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Inspection on 02/08/05 for Lakenham Residential Home

Also see our care home review for Lakenham Residential Home for more information

This inspection was carried out on 2nd August 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Lakenham has recently changed ownership. Prior to this service users, relatives and staff had displayed a great deal of anxiety about their futures. However during the day the inspector spoke with many of the residents and some staff all of which spoke warmly and positively about the changes and were happy living/working at the home. The new owners have worked hard to try to improve communication throughout the home and with service users families to keep everyone informed of any changes. The staff team are keen to ensure the wellbeing and comfort of the service users and were observed treating them with great respect and kindness. All service users spoken with praised the care they received from the staff and said they were very happy living at the home. The home manages daily activities well. The building is well maintained and the standard of the decoration and furnishings is of a good standard.

What has improved since the last inspection?

The home has developed a management team, which includes senior care staff. This has been done to involve staff in decision-making and improve communication. The home has put in place a new medication policy and improved medication procedures.

What the care home could do better:

Further work needs to be done to improve moral throughout the existing staff team. Care plans must be expanded to include details of how specific individual needs will be met. The staff must have further training in the protection of vulnerable adults to ensure the safety of the residents. All staff must follow the medication policy and ensure that all creams are stored and dated appropriately.

CARE HOMES FOR OLDER PEOPLE Lakenham Residential Home Lakenham Hill Northam Bideford EX39 1JJ Lead Inspector Caroline Rowland-Lapwood Announced 2 August 2005 nd 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. Lakenham Residential Home CS0000062626.V217092.R01.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Lakenham Residential Home Address Lakenham Hill, Northam, Bideford, Devon, EX39 1JJ 01237 473847 01237 470790 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) Mr Timothy Oliver Murphy Mrs Cordelia Wai-Yu Murphy Care Home 28 Category(ies) of OP Old Age [28] registration, with number of places Lakenham Residential Home CS0000062626.V217092.R01.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: None 10th March 2005 [Shortly before change of ownership] 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. Date of last inspection Lakenham Residential Home CS0000062626.V217092.R01.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over four and a half hours on 2nd August. The Provider/ Registered Manager, Mrs Wai-Yu Murphy and Mr Christopher Hampton were present during the inspection. Residents, and members of staff on duty also took part in the inspection. The inspector looked around the building; a number of records were inspected, which included the pre inspection questionnaire, care plans and other policy documents. What the service does well: Lakenham has recently changed ownership. Prior to this service users, relatives and staff had displayed a great deal of anxiety about their futures. However during the day the inspector spoke with many of the residents and some staff all of which spoke warmly and positively about the changes and were happy living/working at the home. The new owners have worked hard to try to improve communication throughout the home and with service users families to keep everyone informed of any changes. The staff team are keen to ensure the wellbeing and comfort of the service users and were observed treating them with great respect and kindness. All service users spoken with praised the care they received from the staff and said they were very happy living at the home. The home manages daily activities well. The building is well maintained and the standard of the decoration and furnishings is of a good standard. Lakenham Residential Home CS0000062626.V217092.R01.doc Version 1.20 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Lakenham Residential Home CS0000062626.V217092.R01.doc Version 1.20 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 Lakenham Residential Home CS0000062626.V217092.R01.doc Version 1.20 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) 2,3,4,&5 Service users benefit from good admission and assessment practice, which ensures that the home is able to meet their needs. EVIDENCE: Care needs are met through a full assessment process that is carried out before a resident decides to live at the home. Care plans are completed from this information; a resident who has recently moved into the home confirmed this. The assessment includes all the elements listed in the standard. A comprehensive assessment was seen for a resident recently admitted to the home. Each resident has a contract, the inspector saw a copy, and some minor amendments need to be made. The home does not admit residents for intermediate care. Lakenham Residential Home CS0000062626.V217092.R01.doc Version 1.20 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 standard(s) 7,8,9,&10 Resident’s health and social care needs are well met and promoted by good planning arrangements. Resident’s privacy and dignity are met and promoted by the staff and management team at Lakenham Residents are not being properly protected by the medication procedure. EVIDENCE: The home promotes residents’ welfare in co-operation with families and health care professionals, evidence was seen of this in the individual care plans and visiting professionals notes. The inspector looked closely at three residents’ care plans and case tracked their care. Their care plans included detailed information about their needs. They were well laid out and easy to read. However, they did not describe how the home was going to meet the identified needs of the residents. Lakenham Residential Home CS0000062626.V217092.R01.doc Version 1.20 Page 10 Residents or their relatives are involved care planning, this was confirmed by several residents. The procedures in place for the storing of medication are inadequate and therefore do not protect residents from harm. Topical creams were opened but not dated and were found in several residents bedrooms. Lakenham Residential Home CS0000062626.V217092.R01.doc Version 1.20 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 standard(s) 12,13,15 Social activities and meals are well provided for. Residents are encouraged to maintain contact with their families or friends as they wish. Residents are free to follow their religious beliefs. EVIDENCE: A variable, nutritious diet is provided at the home. This was confirmed by residents and from the meal on the day of the visit. A menu is displayed outside the dining room. Some comments made by the residents on the day included “ the food is very good”, “there is always plenty of it” and “the food is very tasty”. Residents confirmed that they were able to have visitors at any time and that they were always made welcome. A religious minister visits the home on a weekly basis and residents have the opportunity to take communion if they so wish. There is a chapel in the home where Mass takes place four times a year. Lakenham Residential Home CS0000062626.V217092.R01.doc Version 1.20 Page 12 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’ complaints are taken seriously. Arrangements for protecting service users are unsatisfactory. EVIDENCE: Residents confirmed that their views are taken seriously, that their concerns are fully taken on board and that action is taken where needed. Residents confirmed that they had received a copy of the home’s complaint procedure. However it was recommended that it be displayed in a prominent position in a large print for all to see. It must also include an assurance that any complaint received will receive a response within 28 days. Since the home has changed ownership there have been several anonymous complaints made to the CSCI with regard to the general health and welfare of residents and changes in staff responsibilities. The home has dealt with these complaints in a very positive manner and none of the complaints have been upheld. Not all staff has had up to date training in the protection of vulnerable adults. Lakenham Residential Home CS0000062626.V217092.R01.doc Version 1.20 Page 13 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) 19,20,25,26 The residents live in a homely, safe and attractive home. EVIDENCE: The home is very well maintained and decorated, with several communal and private areas available on the ground and 1st floor. There are also facilities in the lower ground floor but these are not currently used. Grounds are kept neat and well tended. The home’s environment is very comfortable and provides the residents with an attractive and homely place to live. Residents’ rooms suit their needs and have been personalised. The home was exceptionally clean throughout. The laundry and the sluice room were clean and tidy. Lakenham Residential Home CS0000062626.V217092.R01.doc Version 1.20 Page 14 All service users’ rooms are individually and naturally ventilated, and have been fitted with window restrictors. Rooms are centrally heated, radiators being controllable in service users’ own rooms. All radiators have been covered. Emergency lighting provided throughout the home is checked monthly. The homes’ water tanks are checked annually for Legionella. All bath taps are fitted with thermostatic valves to provide water close to 43C. Lakenham Residential Home CS0000062626.V217092.R01.doc Version 1.20 Page 15 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 Staff are employed in sufficient numbers to meet residents needs. EVIDENCE: On the day of the inspection the owners, four care assistants, a cook, dining room assistant and maintenance person were on duty. Staff were seen spending time talking with residents and seemed unhurried and relaxed in their work. Lakenham Residential Home CS0000062626.V217092.R01.doc Version 1.20 Page 16 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) 38 The residents live in safe surroundings. The home takes seriously their responsibility to ensure residents’ safety and well-being. EVIDENCE: This standard was not fully inspected. All the radiators are guarded to prevent harm from burns. Water temperatures are regulated to prevent harm from scalding. All the windows are restricted to prevent harm from falling. Lakenham Residential Home CS0000062626.V217092.R01.doc Version 1.20 Page 17 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 3 3 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 x 15 3 COMPLAINTS AND PROTECTION 3 3 x x x x 3 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 x x x x x x x 3 Lakenham Residential Home CS0000062626.V217092.R01.doc Version 1.20 Page 18 No 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 16 Regulation 22.4 Requirement Timescale for action 08/09/05 2. 18 13(6) 3. 9 13(2) The Registered person shall, within 28 days after the date on which the complaint is made, or such shorter period as may be rerasonable in the circumstances, inform the person who made the complaint of the action that is to be taken. The Registered person shall 08/12/05 make arrangements, by training staff or by other measures, to prevent the service susers being harmed or suffering abuse or being placed at risk of harm or abuse. The Registered person shall 15/08/05 make arrangements for the safekeeping and administration of medicines. ( This rrealted to the dating and safe storage of topical creams). RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Lakenham Residential Home CS0000062626.V217092.R01.doc Version 1.20 Page 19 1. 2. 3. 16 2 7 The complaints procedure should be displayed in a prominent position and in a format which all residents can see and understand. The contracts currently in place need to be updated. Care plans should be expanded to clearly show how identified needs will be met. Lakenham Residential Home CS0000062626.V217092.R01.doc Version 1.20 Page 20 Commission for Social Care Inspection Exeter Office, Suites 1 & 7 Renslade House Bonhay Road Exeter, EX4 3AY 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 CS0000062626.V217092.R01.doc Version 1.20 Page 21 - 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!