safety issues had been provided for all staff so that they were able to promote the health, safety and welfare of the people they cared for. Residents felt safe living at the home one said, “I feel safe and well looked after here”. Lakeview Nursing Home DS0000025566.V278912.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 X 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X 2 3 STAFFING Standard No Score 27 X 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X X X 3 Lakeview Nursing Home DS0000025566.V278912.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 Standard OP25 Regulation 13 (4) Requirement Steps must be taken to ensure that surface temperatures of radiators do not exceed 43°c. The risk assessments must be kept under review and radiator guards fitted if needed. Timescale for action 31/05/06 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 OP31 Good Practice Recommendations The registered manager should ensure that she obtains a relevant management qualification. Lakeview Nursing Home DS0000025566.V278912.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Lakeview Nursing Home DS0000025566.V278912.R01.S.doc Version 5.1 Page 22 - 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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