Inspection on 20/01/06 for Lakeside Rest And Nursing Home

This inspection was carried out on 20th January 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 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 Rest And Nursing Home 05/06/07

Lakeside Rest And Nursing Home 21/04/05

Lakeside Rest And Nursing Home 01/11/04

Lakeside Rest And Nursing Home 10/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Lakeside Rest And Nursing Home Chorley Road Worthington, Standish Wigan Lancashire WN1 2XN Lead Inspector Kath Smethurst Unannounced Inspection 20th January 2006 09:30 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 Rest And Nursing Home DS0000005686.V278145.R01.S.doc Version 5.1 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 Rest And Nursing Home DS0000005686.V278145.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lakeside Rest And Nursing Home Address Chorley Road Worthington, Standish Wigan Lancashire WN1 2XN 01257 422931 01257 422723 lakesidenhl@aol.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) Millennium Care U.K. Ltd Mary Ellen Morley Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50) of places Lakeside Rest And Nursing Home DS0000005686.V278145.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Maximum number of service users 50 - these to include up to 50 OP of either sex The service should at all times employ a suitably qualified and experienced Manager who is registered with the CSCI 21st April 2005 Date of last inspection Brief Description of the Service: Lakeside provides nursing and personal care for 50 older people. It is located close to Worthington Lakes and Standish town centre, and is set in its own, extensive grounds. The home has three floors and there is a passenger lift to all levels. A variety of aids and adaptations around the building to allow residents to move about independently. Forty-two bedrooms are single; thirtyseven have an en-suite toilet. There are six communal bathrooms. Communal toilets are provided on each floor. Lakeside Rest And Nursing Home DS0000005686.V278145.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over six hours during the morning and afternoon. The inspector looked around some but not all of the home, observed activities, checked care plans, and some records. To get more information about the home the inspector spoke to six residents, five staff and the manager. What the service does well: What has improved since the last inspection? Although the manager is very experienced she has attained the NVQ (National Vocational Qualification) level 4 registered managers award. Risk assessments relating to the use of bedrails are now being reviewed regularly. Lakeside Rest And Nursing Home DS0000005686.V278145.R01.S.doc Version 5.1 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. Lakeside Rest And Nursing Home DS0000005686.V278145.R01.S.doc Version 5.1 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 Rest And Nursing Home DS0000005686.V278145.R01.S.doc Version 5.1 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): 4 The manager and staff demonstrated a high level of commitment to ensuring the needs of residents were being met. EVIDENCE: All residents spoken to felt their needs were being met. During the inspection staff were seen to be attentive to the needs of residents and knew what care was needed. The manager had identified where staff required training and had arranged training sessions for staff in different aspects of care such as moving and handling, first aid, medication, dementia care and National Vocational Qualifications. Where it was identified that residents had specialist health needs, health care professionals were involved. For example general practitioners, district nurses, optician and chiropodist. Discussion with staff and observation of care practice demonstrated they were very knowledgeable about the residents care needs. Lakeside Rest And Nursing Home DS0000005686.V278145.R01.S.doc Version 5.1 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 the following standard(s): 7,8,9 & 10 Care plans were detailed, up to date and provided staff with the information they need when delivering care. Health care needs were well met with evidence of multi disciplinary working taking place. The medication at this home is well managed promoting good health. Personal support is offered in such a way as to promote residents privacy. EVIDENCE: Four care plans were examined. All contained comprehensive information relating to residents personal, social and health care needs. Daily entries in care notes were completed in all the plans examined. The plans were easy to read, had been regularly reviewed and set out clear guidance for staff to take when providing care. Daily entries in care notes were completed and gave details of care provided and resident’s well being. There was written evidence that the plans had been signed and agreed by either the residents or their representatives. The care plans examined contained some very good information in respect to residents past lives, needs, likes/dislikes and chosen lifestyle. For example one read, “Likes a lamp on throughout the night or bathroom light on and door ajar” a second “Allow X to choose the clothes he desires to wear”. Lakeside Rest And Nursing Home DS0000005686.V278145.R01.S.doc Version 5.1 Page 10 Comprehensive risk assessments were in place in all files examined. They covered areas such as nutrition, pressure areas, moving and handling, bedrails and falls. All had been reviewed and updated on a regular basis. The health care needs of residents were being met. Individual care records inspected showed evidence of visits from General Practitioners, chiropodist, optician and district nurses. Procedures were seen in the Home that described safe medication handling. Nursing staff administer medication. Medication storage was seen to be secure and orderly. Medication Administration Records (MAR) were supplied by the pharmacy except for example when additional medication was provide mid-month then, make hand written entries. The medication records inspected were clear and up to date. A separate system is in place for recording the receipt, disposal and administration of controlled drugs. Controlled drugs are securely stored. Anecdotal evidence from residents indicated that staff respected their privacy and dignity. During the inspection staff were seen to treat residents with respect and consideration, were attentive to individual needs and discreet when providing assistance. Written evidence in care plans showed that resident’s needs in respect to dignity were considered important. For example one care plan instructed staff to, “ensure privacy and dignity at all times”. Lakeside Rest And Nursing Home DS0000005686.V278145.R01.S.doc Version 5.1 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 the following standard(s): 12, 13 & 14 Social activities are very good offering variety, choice and interest for people living in the home. Visiting arrangements are good ensuring links between residents and their relatives and friends are maintained. Personal support is offered in such a way as to enable residents to exercise choice and control over their lives. EVIDENCE: On the day of the unannounced inspection, the routines of daily living were observed to be flexible. Residents were seen to be getting up in the morning at times that suited them. Staff were attentive to the needs of the residents. They took time to sit, chat and socialise when their duties allowed. For example in the afternoon care staff spent time playing dominoes with residents. A friendly but respectful banter was observed between residents and staff. The high standard set at the last inspection in relation to lifestyle experience has been maintained. The Inspector spent some time with service users in the Activities Lounge. Each service user was encouraged to take up some form of occupation, whether it was knitting, sewing or reading. There was focus on an individuals abilities, rather than his or her disabilities. Residents listened to Lakeside Rest And Nursing Home DS0000005686.V278145.R01.S.doc Version 5.1 Page 12 their choice of music, decided by consensus. There was a good level of conversation across a broad range of topics and residents were observed interacting positively with one another and staff. The planned activities take account of cultural interests and residents play a large part in planning functions. An individual record is maintained of the activities residents take part in. The activities organiser has developed an excellent programme. Activities take place both inside and outside the home and on a regular basis. Photographic and written records reflect the extensive and varied range available. Residents support various charities by making craft items for sale. For example this year the residents are making cot blankets and cardigans for the baby special care unit at Wigan Infirmary. Residents enter photos and crafts in the Standish Show. Many have won prizes and commendations. Regular outings are also organised. For example one resident described how much she had enjoyed a trip on a barge during the summer. Care plans take note of residents social interests. Regular residents meetings are held regularly and well attended. The minutes of the last meeting were examined and indicated residents were satisfied with the range and frequency of activities available. While social inclusion is encouraged, individual choices and preferences are taken into account. Those who choose to spend time in their own rooms may do so. Residents wishing to maintain their religious links are encouraged to do so. Care plans contain details of resident’s preferred religion. The home has an open visiting policy. There are no restrictions on the time people visit. Evidence of this was highlighted in the visitor’s book where entries showed residents friends and relatives visiting at different times during the day and evening. The only time restrictions would be imposed is when requested by residents. Residents spoken to expressed satisfaction with care provided and organisation of life at the home. Observation of care practice and information in care plans indicated residents are encouraged to make choices. For example in respect to where they spend their day. While some residents chose to sit in the lounge a number were observed to spend their time in their own rooms. This was further illustrated in care plans. For example one care plan instructed staff that X “Likes to choose own clothes”. Lakesides policy on admission is that residents are encouraged to bring in personal items that will help them to settle in to life at the home, the extent of which is agreed prior to admission. Evidence of personalisation was seen in resident’s bedrooms where personal mementoes and photographs were on display. Feedback from residents confirmed they were able to exercise choice. Lakeside Rest And Nursing Home DS0000005686.V278145.R01.S.doc Version 5.1 Page 13 For example in respect to rising and retiring times. Another example was observed during the inspection. A resident indicated she did not want the lunch time meal staff ensured an alternative was provided. Lakeside Rest And Nursing Home DS0000005686.V278145.R01.S.doc Version 5.1 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): 18 The policies and practices of the home protect service users from abuse, but some staff need training so they are fully conversant with the procedures and are aware of the steps to take in a case of suspected abuse. EVIDENCE: Policies and procedures in respect to the recognition and signs of abuse are in place. The home ensures all staff completes a POVA and CRB (Protection of Vulnerable Adults Register/Criminal Records Bureau) before they commence work. The manager understood the potential indicators of abuse and was aware of the steps they needed to take if there was a suspicion or allegation of abuse. It was noted in training records that whilst some staff had received protection of vulnerable adult training some had not. The manager advised she had already identified this and was hoping to arrange training. This needs to be addressed to ensure staff are fully aware of procedures and what action to take if such a situation arises. Lakeside Rest And Nursing Home DS0000005686.V278145.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 The standard of the environment within this home is good providing, residents with an attractive, homely and clean place to live. EVIDENCE: Lakeside is well maintained internally and externally. The home was refurbished relatively recently nevertheless improvements to the fabric of the building continue. For example, when bedrooms become vacant they are redecorated. There are three lounges and large dining area. These areas are furnished with good quality items. Ornaments, pictures and flowers enhance the homeliness of these areas. Outdoor space is extensive and residents spoken to were very complimentary about the garden areas. Lakeside Rest And Nursing Home DS0000005686.V278145.R01.S.doc Version 5.1 Page 16 The Home was clean throughout with no offensive odours. Previous inspection reports indicate high standards of hygiene have been consistently maintained. Residents in discussions also highlighted the cleanliness of the home. Domestic staff demonstrated attention to detail so that the Home was presented at its best. Lakeside Rest And Nursing Home DS0000005686.V278145.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 & 30 A comprehensive training programme is in place, which equips staff with the skills, and knowledge to meet residents assessed needs. EVIDENCE: A comprehensive staff development programme is in place and records of training are maintained. There was evidence that new staff undertake induction training that meets the National Training Organisation (NTO) specification following which foundation training is undertaken. On-the-job supervision continues until such time as the member of staff feels or is deemed to be competent in a task. Since the last inspection the home has achieved Investors in People status. Ongoing training is available and there is ample evidence that these opportunities are taken up. NVQ (National Vocational Qualifications) are actively promoted. Currently 70 of staff are in receipt of NVQ level 2 and 3. This is commended as the percentage is significantly above the required standard. Discussion with the manager indicated that the home was working towards an even higher percentage. It was also pleasing to note that training opportunities are made available to catering and domestic staff. For example all domestic staff have attained relevant NVQ awards. Lakeside Rest And Nursing Home DS0000005686.V278145.R01.S.doc Version 5.1 Page 18 Samples of training records were examined. The records confirmed the range of courses that staff had attended. Training included workshops, seminars, information sessions, as well as formal, accredited learning. This training and education is over and above the NVQ training that the majority of the staff group is involved in. Recent courses undertaken include NVQ assessors course, palliative care, food hygiene, infection control, dementia care, sensory impairment, first aid, moving and handling, continence awareness, moving more often, optical awareness, medication, nutrition and NVQ 2 and 3. Future training planned includes food hygiene, first aid, dementia care, continence, COSHH, caring for the carer and NVQ. Staff who commented confirmed that training was encouraged and widely available. One member of staff said that the training provided was “ Good” and “ More than enough”. Lakeside Rest And Nursing Home DS0000005686.V278145.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 & 35 The home regularly reviews aspects of its performance through a good programme of self-review and consultations, which include seeking the views of residents, staff and relatives. A satisfactory accounting system was in place, which protected resident’s interests. EVIDENCE: Effective internal and external quality assurance systems are in place such as staff and residents meetings and visitor/residents/staff satisfaction surveys. A sample of the most recent completed surveys was examined. The feedback from residents, visitors and staff was very positive. For example one staff response stated, “ I like working at Lakeside staff and management are very approachable” while a resident commented that “ I am treated very well the staff are grand”. The owner visits nearly every day. He speaks to residents and staff and undertakes audits. He also produces a written report once a month. While the Lakeside Rest And Nursing Home DS0000005686.V278145.R01.S.doc Version 5.1 Page 20 reports of these visits are available in the home copies need to be forwarded to the CSCI. The home has a system for recording the complaints of those who don’t wish to complain formally. Residents are informed of CSCI inspections and inspection reports are available for visitors and residents to read. The Contracts Section of Wigan Social Services Department, in conjunction with a company called RDB Limited, has undertaken a voluntary star rating of homes in Wigan. As part of the rating process an annual audit of quality is undertaken. This includes consultation with service users and staff. Lakeside has been awarded 5 stars, which is the highest rating. The home has a satisfactory accounting system in place. Staff could determine exactly how much money the home was holding for each resident. The Home looks after small amounts of resident’s personal allowances. Detailed records are held of all transactions. All monies held for safekeeping are kept individually. A record is kept of monies credited and debited and receipts were obtained for financial transactions. Secure facilities are provided for the safe keeping of money. Lakeside Rest And Nursing Home DS0000005686.V278145.R01.S.doc Version 5.1 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 X X X 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 3 X X X X X X X STAFFING Standard No Score 27 X 28 4 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X X Lakeside Rest And Nursing Home DS0000005686.V278145.R01.S.doc Version 5.1 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. 1 2 Standard OP18 OP33 Regulation 13 26 Requirement Staff must undertake training in the recognition and signs of abuse. Copies of the unannounced quality monitoring visit reports must be forwarded to the CSCI. Timescale for action 30/06/06 01/03/06 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 Lakeside Rest And Nursing Home DS0000005686.V278145.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 Rest And Nursing Home DS0000005686.V278145.R01.S.doc Version 5.1 Page 24 - 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. 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