Inspection on 12/05/09 for Lakeside House

This inspection was carried out on 12th May 2009.

CQC found this care home to be providing an Good service.

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.

Other inspections for this house

Lakeside House 28/04/10

Lakeside House 23/03/10

Lakeside House 28/01/10

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Key inspection report CARE HOMES FOR OLDER PEOPLE Lakeside House Lakeside House Lakeside Darlington County Durham DL1 5TH Lead Inspector Tanya Newton Key Unannounced Inspection 12th May 2009 09:00 DS0000072914.V375353.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Lakeside House DS0000072914.V375353.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Lakeside House DS0000072914.V375353.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lakeside House Address Lakeside House Lakeside Darlington County Durham DL1 5TH 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) Southern Cross OPCO Ltd Paul Dawson Care Home 67 Category(ies) of Dementia (67), Old age, not falling within any registration, with number other category (67), Physical disability (12) of places Lakeside House DS0000072914.V375353.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home with nursing - Code N to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category - Code OP, maximum number of places, 67 Dementia - Code DE, maximum number of places, 67 Physical disability - Code PD, maximum number of places 12 the maximum number of users who can be accommodates is 67 2. Date of last inspection N/A Brief Description of the Service: Lakeside house is a care home which is able to provide both nursing and residential care to people with dementia. The home also has a unit for young people with physical disabilities. Fees range from £435.55 to £615.00 per week. Lakeside House DS0000072914.V375353.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two star – good service. This means that the people who use this service experience good quality outcomes. The inspection was unannounced and carried out over 5.5 hours. Prior to the inspection the home were asked to complete a self assessment document called an AQAA. This provides the Commission with information about the home. The manager, staff and people living at the home were spoken to and their views have been included within the report. A tour of the home was taken and records were examined. What the service does well: The people spoken to say they are happy with the care and support they receive. Pre-admission assessments are thorough and people said that they had sufficient information about the home before choosing to stay there. People also confirmed that they new how to make a complaint or raise a concern if they needed to. The staff are aware of their responsibilities if they believe that neglect or poor care practice is taking place and were confident that if they raised any issues that they would be dealt with appropriately by the manger. People looked well cared for and there was a good relationship between staff and people living at the home. The atmosphere was calm and relaxed. People said that they enjoyed the activities and the food they were given and that they were encouraged to make decisions and choices in all aspects of their lives. The home is well furnished and decorated to a high standard and people are encouraged to personalise their rooms to make them feel more homely. There are thorough recruitment systems in place to make sure that staff are suitable and safe to work with the people living at the home. All staff receive a range of training to provide them with the skills and knowledge to carry out their roles effectively. The home operates an ‘open door policy and has good systems for seeking feedback from people about the service being provided. Lakeside House DS0000072914.V375353.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Lakeside House DS0000072914.V375353.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 Lakeside House DS0000072914.V375353.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their needs properly assessed before being admitted to the home. EVIDENCE: The home has a statement of purpose and a service user’s guide which are displayed within the entrance foyer of the home. Brochures are also available. These documents provide people with information about the home prior to them moving in. People are able to come and visit the home to see if they want to stay there. Three people’s care files were looked at. All contained a detailed admission assessment to ensure that the home is able to meet their needs. Lakeside House DS0000072914.V375353.R01.S.doc Version 5.2 Page 9 The home does not admit people solely for intermediate care although respite care is provided. Lakeside House DS0000072914.V375353.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good systems are in place to ensure that the health care needs of the people living at the home are met. People can be confident that their privacy and dignity is protected and that they are treated with respect. EVIDENCE: Three care plans were looked at to make sure that people’s health and personal care needs were being documented and met in a planned way. In the main care plans were comprehensive and well written. Some required additional detail, for example, one person had very detailed religious observations in their assessment, yet this information was not included within their plan of care. There was evidence of the involvement of specialist healthcare staff and the manager and staff said that they had forged good links with the Primary Care Trust (PCT). People living at the home are encouraged where possible to be involved within the care planning process although some choose not to. One Lakeside House DS0000072914.V375353.R01.S.doc Version 5.2 Page 11 person said, “I haven’t seen my care plan, I don’t want to as I am not interested. I am getting well looked after and that’s all that matters to me”. During the visit we looked at how medication was being looked after by the home. The home does support people who want to administer their own medication and they carry out a risk assessment first to make sure that it is safe. In the main medication systems were working well. A better system to demonstrate what medication has been ordered should be set up and the home needs a pill counter so that audits on medication can be carried out. One person had run out of medication although it had been ordered from the pharmacy. The home was advised to contact the PCT if they had issues with medication being delivered on time. The temperature of the drug treatment room needs to be monitored closely as it was very warm. All medication is administered by either a qualified nurse or a senior care assistant once they have received the appropriate training. The staff were observed throughout the inspection to be treating people with dignity and respect. Comments from people living at the home included, “you can do whatever you want, staff treat you with respect” and “we are well looked after, it couldn’t be better, you can make choices about what you want to do”. Lakeside House DS0000072914.V375353.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The recreational and social needs of people are well catered for which enables them to make daily choices and promotes independence. EVIDENCE: The home employs an activities co-ordinator for 27.5 hours per week. An additional co-ordinator will be employed as the numbers of people resident in the home increase. Activities take place both individually and in groups. Minibus trips take place on a weekly basis and include trips to coffee shops, ice cream parlours, places of local interest and the coast. An exercise class is carried out in the home every two weeks and outside entertainers visit the home on a monthly basis. Children from the local primary school also come and visit the home. A minister visits the home every two weeks. Due to the very differing needs of the people living at the home activities should be further developed. Lakeside House DS0000072914.V375353.R01.S.doc Version 5.2 Page 13 Family and friends are encouraged to visit the home at any time. The home provides a varied balanced menu. All meals are home cooked by the chef and specialist diets and cultural requirements can be catered for. People are offered a choice. People can have their meals in their own rooms or in one of the dining rooms. Dining rooms are attractively set up and food is served from a hot trolley. Comments about the meals included, “the food is good, you get a choice, I like to have toast on a morning and there are always plenty of drinks offered” and “the food is good, you always get a pudding”. Lakeside House DS0000072914.V375353.R01.S.doc Version 5.2 Page 14 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse. EVIDENCE: The home has received one complaint since it opened. The home has clear policies for managing complaints and people living at the home said that they could tell someone if they had any problem. The home has clear policies which link with the local authority procedure for managing any allegations. Staff spoken to during the inspection said that they would have no hesitation in whistle blowing (telling someone) if they saw or heard anything inappropriate. The majority of staff had received training in the protection of vulnerable adults (pova). Lakeside House DS0000072914.V375353.R01.S.doc Version 5.2 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe, comfortable, well-maintained and homely environment. EVIDENCE: Lakeside House is a purpose built home. It is well decorated and furnished to a high standard throughout. All the bedrooms viewed reflected the individual’s personal preferences and choice. People are encouraged to bring in items of furniture to make their rooms more homely. All rooms have en-suite WC and hand basins and 45 rooms have en-suite wet rooms. The bedroom doors all have locks and there is lockable storage space in the rooms. This means that people can keep their belongings private and secure. The home is clean, comfortable and well maintained. Lakeside House DS0000072914.V375353.R01.S.doc Version 5.2 Page 16 The unit for young physically disabled people would benefit from being made more accessible, for example push button access to doors to communal areas. Ramps are needed so that people can access the outside areas. Additional grab rails may be required to communal bathrooms in this unit. An accessible kitchenette should also be considered for this unit, to promote people’s independence. The home has good infection control policies. The staff have access to protective clothing such as gloves and aprons. The home has a team of domestic staff who work hard to maintain good standards of cleanliness throughout the home. Lakeside House DS0000072914.V375353.R01.S.doc Version 5.2 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that staff are trained and on duty in sufficient numbers to meet their assessed needs. EVIDENCE: Staffing numbers in the home are sufficient to meet the needs of the people living there. As the numbers of people living at the home increase, staffing numbers will be reviewed to ensure that they continue to be sufficient. There is a clear training matrix which demonstrates the training which is being provided for staff. All staff receive an induction when they commence employment. Training includes first aid, moving and handling, fire, health and safety, food hygiene, pova, challenging behaviour and infection control. 90 of staff either hold or are working towards an NVQ in care. Comments from staff were positive and included, “I have been here since it opened, I had an induction and all of my mandatory training. The morale is good, staff get on well. I get good support and supervision. It’s a good place to work. I have also had training in dementia” and “It’s a lovely place to work, the staff get on well and there are plenty of training courses available. I am doing my NVQ and an infection control course at present”. Lakeside House DS0000072914.V375353.R01.S.doc Version 5.2 Page 18 Staff files were looked at. All contained a completed application form and two written references. The files show that satisfactory criminal record bureau (CRB) and protection of vulnerable adults (POVA) checks have been obtained. The manager also carries out audits on staff files to identify any issues. Lakeside House DS0000072914.V375353.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and run. People who live and work at the home can contribute to the decision making process. EVIDENCE: The manager has the skills and qualifications to manage the home effectively. All of the people spoken to said that she operates ‘an open door policy’. The home has a good range of quality assurance systems in place to seek the views of people living at the home. These include weekly manager surgeries, bi-monthly meetings for residents and relatives, monthly staff meetings and customer satisfaction surveys. Lakeside House DS0000072914.V375353.R01.S.doc Version 5.2 Page 20 Regular audits are also carried out by the manager on a monthly basis. The operations manager visits the home and carries out audits, to make sure that the home is operating to company policy. A check was made on the systems to manage people’s money. The company holds a pooled bank account to hold people’s money. Regular audits are carried out by the company and a record of receipts is maintained for each individual. It may be beneficial for the home to carry out financial risk assessments for people living at the home. Some of the people said that they would like their own money when going out. When activities take place in the main they are funded through the home’s petty cash system. Supervision is provided for all staff Regular health and safety checks are carried out within the home. All staff receive basic health and safety training. These measures help to ensure that the health, safety and welfare of the people living and working at the home is promoted and safeguarded. Lakeside House DS0000072914.V375353.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Lakeside House DS0000072914.V375353.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. 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 Refer to Standard OP7 Good Practice Recommendations Care plans should be further developed so that they reflect the information gathered within the initial assessment of need. Systems to record medication which has been ordered and to ensure stock is delivered on time should be further developed. Activities within the home should be further developed to suit the individual needs of people living at the home. The young physically disabled unit should be further developed to make it more accessible for people living or staying there. It should include a kitchenette, additional aids for bathrooms, ramps to access the grounds and push button access to doors to make them accessible to people in wheelchairs. Financial risk assessments should be completed for those people who want to manage their own money. People DS0000072914.V375353.R01.S.doc Version 5.2 Page 23 2 3 4 OP9 OP12 OP19 5 OP35 Lakeside House should be supported to manage their own money where possible. Lakeside House DS0000072914.V375353.R01.S.doc Version 5.2 Page 24 Care Quality Commission North Eastern Region Citygate Gallowgate Tyne & Wear NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.northeastern@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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