CARE HOMES FOR OLDER PEOPLE
Lake View Rest Home 10-12 Lake Road Fairhaven Lytham FY8 1BE Lead Inspector
Lillian McMullen Unannounced 11 August 2005
th 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 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 View Rest Home F57 F09 S64226 Lake View Rest Home V244635 110805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Lake View Rest Home Address 10-12 Lake Road Fairhaven Lytham Lancashire FY8 1BE 01253 735915 01253 735915 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Lakeview Rest Homes Limited Miss Sarah Williams Care home only 29 Category(ies) of OP Old Age (29) registration, with number of places Lake View Rest Home F57 F09 S64226 Lake View Rest Home V244635 110805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The service is registered for a maximum of 29 OP (Older People 65 and over) service users. Date of last inspection 8th November 2005 Brief Description of the Service: Lake View is registered to accommodate 29 service users aged 65 yrs and above of both sexes. The home provides excellent environmental standards, all rooms are single and all have bathroom en suites facilities. The home provides personal care and consults with G.P.s and district nurses regarding the medical needs of the service users. The facilities within the home are good. A passenger lift is in place that allows for independent movement between floors. Access in and out of the home can also be achieved independently as there are no steps to negotiate. A programme of activities is in place and the management and staff encourage, social stimulation, both in and outside the home. Transport is always available for outings and trips either for group events or for individual shopping trips or to keep appointments. The hairdresser visits weekly and arrangements are made for the chiropodist, dentist and optician to visit the home if the service users are unable or do not wish to access community resources. Lake View Rest Home F57 F09 S64226 Lake View Rest Home V244635 110805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 10.30am and took place over 6 hours. At the time of the inspection there were 27 residents in the home. The Inspector spoke to 7 residents, 3 visitors, 1 staff member and the manager. Comment cards were left for relatives and residents, the ones completed during the inspection, all contained positive views of the home. What the service does well: What has improved since the last inspection?
Since the previous inspection the Service User Guide has been issued to all residents, evidence of this was found as when the inspector was touring the building she noted at least two bedrooms were the Service User Guide was on show. The registered manager continues with her own personal development and hopes to complete her Registered Managers Award by the start of 2006, to achieve this she has had to change the training provider and now travels to Runshaw College to complete this course of study.
Lake View Rest Home F57 F09 S64226 Lake View Rest Home V244635 110805 Stage 4.doc Version 1.40 Page 6 Staff continue to be supported in their personal development frequent training is offered and a new training provider has been commissioned to ensure staff have a consistent approach to NVQ training. Recruitment procedures have improved all staff are now checked by the Criminal records Bureau prior to employment. 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. Lake View Rest Home F57 F09 S64226 Lake View Rest Home V244635 110805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Lake View Rest Home F57 F09 S64226 Lake View Rest Home V244635 110805 Stage 4.doc Version 1.40 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 standard(s) 3 The admission and assessment procedures were clear to ensure the care needs of residents are met. EVIDENCE: The Inspector examined the records of the last three residents to be admitted and found that in all cases a full assessment of need had been carried out prior to admission, therefore ensuring that the home could meet the residents needs. Also on file was information from other sources such as hospital discharge information. The details gained through the assessment process then form the basis of the initial care plan. The registered manager informed the Inspector that she or another senior manager from the company always visit the prospective resident in their place of residence to carry out the assessment and that following the assessment the
Lake View Rest Home F57 F09 S64226 Lake View Rest Home V244635 110805 Stage 4.doc Version 1.40 Page 9 prospective resident is invited to visit Lake View to view the facilities and meet the staff and other residents. One resident spoken to confirmed that she had visited the home with her relatives and had been impressed about how welcoming and friendly everyone was. Lake View Rest Home F57 F09 S64226 Lake View Rest Home V244635 110805 Stage 4.doc Version 1.40 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 standard(s) 7,8 and 10. The care planning process ensures the assessed needs of the residents are met. EVIDENCE: Individual records are kept for each resident with a plan of care setting out in detail the action that needed to be taken by care staff to ensure all aspects of health, personal and social care needs of the residents were met. Each care plan is reviewed, on a monthly basis and residents and their relatives are encouraged to be involved in the care planning process. Specialised needs are well documented. One resident who has complex medical needs has additional information on file regarding the specialised equipment required to meet her needs and the involvement of the district nurse and continence advisor. This resident told the inspector that whilst her physical condition leaves her feeling depressed she is very happy and comfortable at the home. She said that “staff are good and that they are always here to help”. The inspector advised that by including information regarding the residents’ life history and significant life events would help the development of the care
Lake View Rest Home F57 F09 S64226 Lake View Rest Home V244635 110805 Stage 4.doc Version 1.40 Page 11 documentation. This would help staff in getting to know the resident and have a holistic approach in developing the care plan. All residents spoken to were happy with the care they receive. One resident said that “staff are wonderful they will do anything you ask of them, they always have a smile on their face”. Visitors spoken to were extremely complementary regarding the care the residents receive saying it does not matter what time you come every thing is the same and the staff are very attentive. Residents and visitors spoken to throughout the inspection spoke favourably about the registered manger commenting that she always has time to speak to you and that she knows each resident and their relatives personally. Observations made by the inspector during the inspection revealed that staff had a good understanding of the care needs of the residents and witnessed staff assisting residents and was pleased to see they had good relationships with residents and carried out all tasks in a friendly and sensitive way. Lake View Rest Home F57 F09 S64226 Lake View Rest Home V244635 110805 Stage 4.doc Version 1.40 Page 12 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 standard(s) EVIDENCE: None of the above standards were assessed at this inspection. Lake View Rest Home F57 F09 S64226 Lake View Rest Home V244635 110805 Stage 4.doc Version 1.40 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 standard(s) EVIDENCE: None of the above standards were assessed at this inspection. Lake View Rest Home F57 F09 S64226 Lake View Rest Home V244635 110805 Stage 4.doc Version 1.40 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 standard(s) 19 and 26 The planned maintenance and renewal programme for the redecoration and refurbishment of the home ensures that residents live in a comfortable, homely and safe environment. EVIDENCE: Lake View provides good environmental standards all bedrooms have full bathroom en suite facilities. The Inspector conducted a partial tour of the home and found that the physical standards are consistently good through out the building. Redecoration and refurbishment is, a continual programme. All radiators were guarded and fail-safe devices are fitted to all hot water outlets. The communal rooms are spacious, comfortable and furnished to a good standard with mostly domestic type furniture. The residents’ bedrooms were all
Lake View Rest Home F57 F09 S64226 Lake View Rest Home V244635 110805 Stage 4.doc Version 1.40 Page 15 individual, reflecting their preferences and containing personal possessions. Specialist equipment was seen around the home ensuring individual needs are met whilst promoting independence. The laundry room is situated to the rear of the home away from food storage and preparation. There is seating areas to the front and the side of the home for residents to sit and enjoy during the summer months. All outside space is easily accessible to residents. The home was found to be warm, clean and free from any offensive odours. Lake View Rest Home F57 F09 S64226 Lake View Rest Home V244635 110805 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 and 30 The recruitment policy is consistently applied ensuring only suitable staff are employed. EVIDENCE: There is a stable staff group at Lake View with many of the staff being in post for a number of years. This provides evidence that residents are cared for by staff that are known to them. Examination of the staff rota provided evidence that adequate staff are employed to meet the needs of the residents accommodated. Discussion with residents confirmed that they feel well cared for by staff that know what they are doing. One resident said “there is always plenty of staff on duty, all you have to do is ring the bell, day or night and they come, you never have to wait”. The Inspector examined two staff files and found that they contained all the information required, confirming that the recruitment procedures had been followed. However the inspector did advice that the application form could be developed further to ensure that dates were included in the section for previous employment in addition the section for applicants to state if they have or not have any criminal record should state that the post they are applying for is not protected under The Rehabilitation of offenders Act. Lake View Rest Home F57 F09 S64226 Lake View Rest Home V244635 110805 Stage 4.doc Version 1.40 Page 17 The Inspector examined the training records and noted all staff had undergone induction training and attended relevant training courses as their employment progressed. The manager promotes National Vocational Qualification (NVQ) training and all staff are expected to commence this training as soon as is practical following induction training. The manager has recently changed the training provider for the NVQ training, as the previous provider was not consistent in providing work-based assessments. This she hopes will keep staff enthusiastic and motivated to progress their personal development. Lake View Rest Home F57 F09 S64226 Lake View Rest Home V244635 110805 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: None of the above standards were assessed at this inspection. Lake View Rest Home F57 F09 S64226 Lake View Rest Home V244635 110805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x
COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x x Lake View Rest Home F57 F09 S64226 Lake View Rest Home V244635 110805 Stage 4.doc Version 1.40 Page 20 Are there any outstanding requirements from the last inspection? 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 Regulation Requirement Timescale for action 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. 2. Refer to Standard 7 29 Good Practice Recommendations to develop the care documentation by the inclusion of resident life history. to develop the staff recruitment application form further to include date in relation to employment history and to include that the post is not protected under the rehabilatation of offenders act. Lake View Rest Home F57 F09 S64226 Lake View Rest Home V244635 110805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Unit 1, Tustin Court Portway Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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