Inspection on 23/05/06 for Lambspark Residential Home

This inspection was carried out on 23rd May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Lambspark Residential Home 08/08/08

Lambspark Residential Home 09/08/07

Lambspark Residential Home 11/11/05

Lambspark Residential Home 10/05/05

Lambspark Residential Home 24/11/04

Lambspark Residential Home 19/05/04

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

CARE HOMES FOR OLDER PEOPLE Lambspark Residential Home 38 Merafield Road Plympton Plymouth Devon PL7 1TL Lead Inspector Wendy Baines Unannounced Inspection 23rd May 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 Lambspark Residential Home DS0000003538.V291801.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. Lambspark Residential Home DS0000003538.V291801.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lambspark Residential Home Address 38 Merafield Road Plympton Plymouth Devon PL7 1TL 01752 330470 01752 345126 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Richard Wraighte Mrs Tracey Elizabeth Wraighte Care Home 33 Category(ies) of Dementia - over 65 years of age (33), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (33), Old age, not falling within any other category (33), Physical disability over 65 years of age (33) Lambspark Residential Home DS0000003538.V291801.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age 60 yrs Date of last inspection 11th November 2005 Brief Description of the Service: Lambspark is a detached, three storey property situated in the residential area of Merafield in Plympton. The Home is registered to provide residential accommodation and personal care, for a maximum of 33 persons over the age of 60 who may also have dementia, a mental disorder or physical disability. The home has 29 single bedrooms, 10 on the ground floor, 14 on the first floor and 5 on the 2nd floor; and 2 double bedrooms, 1 on the ground floor and 1 on the 2nd floor, all of which have en-suite toilet facilities. On the ground floor there is a small lounge room, with a conservatory attached, where residents may smoke if they wish to, and a dining room with a further lounge area. There is a large, non-smoking lounge room on the 1st floor. A shaft lift provides access from ground to both 1st and 2nd floor levels. There is a call bell system throughout the home. Residents are enabled to access any health or social care services they require and various social activities are arranged by the home. The garden is attractive, spacious and accessible to the residents. Lambspark Residential Home DS0000003538.V291801.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is a summery of a cycle of Inspection activity at Lambspark since the last inspection visit. To help CSCI make decisions about the home, the manager gave us information in writing about how the home is run; documents submitted since the last inspection were examined along with other records of what was found at the last inspection, two site visits totalling 11 hours were carried out with no prior notice being given to the home as to the date and timing, discussions were held with the manager and staff on duty, various records were sampled such as care plans and risk assessments, questionnaires were sent to staff who work at the home and a tour was made of the home and garden, time was spent with the people who live in the home both individually and in groups with staff. The Inspector was also able to meet and talk with visiting relatives and friends. In addition a sample group of residents were selected and their experience of care was ‘ tracked’ through records and discussion with staff and management from the early days of their admission to the current date, looking at how well the home understands their needs, and the opportunities and lifestyle they experience. Time was then spent with these residents and questionnaires were sent to their relatives, GPs and Care Managers where appropriate. This approach hopes to gather as much information about what the experience of living at the home is really like, and to make sure that residents views of the home forms the basis of the report. What the service does well: Residents described living at Lambspark as ‘ Very Nice’, and the staff as kind and caring. Relatives spoken to said that they were always made to feel welcome and one relative spoken to said that the home make regular contact by telephone and advised him of any concerns or issues. The home has a good admissions procedure, which ensures that prospective residents can make choices about where they live and the home can assess if they can meet the individuals needs. Documentation is available to ensure staff are aware of residents daily needs and how they wish to be supported. Residents are encouraged to make choices and to maintain their independence as long as possible. Lambspark Residential Home DS0000003538.V291801.R01.S.doc Version 5.2 Page 6 The Provider and managers of the home have developed and promoted close working relationships with health and social care professionals who visit residents in the home when possible. Lambspark provides a friendly personal service in comfortable homely accommodation. The standards of care are good. 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by Lambspark Residential Home DS0000003538.V291801.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. Lambspark Residential Home DS0000003538.V291801.R01.S.doc Version 5.2 Page 8 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 Lambspark Residential Home DS0000003538.V291801.R01.S.doc Version 5.2 Page 9 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): 1,2,3,4,5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Prospective residents and their family/representatives can be confident that their care needs will be properly assessed to ensure that the home will be able to meet their needs. EVIDENCE: The home provides prospective residents with sufficient written information regarding the home and the services provided to enable them to make an informed choice about where they live and the type of care they receive. A Statement of Purpose and service user guide is available and covers all areas as required. Prospective residents are invited to the home but may not always choose to do so. A thorough Pre-admission assessment is completed at the home, at the residents own home or hospital according to the circumstances in place, to establish if care needs can be met. All residents are given a contract/statement of terms and conditions and are invited to stay in the home on a month’s trial at the end of which they can decide if they wish to stay. Lambspark Residential Home DS0000003538.V291801.R01.S.doc Version 5.2 Page 10 Care records were inspected for two residents who had recently moved to the home and it was evident that these procedures had been followed. Discussion took place with one of the residents and their relative and both said that they had received good support and information from the home, which had helped them make decisions and settle well into their new environment. Lambspark Residential Home DS0000003538.V291801.R01.S.doc Version 5.2 Page 11 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 judgement has been made using available evidence including a visit to the home. Residents’ health, personal, and social care needs are being met and residents are treated respectfully. EVIDENCE: Following admission the home uses all the information they have received to undertake their own assessment and to complete an individual care plan. Samples of this documentation were seen and included information relating to residents health, personal and social care needs. Details included daily routines, residents preferences about how they wished to be supported and specific guidelines for staff where necessary. The manager and senior staff liaise with health care professionals at all levels to promote the health and well being of residents living in the home. Records and discussion confirmed that the home has regular contact with the District Nurse service, Chiropody, Continence advisor, and Dietician when required. Lambspark Residential Home DS0000003538.V291801.R01.S.doc Version 5.2 Page 12 A register of falls had been completed and residents had been risk assessed in relation to falls and fractures. A senior member of staff had attended training relating to this area of care and prevention. The homes medication procedures were inspected and all records were found to be in good order and up to date. A Blister Pack- Venalink system is used and the home also uses a ‘potting-up’ system to prepare each individual’s medication for the day. Discussion took place with the Registered Manager for the need to ensure that the homes Medication procedures comply with ‘The Royal Pharmaceutical Guidelines for the Storage and administration of medication in care homes’. Controlled drugs were correctly stored, administered, and recorded with clear records showing appropriate information as required. All staff responsible for handling medication receive training and support from the local Pharmacist. Residents spoken to said that they were treated with the utmost respect, their privacy was always observed when washing and bathing, and that most staff were ‘ gentle, considerate and kind’. Lambspark Residential Home DS0000003538.V291801.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Social activities are managed well, and provide interest for the residents. Meals are nutritious and varied. EVIDENCE: Residents living at Lambspark have a range of support needs, some are able to arrange their own social/leisure arrangements and others are more dependent on staff and family. Residents’ likes and interests are recorded as part of the admissions process, and this information included cultural/religious beliefs and information regarding family, friends and other significant contacts. There is a notice board in the home, which provides information about; weekly in-house entertainment, visits by the hairdresser, and mobile library. The home has three communal sitting rooms and a large attractive level garden with seating. Residents can request a daily newspaper, which will be delivered to their room. Each sitting room has a TV/video/DVD, and residents can also choose to have a television and telephone in their own bedroom. The home has a seven- seat vehicle, which is used for organised trips and staff will also support residents to arrange public transport when required. Lambspark Residential Home DS0000003538.V291801.R01.S.doc Version 5.2 Page 14 On the day of the inspection staff were sitting with some residents playing dominoes, and others were relaxing in the sitting room or individual bedrooms. Residents and family said that visitors were welcomed at all times and that staff were always ‘ welcoming, helpful, and friendly. The manager advised that due to age related conditions including Dementia some service users require a higher level of support to ensure their well being and safety. Staff were aware of the needs of service users who may wander or harm themselves and were supporting them whilst encouraging independence and choice where possible. Resident’s dietary likes, dislikes and specific needs are recorded as part of the admissions process. Residents are also weighed monthly and this information is recorded. Referrals are made to the Dietician for advice and support when required. The two weekly menu plan showed a variety of traditional meals to provide a nutritious diet. Meal times are flexible and residents are able to eat in their rooms if they choose. Examples were given of changes made to the menu following the results of a questionnaire completed by residents. During the inspection residents were served tea and snacks throughout the day. Residents spoken to said that cups of tea were always provided and some residents had their own fridge in their room to store their own snacks and drinks. Lambspark Residential Home DS0000003538.V291801.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The home has a satisfactory complaints procedure with evidence that residents feel their views are listened to and acted on. EVIDENCE: The home has a written complaints procedure and a copy of this was this was available on the residents’ notice board. Residents spoken to said that they would know who to speak to if they had a concern and that the manager and owner of the home were always available. Since the last inspection CSCI has received one complaint regarding the home, which has been investigated by the provider within the agreed timescales. Documentation regarding this concern confirmed that the home takes all complaints seriously and provides the complainant and/or resident with written details of the outcome. The home has a key-worker system and daily recording procedures and handover meetings where any concerns are discussed and dealt with. There were copies available of the Local Adult Protection Guidance and ‘Alerters’ Guide, and one senior member of staff has attended the Plymouth Adult Protection training. Dates were available for arrangements of all staff to attend this training. Lambspark Residential Home DS0000003538.V291801.R01.S.doc Version 5.2 Page 16 Lambspark Residential Home DS0000003538.V291801.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,23,24, 25,26. Quality in this outcome area is satisfactory. This judgement has been made using available evidence including a visit to the home. Residents live in a pleasant, clean home that is comfortable and warm, with sufficient facilities to meet their needs. EVIDENCE: All communal parts of the premises were seen during the inspection as well as several residents’ bedrooms and bathroom facilities. The home was found to be clean and tidy throughout, however the general initial impression of the house could be improved by updating décor and replacing some communal carpets, which are becoming worn. The owner of the home said that there is an on-going rolling programme of refurbishment, which would include these communal areas as well as residents’ rooms. There is also a plan to convert the current managers flat/attic to two en-suite bedrooms, this will also include a large communal bathroom/toilet. Lambspark Residential Home DS0000003538.V291801.R01.S.doc Version 5.2 Page 18 Radiators are covered to prevent the risks of burns however, control valves have yet to be fitted to the hot water outlets accessible to residents and identified as posing a risk of scalding. The requirement remains outstanding form the previous inspection. The manager and owner of the home said that window restrictors have been fitted to windows where an assessment has identified a significant risk. Discussion took place with the manager regarding the need to fit restrictors to all windows where residents suffer from confusion, i.e. Dementia. The home has had an Occupational Therapy assessment completed for the home and an action plan to address any issues. The home was clean and fresh smelling throughout. Lambspark Residential Home DS0000003538.V291801.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Residents can feel assured that the staff working at Lambspark have the experience and skills to meet their needs. EVIDENCE: Staff seen on duty were friendly and good-natured. Residents were spoken to respectfully and staff knocked on bedroom doors before entering. Residents spoken to said that staff were kind and caring, and ‘ always willing to help’. Since the last inspection staffing levels have been reviewed and this has now increased from three to four staff in the afternoon. The rota confirmed that there are 5/6 staff in the morning, which also includes an additional senior member of staff. During the morning and early afternoon care staff are also supported by catering, laundry and domestic staff. A sample of staff files were seen and records of staff recently employed in the home. The homes recruitment procedure is robust although the application form does not allow for checks in employment history. Staff spoken to who had recently started work in the home described how they had worked alongside an experienced member of staff during their induction. The home had received details of the National Training Organisations specifications for Induction and advised that the current induction process would be reviewed. Lambspark Residential Home DS0000003538.V291801.R01.S.doc Version 5.2 Page 20 New staff had registered to complete NVQ and Mandatory Health and safety training. Individual training records confirmed that all staff undertake NVQ training and specialist training relevant to the home and need of individuals. Some staff members were attending continence training on the day of the inspection and information was available regarding planned training events for POVA and Fire safety. Lambspark Residential Home DS0000003538.V291801.R01.S.doc Version 5.2 Page 21 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): 31,32,33,35,36,37,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Residents benefit form living in a well managed home where their best interests are always considered. EVIDENCE: Residents spoken to said that they feel safe and secure in the home and felt that it was well managed. Mr and Mrs Wraighte, the Registered Provider and manager are available each day during the week, and at times at the weekends, and meet with residents and staff on a daily basis. Residents spoken to said that the manager is always available and felt confident that she would deal with any concerns. It was evident throughout the inspection that residents and staff benefit from an open, inclusive and positive style of management. Mrs Tracey Wraight is currently the Registered Manager for the home but chooses to work directly Lambspark Residential Home DS0000003538.V291801.R01.S.doc Version 5.2 Page 22 with residents as part of the care team. The home also has an assistant manager who is responsible for care records, training and other administrative tasks. The home offers support to residents who are unable to manage their finances. All money held by the home is recorded and this information was found to be in good order and up to date. Discussion took place with the Registered Provider regarding the need to ensure that money is stored safely at all times. Records were available to indicate that care staff were offered regular, individual supervision to discuss issues of care practice and personal development. In addition regular staff meetings take place and daily shift handover between senior staff. All staff receive an annual appraisal. Necessary records are in place and maintained to ensure the safety of residents and the effective and efficient running of the home. Health and Safety in the home is covered in policies and procedures for safe working practices. The Pre-inspection questionnaire included a list of annual and regular checks and tests to maintain fire safety, electrical, and gas systems to ensure their safety and good working order. The home regularly sends out questionnaires to families and other agencies and the results are then made available. Lambspark Residential Home DS0000003538.V291801.R01.S.doc Version 5.2 Page 23 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 3 3 3 3 X 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 X X 3 3 2 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 3 3 X 2 3 3 3 Lambspark Residential Home DS0000003538.V291801.R01.S.doc Version 5.2 Page 24 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 OP25 Regulation 13 Requirement Design solutions must be in place to ensure that water is stored at a temperature of at least 60 C, distributed at 50 C and provided close to 43 C. from bath taps/showers. Risk assessments must be completed for all other hot water outlets including wash hand basins. The Registered Provider must ensure that design solutions are in place for residents who are at risk due to confusion. Previous timescale- 31.03.06. Timescale for action 30/09/06 2 OP35 16 Risk assessments must be completed for all windows and restrictors fitted where a significant risk has been identified. This would include any residents with Dementia or any other condition, which may cause confusion. The Registered Provider must 31/07/06 ensure that money belonging to residents, which is held by the home is stored securely at all times. DS0000003538.V291801.R01.S.doc Version 5.2 Page 25 Lambspark Residential Home 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 Lambspark Residential Home DS0000003538.V291801.R01.S.doc Version 5.2 Page 26 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. 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