Inspection on 11/07/06 for Lakeside Residential Home

This inspection was carried out on 11th July 2006.

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

Other inspections for this house

Lakeside Residential Home 14/02/06

Lakeside Residential Home 12/07/05

Lakeside Residential Home 09/02/05

Lakeside Residential Home 07/09/04

Lakeside Residential Home 17/02/04

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

CARE HOMES FOR OLDER PEOPLE Lakeside Residential Home Lakeside Ernesettle Green Plymouth Devon PL5 2ST Lead Inspector Kim Fowler Unannounced Inspection 11th July 2006 10:00 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 Lakeside Residential Home DS0000030844.V292648.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. Lakeside Residential Home DS0000030844.V292648.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lakeside Residential Home Address Lakeside Ernesettle Green Plymouth Devon PL5 2ST 01752 365677 01752 368715 linda.tippett@plymouth.gov.uk Woodlands.school@plymouth.gov.uk Plymouth City Council 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) Linda Mary Tippett Care Home 29 Category(ies) of Dementia - over 65 years of age (29) registration, with number of places Lakeside Residential Home DS0000030844.V292648.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th February 2006 Brief Description of the Service: Lakeside is a care home that is registered for a maximum of 29 older people who have dementia. It is owned by Plymouth City Council and is a purpose built large detached property. The home is situated in a residential area of Plymouth and has pleasant views from the rear of the home across open countryside. Opposite the home is a health centre that is newly constructed for the local GP practice. The home has stair lifts and a passenger lift to the upper floor has been installed. The home is on a bus route, and is within walking distance of local shops. The home has large communal areas, and has a large porch and hall area. The bedrooms are compact and are all single rooms. None have en suite toilet facilities but all rooms are near to toilets and bathrooms. Activities are provided regularly at the home to encourage independence and stimulation and the home is fitted with aids and adaptations to enable the service users to remain as independent as possible. Lakeside Residential Home DS0000030844.V292648.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was undertaken on the 11th July 2006. The Registered Manager was not present during the inspection. One of the Assistant Managers and care staff assisted the inspector. The Registered Manager returned to the home at the end of the inspection and received feedback on the outcome of this unannounced inspection. The inspector made a partial tour of the premises and many of the service users were spoken with. Staff on duty were observed and spoken to in the course of their daily duties. Service user and staff records were inspected. Following the visit the Commission received six relative feedback cards, two health and social care professional feedback cards, two care staff questionnaires and six service users surveys. All service users, relatives and professionals were very positive about the care offered at Lakeside. What the service does well: What has improved since the last inspection? What they could do better: No requirements were made during this inspection. Lakeside Residential Home DS0000030844.V292648.R01.S.doc Version 5.2 Page 6 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. Lakeside Residential Home DS0000030844.V292648.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 Residential Home DS0000030844.V292648.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): 2/5 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Service users can be confident that a full needs assessment will be completed before admission to ensure the home can meet their individual needs. EVIDENCE: Service user files provided evidence that each service user had received a contract with the paying authority. These contracts clearly state the terms and condition of occupancy. Further examination of files found that each of the service user’s files contained a completed pre admission questionnaire. This included a care manager’s care plan and social services completed assessment. All relevant information was well documented on the needs assessment form and this included a risk assessment completed prior to admission. These forms provided information that the home can meet the needs of the service user. Prospective Lakeside Residential Home DS0000030844.V292648.R01.S.doc Version 5.2 Page 9 residents can be assured that their health care needs can be met and also their emotional, social, cultural or religious needs. The deputy manager informed the inspector that either she of one of the other deputy manager’s visit prospective service users in their home or hospital and will liaise with relatives and health and social care professionals to obtain relevant information prior to admission. The home avoids emergency admissions, and prospective service users are invited to visit the home before admission. One service user and two relatives spoken with confirmed that they had visited the home prior to moving in. Evidence was found during examination of files that a service user had stayed for a month’s trial before a permanent place was offered. This gave both the service user and the home an opportunity to see whether all needs could be met. Lakeside Residential Home DS0000030844.V292648.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 good. This judgment has been made using available evidence including a visit to this service. The care plans in place ensure that staff are aware of service users needs and will promote consistency in care. EVIDENCE: Files examined each contained a completed care plan and are updated every month. These care plans give detailed instructions to staff on a daily basis as well as information to new and agency staff to ensure intimate personal care is being provided in a manner that meets with that service user’s approval. The plans are holistic and comprehensive in detail. All care plans contain complete and comprehensive risk assessments. Where possible either the service user or their representative sign the plans to ensure that all risks are recorded and minimised. The home has a “micro care plan” available in the main office for easy access for staff. These files contained information on the care the service user requires as well as risk assessments. The daily record regarding each service user is also recorded by staff at the end of each shift. This easily accessible Lakeside Residential Home DS0000030844.V292648.R01.S.doc Version 5.2 Page 11 information ensures all staff provide continuity in care and service users are assured their care needs will be met. During discussion with some of the service users and visiting relatives it was apparent that service users are involved as much as possible with their care plans and one service user thought they had been at a review to update their care plan. Several service users confirmed that they see either the District Nurse or GP when they wish. One service user was in hospital as a day patient and had a staff member with them as support. It was observed during the inspection that one service user was unwell and the duty manager contacted the local GP practice. This provided evidence that the home has an excellent relationship with the surgery. When the service user’s health deteriorated during the inspection staff contacted the ambulance service and also spent time reassuring the family in attendance. The duty manager and staff remained calm and professional throughout this incident. One family member confirmed that a service user had attended a hospital appointment and was awaiting for a follow up appointment. Service users files show that health care needs are recorded and met. This included information from a dietician and diet for the service user. The inspector observed the administration of medication by the duty manager. The deputy manager informed the inspector that only the duty managers administer medication and they all have received medication training from pharmacist. Medication for respite service users is clearly recorded on admission and then transferred to a MARS, medication record sheet. All other medication is dispensed in blister packs. The duty manager was aware of the principles of medication and had read the homes Policy and Procedure on the administration, disposal and returns of medication to ensure staff are aware of their responsibilities. A discussion with many of the service users confirmed they have their dignity and privacy maintained. This included seeing health care professionals in the privacy of their own rooms. The ambulance service attended to the service user privately in their bedroom. A tour of the premises showed that all bathrooms had suitable locks in place to ensure the privacy of service users. The inspector observed the staff assisting one service user to move into a comfortable chair. This procedure was carried out using a mobile hoist and the staff were observed maintaining this lady’s dignity at all times. Lakeside Residential Home DS0000030844.V292648.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 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 judgment has been made using available evidence including a visit to this service. Lakeside offers good wholesome meals.The planned activities ensure that service users have a varied and interesting lifestyle. EVIDENCE: Several service users confirmed that there are activities in the home. Another service user stated that the local vicar calls at the home regularly. Observation during the meal served during the inspection showed that mealtime is unhurried, relaxed and with plenty of staff around for support if required. Service user individual plans record interests and hobbies and a regular updated activity list is displayed on the homes notice board. Seven family members were in attendance during the time of the inspection. Five of these relatives were spoken with at length. All visitors confirmed they are able to see service users in private and they are able to visit at any reasonable time. One relative informed the inspector that they had been given information about the home before their relative had moved in. This included a complaints procedure. Lakeside Residential Home DS0000030844.V292648.R01.S.doc Version 5.2 Page 13 One service user was observed going to the local shops during the inspection. Discussion with staff, service users and observation during the inspection highlighted that service users are encouraged to make choices as much as possible. This included someone offering each service user a choice for the main meal of the day, a tea meal and a choice of biscuits during a coffee round. The service users and relatives confirmed the food was very good. There was also a good choice and plenty of food available. The menus showed a variety of wholesome food is offered. The home employs a full time cook and this ensures that the home has someone to provide a freshly cook meal daily and individual preferences or special diets are catered for. Menus are displayed daily in large writing on a chalkboard in the entrance hall. Each service user is asked for their choice of meal daily and alternatives are available for any last minute changes. The cook confirmed that there is never any restriction on the quality and quantity of food she is able to order. The cook also orders sweets and ice cream and service users confirmed the ice creams are a welcome treat during the recent hot weather. The home provides extra drinks to ensure the well being of all the service users during the recent heat wave. Lakeside Residential Home DS0000030844.V292648.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 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 good. This judgment has been made using available evidence including a visit to this service. The service users can be confident that any complaints or concerns raised will be listened to, acted upon and well managed by the home, which protects the welfare of the service users. EVIDENCE: The home has a designated complaints file. This file contains information on any complaints received and included the action taken, timescales and all correspondence in relation to each complaint. One complaint was sent to the commission which was forwarded to the home to deal with. This information was recorded in this file and the responses sent to the complainant were seen. This complaint proved to be unsubstantiated. Most of the service users and some of the relatives were aware that the home has a Plymouth City Council complaints procedure. This complaints procedure was clearly displayed on the notice board. All the relatives spoken with were confident that any concerns or complaints they raise would be acted upon and listened to. The discussion with the staff members on duty confirmed that they had recently completed the Adult Protection and POVA training. This ensures staff Lakeside Residential Home DS0000030844.V292648.R01.S.doc Version 5.2 Page 15 have the knowledge and skills to protect service users. Discussion with the staff confirmed that they were aware of the procedure in dealing with any issues and that the home had the alerter guide available. One staff member confirmed that they had read the Policies and Procedures file and there was a policy relating to the Protection of Vulnerable adults. Lakeside Residential Home DS0000030844.V292648.R01.S.doc Version 5.2 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 the following standard(s): 19/26 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Lakeside Residential Home continues to maintain a clean and suitable environment for its stated purpose. EVIDENCE: A partial tour of the premises was undertaken during this inspection. Evidence obtained from the service users, relatives and staff confirmed that the home is well maintained, clean and safe. The home employs a handyman for everyday maintenance jobs to ensure a safe environment. The home has sufficient safe and comfortable living space for the service users. All the service users are able to access the gardens and all the communal facilities. To meet the needs of the service users many of the rooms do not have carpet fitted but do have appropriate flooring. Lakeside Residential Home DS0000030844.V292648.R01.S.doc Version 5.2 Page 17 Appropriate disability equipment is provided in the home, and these include a passenger lift, hoists, stair lifts, wheelchairs, and a call bell system that records when staff visit service user’s rooms. This equipment provides the service users with a building that is appropriately adapted to meet their needs. Radiators are guarded, and hot water outlets are regulated. Window restrictors are fitted to upstairs windows. All pipe work has now been covered. These safeguard the service users from scalds and harm. A recommendation made in the previous two inspection reports was for the home sluice facilities to be in working order. Repairs were being carried out on these sluices during this inspection. The tour of the premises and feedback from the service users and visitors identified that the home is always clean, tidy and free from any odours. The service users can be assured that they will live in an attractive and comfortable home that is regularly maintained. Lakeside Residential Home DS0000030844.V292648.R01.S.doc Version 5.2 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 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 good. This judgment has been made using available evidence including a visit to this service. The service users are supported by well-motivated and caring staff in sufficient numbers to meet the needs of those currently living at the home. Recruitment practices protect service users. EVIDENCE: The staff, service users and relatives spoken with all confirmed that the home has sufficient staff on duty. At times the home has used agency staff. The home does try to use regular agency staff to ensure continuity to care for the service users. Plymouth City Council has a designated training department and staff member’s files showed that regular training is carried out. Staff confirmed they had completed training in Manual Handling, First Aid and Health and Safety. The duty manager informed the inspector that all duty managers have completed medication training with the pharmacist. Staff files contained the required pre-employment checks, including Criminal Record Bureau Disclosures (CRB), ensuring as far as possible suitable staff are employed. All staff files examined contained information regarding interview questions as well as evidence regarding management decisions to recruit staff. Lakeside Residential Home DS0000030844.V292648.R01.S.doc Version 5.2 Page 19 Plymouth City Council (PCC) have a through recruitment and selection Policy and Procedure in place. One staff file for a new employee did not contain all relevant information. However the unit clerk and later during feedback with the manager confirmed that PCC Human Resources department collect all the information. A letter is then sent to the home to confirm the clearance of the staff member before commencing in post. Recorded evidence confirmed the above process and showed that the staff member had the necessary CRB/POVA check and medical clearance to start in post. Discussion with staff and examination of staff files showed that PCC encourages staff training. All staff stated that the manager supports them and training and development needs are regularly discussed during supervision sessions. This ensures the staff are suitably trained to meet the needs of the service users in the home. Lakeside Residential Home DS0000030844.V292648.R01.S.doc Version 5.2 Page 20 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 judgment has been made using available evidence including a visit to this service. The Registered Manager of this home is very good and ensures that records are effectively maintained. The staff team are well trained and above all service users are happy and their needs are met. EVIDENCE: The Registered Manager has been at the home for some time. The manager was only present for the last part of the inspection. Previous discussions with the manager identified that she has a NVQ 4 in care and also the Registered Manager’s award. The manager informed the inspector that she regularly updates her training which provides the home with a competent and qualified manager. Lakeside Residential Home DS0000030844.V292648.R01.S.doc Version 5.2 Page 21 The Quality Assurance system in place included surveys returned to the home. The Registered Manager responds to questions and comments received. Evidence was held on file of these responses providing evidence that the home is run in the best interest of the service users. A discussion with the unit clerk and some relatives confirmed the process to manage service user’s finances. The process in place protects service users. The unit clerk confirmed that each service user has individual money held at the home with receipts and records of expenditure. One service user’s money and expenditure sheet was checked during this inspection and was well recorded and all details were correct. Receipts are provided. At present money over £100 is held for service users in the home’s bank account. PCC are in the process of separating this account into individual named accounts. All members of staff receive appraisals to assess their work performance and identify training and development needs. All staff spoken with confirmed that they receive regular supervision and this responsibility of supervising staff is shared between the manager and the deputies. Staff confirmed there are regular staff meetings. Regular consultation with staff ensures they can contribute to the running of the home and are aware of the home’s aims and objectives, philosophies of care and promotes consistency and improvement. The fire protection system was well maintained. Maintenance checks are being carried out. Staff are receiving appropriate fire protection training to ensure they have the skills to deal with emergencies. Gas and electrical appliances were being routinely serviced and checked. Good health and safety practices reduce any unreasonable risk to an acceptable level. Sampling of service records indicated that equipment is serviced regularly and maintained in good working order, including the fire alarm system. PAT testing is carried out on all electrical equipment and any service user admitted to the home is required to have their personal electrical items PAT tested before admission. Service users are required to provide evidence of the PAT testing to ensure the home is safe. Lakeside Residential Home DS0000030844.V292648.R01.S.doc Version 5.2 Page 22 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 3 X X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Lakeside Residential Home DS0000030844.V292648.R01.S.doc Version 5.2 Page 23 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. 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 OP21 Good Practice Recommendations The home should carry out the redecoration work on the bathrooms as discussed. This recommendation is carried over from the last inspection. The homes sluice facility should be in working order. And the room with an odour should have the odour removed. This recommendation is carried over from the last inspection. 2. OP26 Lakeside Residential Home DS0000030844.V292648.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton 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 Lakeside Residential Home DS0000030844.V292648.R01.S.doc Version 5.2 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. 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