CARE HOMES FOR OLDER PEOPLE
Lakeland View Nursing & Residential Home 220-224 Heysham Road Morecambe Lancashire LA3 1NL Lead Inspector
Christine Marshall Announced 5th July 2005 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. Lakeland View Nursing & Residential Home F57-F09 S6144 Lakeland View V215026 050705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Lakeland View Nursing & Residential Home Address 220-224 Heysham Road, Morecambe, Lancashire. LA3 1NL 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) 01524 410917 Mr Frank George Gregory Nicholls CRH Care Home 33 Category(ies) of OP Old Age 33 registration, with number of places Lakeland View Nursing & Residential Home F57-F09 S6144 Lakeland View V215026 050705 Stage 4.doc Version 1.30 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 to accommodate a maximum of 33 service users to include up to 33 service users in the category OP (Older persons over 65) and up to 10 service users in the category DE (Dementia) Date of last inspection 7th March 2005 Brief Description of the Service: Lakeland View is a large detached property set in the west end of Morecambe Bay.It provides nursing and residential care for 33 older people, including 10 places for people with dementia, in single and double accommodation. It is close to bus routes, shops and amenities.There is ample parking space for visiting professionals and relatives. There is a small garden area to the front of the building and a small area by the side, with a patio to the rear of the dining room. Lakeland View has three floors and there is a passenger lift in place.There are four lounge areas and a conservatory area. One lounge is dedicated to the service user with some level of confusion and another lounge area is dedicated for quiet time. The small lounge has a television in and adjoins the conservatory sun lounge. There is a large and light dining area. The home is owned by Mr Frank Nichols and the acting general manager is Mrs Bernadette Wallbank. Lakeland View Nursing & Residential Home F57-F09 S6144 Lakeland View V215026 050705 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This is the first of two inspection visits, scheduled from 1st April 2005 to 31st March 2006. This announced inspection took place over a full day and was carried out by Mrs Christine Marshall, the home’s designated lead inspector, accompanied by Mr Simon Hill, pharmacy inspector. The pharmacy inspector examined all of the home’s medication systems and the lead inspector undertook a full tour of the home, including bedrooms, lounge and dining areas and bathrooms. Plans of care for the people living at the home were examined, as were the policies and procedures for the management of the home. The people living at the home told the inspector that they would like to be called residents. Comment cards were sent out to the residents and when returned, were all very positive and indicated that everyone is satisfied with the care that they receive. The inspector spoke individually with four of the residents, and had group discussions with five other people living at the home. There were no relatives available during the inspection visit. An official contracts reviewer from the Lancashire Social Services visited the home during the inspection and told the inspector that he had visited the home previously and that each of the clients he had spoken to had been very happy with their care at Lakeland View. The registered provider, acting general manager, six care staff and two kitchen staff spoke with the inspector. Everyone at the home was welcoming and co-operative with the inspectors throughout the visit. Lakeland View Nursing & Residential Home F57-F09 S6144 Lakeland View V215026 050705 Stage 4.doc Version 1.30 Page 6 What the service does well: What has improved since the last inspection?
Lakeland View Nursing & Residential Home F57-F09 S6144 Lakeland View V215026 050705 Stage 4.doc Version 1.30 Page 7 A new hairdressing room has been provided and this means that residents can have their hair done in privacy and comfort. The floor covering by the dining room serving hatch has been replaced, making the area safe and clean. Bathrooms and toilets have been fitted with thermostatic valves to prevent hot water from harming the residents and each bathroom in the home is now usable, giving more choice to residents. The door to the laundry area is now fitted with a lock to keep residents safe from potentially falling down stairs. The major refurbishment programme for the home has basically been completed, making the home more comfortable and there is now an ongoing maintenance program in place. The service users guide, which is a written document advising people of what the home offers and what kind of people live there, has now been reviewed and includes information about the new care that is offered for people with dementia. What they could do better:
Supervision programs are set up for the staff, but these have not been started yet. These are meetings between the care staff and the management of the home, where talks take place about how the carer is doing at the home, if there are any training courses that the carer wants to attend and to make sure that the residents are getting the best care that can be given; Mr Nichols has planned to begin these programs within the next four weeks. Bedrooms 28 and 29 are in need of the glass replacing in the double glazed units, so that a clearer view can be seen by the residents. New carpets could be fitted to the corridors of the first and second floors to make the home look more homely. Mr Nichols has actually made arrangements for this to be done in the near future. Although the refurbishment programme has attended to the major issues such as painting and decorating bedrooms and corridors, a large number of the bedroom doors badly marked and need to be varnished to make the home look more cared for.
Lakeland View Nursing & Residential Home F57-F09 S6144 Lakeland View V215026 050705 Stage 4.doc Version 1.30 Page 8 Two bottles of unlabelled solutions had been left in the unlocked sluices and the acting general manager assured the inspector that these would be removed immediately, to make sure that the residents were safe from harm. 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. Lakeland View Nursing & Residential Home F57-F09 S6144 Lakeland View V215026 050705 Stage 4.doc Version 1.30 Page 9 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 Lakeland View Nursing & Residential Home F57-F09 S6144 Lakeland View V215026 050705 Stage 4.doc Version 1.30 Page 10 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) 1,2,3,4 & 5. 6 is not applicable to this home. If a person is considering moving into Lakeland View, they are supplied with enough information to help them make that decision. The home also gathers enough information about the person to ensure that their needs can be met. This means that people can make good choices and receive the care they require EVIDENCE: There is a Statement of Purpose and Service Users Guide in place; this is a set of written information that tells you about the care service that is offered, who the manager and staff are and what the resident can expect if he or she decides to live at the home. Prospective residents are always invited to the home to meet the staff and other residents.
Lakeland View Nursing & Residential Home F57-F09 S6144 Lakeland View V215026 050705 Stage 4.doc Version 1.30 Page 11 Every resident gets a contract of care from the home and this ensures that there are no misunderstandings about things such as any extra costs that might be incurred, or periods of notice to leave the home. Trial periods of stay are offered so that if the resident or the manager is not happy, then a review can be done to decide whether or not the resident is in the right home for the care that he or she needs. Lakeland View Nursing & Residential Home F57-F09 S6144 Lakeland View V215026 050705 Stage 4.doc Version 1.30 Page 12 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) 7,8,9, 10 & 11 The residents’ health and social care needs are met and people are treated with dignity and respect at this home. Residents are fully supported in their daily lives. EVIDENCE: Residents spoken to told the inspector that they had the GP of their choice and that they had regular visits by the chiropodist, dentist, optician and also hearing aid services. The residents remarked that they were more than happy at the home and that the staff were very kind. The inspector looked at three plans of care and found these to be extremely informative, clear about the care that each person needed and reviewed at least monthly. The inspector commended these plans of care. Lakeland View Nursing & Residential Home F57-F09 S6144 Lakeland View V215026 050705 Stage 4.doc Version 1.30 Page 13 Residents spoken to told the inspector that they knew about these records of care and that they were happy with them. The pharmacy inspector looked at the medications and found that there were some minor problems, but the system had seen some significant improvements since the previous inspection visit. The pharmacist gave some advice about this so as to improve things. Care staff were fully aware of the care that was needed by each resident, and paid particular attention to small personal details of each person’s preferences. The home is very sensitive to the needs of the dying resident and use a document called the Integrated Care Pathway, Last Days of Life, which involves a very compassionate and well recorded care pattern for this last aspect of care. The inspector saw one of these care records and commended the communication and bereavement planning that it contained. Lakeland View Nursing & Residential Home F57-F09 S6144 Lakeland View V215026 050705 Stage 4.doc Version 1.30 Page 14 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) 13 & 14 Residents are supported in their expectations and preferences of daily living. EVIDENCE: The inspector spoke to a number of residents an each one said that they enjoyed having their relatives visit and that they were always welcomed by the staff at the home. A visiting priest was giving communion to residents when the inspector visited and one resident said that he enjoyed this regular contact with his minister. Daily lives are very flexible and residents told the inspector that they are encouraged to be as independent as they can be. Lakeland View Nursing & Residential Home F57-F09 S6144 Lakeland View V215026 050705 Stage 4.doc Version 1.30 Page 15 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) 16 & 18 Residents are able to voice their complaints and know who to speak to if they have any concerns. Adult protection systems are in place, which means that residents live in a safe environment where their satisfaction is assured. EVIDENCE: There is a clear written complaints procedure for the residents and their relatives; this is included in the information pack that is called the Service Users Guide. There have been no complaints since the previous inspection either at the home or to the Commission for Social Care Inspection. Residents told the inspector that they had nothing to complain about at all. Staff files showed that there is a good training program in the awareness and prevention of abuse. Care staff spoken to also told the inspector that they knew about protecting the residents from abuse and that they had been given training about this. Lakeland View Nursing & Residential Home F57-F09 S6144 Lakeland View V215026 050705 Stage 4.doc Version 1.30 Page 16 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) 19,20,21,22,23,24 & 25 A safe and comfortable environment is provided for the residents. Bedrooms are furnished and decorated to a satisfactory level and suit the individuals’ tastes and preferences, meaning people are living in homely surroundings. EVIDENCE: The inspector visited resident’s bedrooms and noted that each room was personalised and comfortable. Bedrooms 6 and 8 have non-slip vinyl fitted to the floor, this has been assessed and agreed with the resident and their relatives and is recorded in the plans of care. The inspector advised that when these rooms were vacated, then carpet should be fitted before the rooms are offered to any other resident. There are four lounge areas and a dining area that are comfortable and homely.
Lakeland View Nursing & Residential Home F57-F09 S6144 Lakeland View V215026 050705 Stage 4.doc Version 1.30 Page 17 The inspector spoke to the maintenance man who confirmed that there is an ongoing refurbishment programme for the home. However, some of the bedroom doors are in need of re-varnishing as they are badly marked. There are adequate toilet and bathing facilities in place throughout the home. The inspector noted that there are aids and adaptations such as grab rails in toilets and there are also two assisted baths for residents that cannot get in and out of the bath without help. There are nursing beds and special mattresses in place for the prevention and protection of pressure sores; the inspector visited a resident in a special bed who said that they were comfortable. Lakeland View Nursing & Residential Home F57-F09 S6144 Lakeland View V215026 050705 Stage 4.doc Version 1.30 Page 18 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, 28, 29 & 30 The residents care needs are met through good levels of staff, who have the appropriate qualifications and experience necessary for the delivery of a good care service. EVIDENCE: The list of staff on duty showed that there are good levels of carers and domestic staff on duty at the home. Discussions with the carers and the kitchen and domestic staff were very positive and showed that there is a good skill mix of people in place. 100 of the care staff have achieved the National Vocational Qualifications (NVQ) to at least level 2: This is commendable. Inspection of the recruitment files showed that all checks are done before a person can start work at the home. There is a robust training program at the home and carers told the inspector that they had done all of the required training to make them competent and safe to look after the residents. Lakeland View Nursing & Residential Home F57-F09 S6144 Lakeland View V215026 050705 Stage 4.doc Version 1.30 Page 19 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) 33, 35, 36 & 38 The home makes sure that the best interests of the residents are protected in that there are regular checks that focus on the quality of care that is provided. However staff need to have formal supervision to promote quality care delivery. EVIDENCE: Regular quality checks are recorded so that the home can maintain its accredited International Standards Award (ISO) 9000 quality monitoring system. These are done by questionnaires, speaking to residents, their relatives and care staff meetings. Lakeland View Nursing & Residential Home F57-F09 S6144 Lakeland View V215026 050705 Stage 4.doc Version 1.30 Page 20 The inspector looked at a sample of the records for keeping residents’ personal monies and these were satisfactory. Supervision programs for the staff are not yet up and running and the owner Mr Nichols assured the inspector that these are going to be up and running within the next four weeks. The home complies with all of the health and safety regulations, however inspector found two unlabelled bottles of fluid in the unlocked sluices and this is a potential hazard for the residents; the manager assured the inspector that these would be removed immediately. Lakeland View Nursing & Residential Home F57-F09 S6144 Lakeland View V215026 050705 Stage 4.doc Version 1.30 Page 21 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 2 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x
COMPLAINTS AND PROTECTION 2 3 3 3 3 3 3 x STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 2 x 2 Lakeland View Nursing & Residential Home F57-F09 S6144 Lakeland View V215026 050705 Stage 4.doc Version 1.30 Page 22 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. 2. 3. Standard OP36 OP38 OP9 Regulation 18 13 13 Requirement All staff must have formal supervision. Hazardous solutions must be labelled and stored in a locked cupboard. The manager must ensure all medication is administered as prescribed with reference to out of stock medications, dose omissions without explanation and medications that have a variable dose. The manager must ensure an accurate record of receipt and disposal is made for all medicines kept in the home. The manager must ensure the temperature of the medication room is below 25°C at all times. The manager must ensure the medication room is locked when not in use and access is restricted to designated staff. Timescale for action 5th August 2005 Immediate 3oth July 2005 4. OP9 13 30th July 2005 30th July 2005 30th July 2005 5. 6. OP9 OP9 13 13 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Lakeland View Nursing & Residential Home F57-F09 S6144 Lakeland View V215026 050705 Stage 4.doc Version 1.30 Page 23 No. 1. 2. Refer to Standard OP19 OP9 Good Practice Recommendations A number of bedroom doors are badly marked and should be re-varnished. Handwritten medication administration records should be double-checked and evidenced by two staff signatures. Lakeland View Nursing & Residential Home F57-F09 S6144 Lakeland View V215026 050705 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 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 Lakeland View Nursing & Residential Home F57-F09 S6144 Lakeland View V215026 050705 Stage 4.doc Version 1.30 Page 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
