Inspection on 26/09/05 for Lake View Nursing Home

This inspection was carried out on 26th September 2005.

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 22/03/06

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 Announced Inspection 26/09/05 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.V251914.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. Lakeview Nursing Home DS0000025566.V251914.R01.S.doc Version 5.0 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 57 Category(ies) of Dementia (4), Dementia - over 65 years of age registration, with number (36), Old age, not falling within any other of places category (42), Physical disability (4) Lakeview Nursing Home DS0000025566.V251914.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 7. Up to 28 service users in the category of OP who need nursing care. Up to 4 service users in the category of DE, aged 50 plus. Up to 14 service users in the category of OP who need personal care only. The service should, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Up to 10 service users in the category of DE (E) who need personal care only. Up to 26 service users in the category of DE(E) who need nursing care. Up to 4 service users in the category of PD, aged 50 plus. Date of last inspection 23rd February 2005 Brief Description of the Service: Lakeview is a residential and nursing home providing 24-hour care and accommodation for fifty seven 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 forty-nine residents users were living in 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.V251914.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 that took place over one full day in September 2005. 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. Comment cards received from residents and relatives have also been used in the production of this report. 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? Progress has been made in addressing most of the requirements made at the last inspection. Steps have been taken to make sure radiators are not too hot and that water is delivered at a safe temperature. The fitting of new floor covering to corridors and new carpets in some bedrooms has improved the environment so that residents live in more comfortable surroundings. Lakeview Nursing Home DS0000025566.V251914.R01.S.doc Version 5.0 Page 6 Policies and procedures in relation to the administration of medicines have been reviewed and improved so that good practice is maintained. 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.V251914.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 Lakeview Nursing Home DS0000025566.V251914.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): Standard 3 was not assessed at this inspection and standard 6 does not apply as Lakeview does not provide intermediate care. EVIDENCE: Lakeview Nursing Home DS0000025566.V251914.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 ,9 The care planning process was thorough enough to ensure the needs of residents were properly identified and managed. The provision of basic nursing care and management of health care needs was of a good standard and made sure the health and welfare of clients was effectively managed. Policies and procedures were in place to facilitate the safe handling of medicines so that residents were protected. EVIDENCE: Lakeview Nursing Home DS0000025566.V251914.R01.S.doc Version 5.0 Page 10 Care records seen showed that each resident had a plan of care based on the pre admission assessment so that individual needs were identified and instructions for staff as to how those needs would be met were clear. The manager said that residents and their relatives were consulted about the care planning process and the care plans seen had been signed by residents who were able to do so or by their relative. Discussion with the manager and other members of staff showed that care plans were drawn up and reviewed by trained nurses who had experience of this process. Risk assessments that enabled health care to be provided safely were in place so staff were confident about this part of their job and residents able to feel safe when being assisted with personal care needs or receiving nursing care. When asked about the care they received residents said, “I just ask a care assistant if I want a bath and they help me, the chiropodist visits and I’ve had new glasses since I came here”. Visitors spoken to say that they were satisfied with the care their relative received. Comments included, I have seen my mum’s care plan but there was nothing in there that I didn’t already know, they’re very good at meeting her needs” and “ I am satisfied with the care, the staff uphold her dignity as best they can and I’ve seen the care plan and been kept informed of any changes”. Staff were able to discuss the individual needs of the people they cared for and how they organised their workload to ensure those needs were met. They made reference to way they used the care plans and attended regular handovers when there was a change of shift, so that they knew about any changes to the care residents needed. Polices and procedures were in place to ensure the safe handling of medication within the home. Requirements made at the last inspection had been addressed. Qualified nurses confirmed that they administered all medication except some external preparations (creams), which were applied by, care staff. Evidence of delegation by a registered nurse to competent care staff had been recorded. The medication administration records (MAR) were generally up-to-date so that the home was able to show that drugs had been administered to residents as prescribed. Lakeview Nursing Home DS0000025566.V251914.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): 13, 14 The management arrangements in place at the home, underpinned by organisational policies and procedures, supported residents to maintain contact with family and friends. Residents were helped to exercise choice so that they had some control over their lives. EVIDENCE: The statement of purpose outlined the home’s visiting policy and included a statement about residents being able to exercise choice in relation to visitors. This meant that residents and relatives knew what the home’s approach to visiting was and could comply with any policies operated by the home. Residents spoken to confirmed that they were able to see visitors in their own room or in one of the communal areas of the home so the meetings could be private if they wished. Visitors present at the inspection said, “I can visit anytime really and I’m made to feel welcome”. During conversations with residents and staff it was evident that residents who were able could make choices about the way they lived within the home and in particular within the privacy of their own room. Rooms had been personalised Lakeview Nursing Home DS0000025566.V251914.R01.S.doc Version 5.0 Page 12 by residents bringing in some of their own possessions so that they had familiar and treasured items around them. A record of all items brought into the home by residents was kept so that staff knew which items belonged to each resident. Residents not able to exercise full control over their financial affairs were mainly helped by a family member. The registered manager knew how and when to access an advocate to act on behalf of a resident without a representative to ensure that any decisions made were in the best interests of that resident. Lakeview Nursing Home DS0000025566.V251914.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): 18 Management processes in relation to abuse were thorough enough to ensure the protection of any vulnerable residents. EVIDENCE: The home had an adult abuse policy and whistle blowing policy, in addition to a copy of guidance issued by the department of health. Discussion with staff showed that they were aware of the above documentation and were quite clear about what they would do if an allegation or suspicion of abuse came to their attention. The manager was aware of her responsibilities in relation to protecting people living at the home and making sure staff were appropriately trained to recognise and act upon any signs of possible abuse. Induction training records for new staff included information and guidance about abuse so that all new staff were familiar with the subject and how to respond to any allegation or suspicion of abuse. Staff confirmed that they received regular updates so that they continued to be made aware of the need to protect the people they care for. Lakeview Nursing Home DS0000025566.V251914.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): The environmental standards were not fully assessed at this inspection. However, progress in addressing any outstanding requirements from the last inspection was checked. EVIDENCE: The home had taken steps to address the concerns raised previously about the hot surface temperatures of some radiators. A number of radiators were randomly tested and one had a very high surface temperature. It was agreed that the registered manager would carry out a risk assessment to identify any radiators that were still too hot. Guards would then be fitted to any radiators that presented a health and safety risk. The programme to cover all exposed pipe work should be completed as soon as possible so that the environment is safe for residents and staff. New flooring had been fitted to the corridors and some bedrooms, which had improved the environment for residents. The reception area has been Lakeview Nursing Home DS0000025566.V251914.R01.S.doc Version 5.0 Page 15 repeatedly flooded and the carpet had shrunk leaving gaps and an uneven surface in parts. Repair or replacement should be undertaken to reduce the risk of tripping or falling. The home should consider securing wardrobes to the wall to prevent them from being pulled over or toppling over. The refurbishment programme of redecoration and replacing worn furniture should progress so that residents continue to live in a comfortable and wellmaintained environment. Lakeview Nursing Home DS0000025566.V251914.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, 29 The skill mix of and number of staff on duty was sufficient to ensure the needs of residents were met. The recruitment process was thorough enough to ensure the continued protection of residents EVIDENCE: Staff rotas showed the number and skill mix of staff on duty at any time and that enough staff were on duty to ensure the needs of residents could be met. Comment cards completed by relatives also confirmed that there was always sufficient numbers of staff on duty so that residents were looked after and attended to properly. When asked about staff residents said, “the staff are very good, they help me with whatever I want”. One visitor said, “The staff treat my mum very well and there seems to e enough staff on duty to look after people”. Staff spoken to felt that there was generally enough staff on duty so that they were able to provide a good standard of care and meet residents’ needs. A recruitment checklist had been introduced to assist the recruitment process. Records showed that the recruitment process was thorough and took into account the need to protect residents. Discussion with the manager showed that she was aware of her responsibility to appoint suitable staff that would be Lakeview Nursing Home DS0000025566.V251914.R01.S.doc Version 5.0 Page 17 able to provide good care and the continuing need to protect people living at the home. Lakeview Nursing Home DS0000025566.V251914.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): 33, 35 The home was managed and organised in a way that helped make sure the service was run in the best interests of residents. The arrangements for handling money on behalf of residents were thorough enough to ensure their financial interests were safeguarded. EVIDENCE: Lakeview Nursing Home DS0000025566.V251914.R01.S.doc Version 5.0 Page 19 A system was in place to monitor the quality of service delivered so that the home could be made aware of their strengths, weaknesses and whether residents were satisfied with the service they received or not. This was done by sending out satisfaction questionnaires twice a year. Discussion with the manager showed that feedback from the survey was used as a means of improving and developing the service. The results of these surveys were made available to residents so that they could be reassured that their views were acknowledged and contributed to the running of the home. The home had been accredited with a nationally recognised quality assurance award that was reviewed annually. The registered manager carried out a quality audit of the operational systems in place at the home. Both systems made sure that the home was complying with company policies and procedures, current legislation and best practice. The home handled few personal allowances for residents. Any personal allowances and money brought in by relatives for residents was stored in a safe that only two members of staff had access to. This meant that residents’ money was appropriately safe guarded. Records were kept of any money handed in for safekeeping and receipts kept for any purchases made on behalf of residents so a clear audit trail of income and expenditure was available if needed. When asked about access to their money residents said, “my son and daughter look after my money” and “I have some money in the safe here at the home, my daughter looks after everything else”. Lakeview Nursing Home DS0000025566.V251914.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 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 2 X X X X X 2 X STAFFING Standard No Score 27 3 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 Lakeview Nursing Home DS0000025566.V251914.R01.S.doc Version 5.0 Page 21 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 19 Regulation 13(4) 23(2) Requirement The registered provider must keep the home in a good state of repair internally. This refers to carpets in some bedrooms and the reception area. The frayed, uneven and worn carpets present a trip hazard to residents, staff and visitors Arrangements must be made for their replacement. (Timescale of 31/05/05 not met). 2 Steps must be taken to ensure that surface temperatures of radiators do not exceed 43°c. A risk assessment must be undertaken and radiator guards fitted if needed. Pipe work in bathrooms and toilets must be guarded. (Timescale of 18/04/05 not met). 31/12/05 Timescale for action 28/02/06 25 13(4) Lakeview Nursing Home DS0000025566.V251914.R01.S.doc Version 5.0 Page 22 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 19 Good Practice Recommendations The home should consider securing wardrobes to the wall to reduce the risk of being pulled over or toppling over. Lakeview Nursing Home DS0000025566.V251914.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Chorley Local Office Levens House Ackhurst Business Park Foxhole Road Chorley PR7 1NW 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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