Inspection on 12/07/06 for Lakenham Residential Home

This inspection was carried out on 12th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Lakenham Residential Home 06/03/09

Lakenham Residential Home 04/02/09

Lakenham Residential Home 20/07/07

Lakenham Residential Home 18/01/06

Lakenham Residential Home 02/08/05

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

CARE HOMES FOR OLDER PEOPLE Lakenham Residential Home Lakenham Residential Home Lakenham Hill Northam Bideford Devon EX39 1JJ Lead Inspector Andy Towse Key Unannounced Inspection 08:50 12th July 2006 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 Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 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. Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lakenham Residential Home Address Lakenham Residential Home Lakenham Hill Northam Bideford Devon EX39 1JJ 01237 473847 01237 470790 cordelia.murphy@Hotmail.com 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) Mr Timothy Oliver Murphy Mrs Cordelia Wai-Yu Murphy, Mr Christopher Charles Hampton, Miss Siobhan Catriona Hampton Mrs Cordelia Wai-Yu Murphy Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th January 2006 Brief Description of the Service: Lakenham Residential Home is a care home registered for 28 beds, providing personal care for service users in the category of old age (OP). The building is a detached former residence of the Duchess of Manchester and is situated on a large corner plot in the Northam area of Bideford. The home is sited in extensive well-kept grounds and has glorious sea and coastal views. Accommodation is provided on four floors and the home is extremely spacious with several large communal, reception and meeting areas. The home also has a Chapel on the ground floor of the home. The majority of rooms are single and en-suite, although two shared rooms are available if required. The home is accessible to all areas via a large, modern passenger lift. A copy of the previous CSCI inspection report was on the main notice board making it available to staff, residents, their relatives and any other visitors to the home. Fees charged range from £390.00 to £525.00 with additional charges being made for chiropody, hairdressing, newspapers and magazines and clothing. Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection which took place over a period of nine hours. The information contained in this report was gathered from a preinspection questionnaire returned by the management of the home, together with written responses to a survey from staff, residents and their relatives and Professionals involved with the home. This information was used to plan the inspection and was later complemented by the inspection which included a tour of the premises, observation of the day to day running of the home and further discussion with staff, management, residents and visiting professionals together with examination of records, including care plans held at the home. Of the thirteen questionnaires forwarded to members of staff, nine responded, of eighteen questionnaires forwarded to residents, five responded. Further responses were received from the general practitioner who visits the home and from telephone conversations with district nurses and discussion with those visiting the home at the time of the inspection. What the service does well: What has improved since the last inspection? Since the last inspection the physical environment has been improved by the replacement of two wash hand basins in two residents’ bedrooms, a new worktop in the first floor kitchen, walls in hallways being repainted, as had the doors to first floor rooms. Externally, the environment has been improved by planters with displays of flowers being put the front door and plants and flowers planted in the courtyard area. The home has initiated a Quality Assurance survey which, when the information is collated will enable the managers to monitor, evaluate and develop the service they offer and take into consideration the opinions of stakeholders. Since the last inspection some mandatory training has been offered to staff, specifically relating to the Protection of Vulnerable Adults and Moving and Handling. Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 Page 6 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. Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 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 Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 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, 5 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Manager ensures that the home is aware of prospective residents’ needs prior to admission. Prospective residents and their relatives are given the opportunity of visiting the home in order that they can make an informed choice about residing there. EVIDENCE: The records of residents were inspected, including three which were examined in more depth. Amongst these were records of recently admitted residents. The file of one recently admitted resident contained a completed nursing assessment demonstrating that the home was aware of this person’s needs prior to admitting him/her and subsequently the home carried out their own assessment. Another recently admitted resident had previously lived in another residential care home and knowledge of their needs had been obtained from that home. Also a relative of the resident had visited the home as part of the Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 Page 9 admission process, which enabled them to gain information regarding the suitability of the home to meet their relative’s needs. Entries in diaries and on notepads made by the registered manager showed that she visited prospective residents, prior to their admission when they were in hospital. In one instance the registered manager said that whilst she didn’t use the visit to carry out a formal assessment it did allow her to obtain relevant information relating to the prospective resident. Lakenham does not offer intermediate care. Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff are provided with information that enables them to meet residents’ needs safely. However improvements are needed in relation to staff roles and responsibilities. The practice of medication administration must be improved to ensure that residents are not put at risk. EVIDENCE: Residents’ files which were inspected were seen to contain care plans. The home also operates a key worker system whereby staff are given specific responsibilities relating to the care of designated residents. Whilst some residents were aware of who their key worker was others were not. Most care staff spoken to were aware of their role as key workers, however one, when spoken to was unable to explain her key worker role and had not made any written entries on relevant files relating to these duties. Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 Page 11 Although there were sections on care plans which were for residents to sign to acknowledge both their involvement and their consent to the content of the plans, these had not always been signed by the residents. Most care plans had the stipulation that the key worker should spend at least half an hour a day with the resident. In discussion, two staff said that this didn’t always happen and that the half hour would include task oriented contact such as assisting a resident to bed rather than talking with that person or providing more individual 1:1 interaction. The management felt that a lot of good interaction takes place during all care provided, including task oriented duties, such as bathing and cleaning a room. It was agreed that staff require further training to ensure they fully understand the concept of “holistic care” and agreed to include this information in care plans. In addition to the “holistic approach”, the home employs a member of staff to assist residents with activities on Mondays and Wednesdays. The home also employs a professional movement with music co-ordinator twice a week. On Tuesdays a volunteer carries out activities, offering arts and crafts. Records showed that activities encompassed taking individual residents out for short walks, and the above mentioned. Staff spoken to said that if they ‘had the time’ they would stimulate residents by initiating games such as bingo and scrabble. The manager also showed a letter received from the Queen in thanks for a card designed by the residents of the home, which had been forwarded to her in celebration of her birthday. Visiting professionals confirmed that they were able to see residents in private and so protect their privacy and dignity. They also confirmed that the home sought their advice regarding the wellbeing and health needs of residents. Examples were seen on residents’ files of their being called by their preferred term of address which helps preserve both their individuality and their dignity. Residents have contact with medical professionals such as general practitioners and community nurses. Information was obtained from both professionals prior to the inspection and during the inspection. This showed that residents received professional advice and attention for conditions such as diabetes and that the home sought medical advice for residents when required. A specific example was information regarding diabetes was in a resident’s file and had been signed by a general practitioner. The process of administering medication was observed during the inspection. It was seen that the medication trolley was left open and unattended in the hallway of the home whilst the staff member administering medication was in the dining room. This is an unsafe practice. The home operates a monitored dosage system of medication administration prepared by the Chemist. Staff receive training in the administration of Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 Page 12 medication from the registered manager who said she had completed the Safe Handling of Medication distance-learning course. She said it is her intention that one of the senior carers also participates on this course. Two of the other staff who also administer medication have been on courses. The home has appropriate facilities for the storage of medication. Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 Page 13 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, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents maintain contact with family and friends. Residents’ spiritual needs are met. Residents are offered a varied diet. EVIDENCE: Residents are free to receive visitors when they wish. Relatives who were visiting the home were spoken to. Two sets of visitors confirmed that they could visit at any time and that the staff were ‘friendly’ and ‘very approachable.’ Residents also confirmed that they could receive visitors whenever they wanted. An entry on a care plan referred to staff ‘assisting residents in maintaining family contact’ and comments from both staff and residents combined by observation showed that this was happening. There is a chapel within the premises. The manager informed the inspector that services were held there and that both priests and ministers visited the home to ensure residents of different denominations had their spiritual needs met. Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 Page 14 Residents were seen to be able to exercise choice about where they ate their meals. This was seen by observation of residents having meals in their rooms, through discussion with residents and staff and from entries on residents’ files. On the day of the inspection the kitchen staff were preparing a meal of roast pork with fresh vegetables followed by home made lemon sweet. Although this meal was not what was stated on the menu displayed in the kitchen, it did correspond to information on the notice board for residents and it looked appetising. Inspection of the kitchen showed that fresh vegetables were available. With regard to resident choice, there was a list on the wall of the kitchen which listed what residents preferred for breakfast, although it was said that the main menu was written without reference to residents. This was later discussed with the manager who said that she actually compiled the menus after assessing waste from the waste bins after meals which gave her information about what residents preferred. There appeared to be general satisfaction amongst residents regarding the food available at Lakenham which was confirmed in the responses received from residents to the pre-inspection surveys. Of the five who responded four said that they usually liked the food available and the remaining one said that this was sometimes the case. Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 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 the following standard(s): 16 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Complaints were seen to be acted upon. On the whole residents are protected from abuse but will be better protected when all staff have completed appropriate training. EVIDENCE: The home has a written complaints procedure. This is prominently displayed around the home which ensures that residents, their relatives and visitors to the home are aware of it. The complaints procedure includes timescales for action to be undertaken. Of the five residents who responded to the pre-inspection survey, four said that they ‘always’ knew how to make a complaint and one responded that he/she usually knew how to make a complaint. With regards to whether residents knew who to speak to if they were not happy, three replied that they always did and two that they usually did. These answers were supported by comments that the staff were ‘always willing to listen’ and that the owner was ‘generally very helpful.’ A complaint made by relatives within the last twelve months shows that visitors are aware of the home’s complaints procedure and how to use it. The Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 Page 16 complaint was referred to CSCI and the owners kept within timescales in their response to it. Responses to the pre-inspection questionnaire by the owners show that the home has a Whistle Blowing Policy and that the manager is aware of the need to refer staff unsuitable for working with vulnerable adults for possible inclusion on the Register for the Protection of Vulnerable Adults (POVA). No staff have been referred. The registered manager is aware that to protect residents staff should have appropriate training. This was discussed with her during the last inspection n January 2006. At that time the manager had acquired copies of the ‘No Secrets’ training video and the ‘Alerter’s Guide’ and intended that all staff would have received training relating to the protection of vulnerable adults by June 2006. Records showed that whilst training had taken place on the 9th and the 22nd of June 2006, some staff had still to attend. Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 Page 17 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 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have access to a safe and comfortable environment. The home is clean, pleasant and hygienic. EVIDENCE: Lakenham Residential Care home is a large, imposing premises. It is on four floors which can be accessed either by stairs or the use of a passenger lift. The home has various lounge areas allowing residents a choice of where to sit and the majority of bedrooms have the advantage of ensuite facilities. The home is situated in a pleasant area which affords its residents good views of the surrounding countryside and seashore. Residents also have access to the garden areas of the home which since the last inspection have been improved by the addition of flower filled planters at the front door and flowers and plants being placed in the courtyard. Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 Page 18 Internally the home has its own chapel which is used by all denominations and affords residents a quiet, peaceful area where their spiritual needs can be met. Internally the home has good standard of hygiene and cleanliness. Since the last inspection the physical environment has been improved by doors and the hallway to the first floor having been repainted, a new worktop being installed in the first floor kitchen and two wash hand basins being replaced in residents’ bedrooms. Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 Page 19 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, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ needs are being adequately met but improvements are needed to ensure staff understand their role. Residents are protected by the home’s recruitment policies. Improvement is needed in relation to staff’s ability to care for residents and staff training. EVIDENCE: The inspector obtained information about the care offered in the home from a variety of sources, including discussions with staff, responses to questionnaires, discussions with the manager and observation. The home employs one designated cleaner who works from 9am till 1pm three days a week. The inspector was told by the manager that care staff are employed to carry out “holistic care” which includes domestic duties relating to individual residents. A printed list in the staff room provides staff with guidance on what work should be carried out. Examples of this being instructions to ‘provide general care for residents’, ‘writing reports’, ‘make and change beds, tidy Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 Page 20 rooms and do general cleaning’, ‘inspect, launder, and mend client’s clothing’ and ‘wash up utensils’ after meals’. It was observed that some care staff were predominantly undertaking domestic duties. On some occasions residents waited for their alarm call to answered in excess of five minutes. On one occasion, after the bell had been ringing for 8 minutes the inspector went to find staff to ensure that the resident was attended to. When discussing the incident with care staff, the inspector was told that there was only one pager and as the staff member with this was attending to another resident they were unable to either attend to the resident who was ringing their alarm and neither were they able to alert other staff to attend to the resident. This was later discussed with the registered manager and proprietor who said that there had previously been several pagers available but these had been damaged or lost and had not been replaced. It was agreed that more pagers would be made available to ensure that staff were more aware when residents were summoning assistance and therefore attend to them with less delay. The home designates some staff as ‘key workers’; this means they are responsible for the welfare of named residents. During a period of observation a key worker was seen spending their time undertaking domestic duties which may or may not have included personal interaction. The key worker had not used the care plans to record any care that was delivered. Responses to staff spoken with during the inspection and from questionnaires returned by staff it appears that they found the level of domestic duties they were required to carry out interfered with their ability to do care work. Some examples of these responses were - ‘far too much time spent on housework’ etc rather than clients’, ‘we work with minimum staff, sometimes short, never have time to spend half hour with our residents, as their key worker, as stated in their care plans’, ‘I feel it would be a great advantage to clients if carers had time to talk and spend a little more time with them’. Some residents and some staff suggested the holistic approach did not fully benefit residents. However during discussion with the providers it was explained that the concept of ‘holistic care’ is not fully understood by staff or recorded clearly in care plans. It was agreed that action would be taken to address this. It was also observed that other staff involvement with residents was mainly task orientated; however staff are employed specifically to spend time with residents. (See Standards 12, 13, 14, 15 relating to Daily Life and Social Activities). Four staff files were examined. These showed that police checks were carried out on staff prior to their being allowed to work unsupervised within the home. Of the four records, the three staff employed since the registered manager took over the post, all had two written references. One staff member was not in receipt of police clearance, but this had been applied for and the registered Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 Page 21 manager said that this was a night care assistant who, in accordance with CSCI requirements and in promoting the safety of residents, would not be working unsupervised. However, according to the Care Standards Act no staff can work in the care home unless a POVA Check has been obtained. This is a check against a list held by the Department of Health, of people who are unsafe to work with vulnerable people. This check can only be obtained if a police check (CRB) has been applied for. Once a POVA first check has been obtained, a staff member can work in a care home under supervision. With regard to training, six of the fourteen care staff have NVQ 2 or higher, another staff member is currently participating on NVQ 3 and a further two staff are to start NVQ 2 training in August 2006. This means that this home is approaching the 50 of staff with NVQ 2 or above, expected as a minimum by the National Minimum Standards. At the previous inspection the home had the requisite number of staff with NVQ 2 qualifications however the departure of several staff since the last inspection has lead to a reduction of this percentage but action taken by the home will rectify this. During the inspection of January 2006 it was required that the manager should introduce training relevant to the care of older adults, with the specific example being that of moving and handling. Since that inspection two training sessions have been carried out however there still remains three staff members who have not received this mandatory training. Since the last inspection the management have provided training on food hygiene, better business seminars, falls & fractures prevention workshops. Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 Page 22 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, 33, 35, 36 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. By completing the care component of NVQ 4 the registered manager will have achieved the relevant qualifications to complement her experience as a manager. Appropriate procedures are in place to protect residents’ financial interests. Staff are appropriately supervised. The safety of residents is ensured by appropriate policies and regular safety checks on equipment. Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 Page 23 EVIDENCE: The registered manager has considerable experience of managing another care home in Devon prior to becoming manager of Lakenham Residential Care Home. With regard to qualifications, she is an enrolled nurse but has not retained her registration with the Nursing and Midwifery Council. In discussion she said she had achieved her Registered Manager’s Award and is about to commence the care component of her NVQ 4 qualification, which when completed will mean that she has obtained the qualification stated in the National Minimum Standards for a registered manager. The administrator has put into place appropriate systems for recording residents’ finances. The home itself does not take responsibility for residents’ finances other than small amounts of personal allowances. When this occurs records, accompanied by receipts are kept and monies are held securely. The administrator has put into place a Stakeholder Survey for 2006/7, which will enable him to monitor and evaluate the service offered by the home. This has been given to all staff, residents and their families and professionals who have involvement with the home. The questionnaires were forwarded about three months ago and as yet only 17 responses have been received. This administrator has yet to collate the information and, where appropriate, act upon it. This will be looked at again at the next inspection. Whilst some questionnaires received from staff prior to the inspection stated that 1:1 supervision was not available, at the time of the inspection the manager and senior staff referred to a supervision system which involved the manager supervising the senior staff, who in turn had responsibility for supervising designated care staff. Staff confirmed that supervision took place every two months. During the inspection of January 2006 reference was made to staff receiving the training needed to ensure their competence in delivering appropriate standards of care. Whilst this training has commenced it has yet to be undertaken by all members of staff, examples of this being moving and handling training and that relating to the protection of vulnerable adults. (Standard 18 and Standard 30). Information contained in the response completed by the registered manager to the pre inspection questionnaire confirms that this home has appropriate policies for maintaining the safety of residents and the running of the care home. Records shown at the time of the inspection confirmed that the safety of residents was ensured by the safety testing of the fire alarm system, certification verifying the safety of electrical installations, gas installations and portable electrical appliances, together with evidence of the servicing of hoists Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 Page 24 and the passenger lift. Fire training for staff had been arranged but due to sickness had to be cancelled and will be rearranged. There is an appropriate system for the recording of accidents. Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 Page 25 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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 Page 26 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 OP7 Regulation Requirement Timescale for action 30/09/06 2. OP9 3 OP30 23 (2) (c) The registered person shall having regard to the number and needs of the service users ensure that equipment provided at the care home for use by service users or persons who work at the home is maintained in good working order. (This refers to the length of time it took for staff to respond to residents’ calls due to lack of pagers). 13 (4) (c) The registered person shall 12/07/06 ensure that unnecessary risks to the health and safety of service users are identified and so far as possible eliminated. (This refers to the practice of leaving the medicine trolley open and unattended when medication is being administered.) 18 (1)(c) The registered person should 30/09/06 (i) ensure that all staff receive training appropriate to the work they perform. (In this instance statutory training such as moving and handling) Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations The plan is drawn up with the involvement of the service user, recorded in a style accessible to the service user; agreed and signed by the service user whenever capable and/ or representative. The manager should ensure all staff receive Adult Protection training. The registered person should provide training for staff to ensure the aims of the home are fulfilled. (This refers to ensuring staff fully understand the concept of ‘holistic’ care, key working, care planning and recording and any guidance in care plans or documents relating to “holistic” care, clearly describe what is meant by this approach). 2. 3 OP18 OP30 Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Devon Unit D1, Linhay Business Park Ashburton Devon TQ13 7UP 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 Lakenham Residential Home DS0000062626.V293402.R01.S.doc Version 5.2 Page 29 - 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!