CARE HOMES FOR OLDER PEOPLE
Lambton House New Lambton Fencehouses Durham DH4 6DE Lead Inspector
Belinda Parker Unannounced 19 May 2005 09:00 am
th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lambton House B54 S7484 Lambton House V227729 190505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Lambton House Address New Lambton Fencehouses Durham DH4 6DE 0191 385 5768 0191 385 2169 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Jason James Thompson Mr Jason James Thompson Care Home 41 Category(ies) of OP - Old Age 41 places registration, with number of places Lambton House B54 S7484 Lambton House V227729 190505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 24th November 2004 Brief Description of the Service: Lambton House is a registered care home providing personal care and accommodation for up to 41 older people in the category of (OP). It is not registered to accommodate persons who require nursing care. The home was opened in April 1999 and is owned by Mr R CoItman and Mr J J Thompson.Lambton House is located on the outskirts of Fencehouses. Local amenities are accessible by public transport. The home is a 2-storey building situated in its own private well maintained grounds. Personal accommodation is provided on both floors. Communal space and service areas are located on the ground floorThe home also provides a daycare service for up to 12 older persons per day. Separate facilities and staff are provided for this service. Lambton House B54 S7484 Lambton House V227729 190505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 19/5/05 over a period of 6 hours. During that time discussion took place with staff and service users. We toured the building and a number of records were examined. All requirements made at the last inspection have been met. What the service does well: What has improved since the last inspection?
Since the last inspection the order has been placed to replace two ground floor front windows, which will provide better insulation for the comfort of service users. All requirements made at the last inspection have been met. These include proving to CSCI that the home is finacially viable, implementing a system to assess staff’s working performance and career development and making health and safety monitoring records available for inspection.
Lambton House B54 S7484 Lambton House V227729 190505 Stage 4.doc Version 1.30 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. Lambton House B54 S7484 Lambton House V227729 190505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Lambton House B54 S7484 Lambton House V227729 190505 Stage 4.doc Version 1.30 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, and 3 The home had clear detailed information available to enable service users to make a decision as to whether they wished to live in the home and also gave prospective service users and their relatives an opportunity to be involved in the admission process. EVIDENCE: The home had available for inspection a copy of the Statement of Purpose and Service User Guide. Prospective service users are given a copy of this document for information. Examination of these documents showed that in specified areas the documents required review and update to ensure prospective service users are being given up to date information. Evidence was available to show that service users or their representative had signed as to their agreement with the Terms and Conditions of residency. Care plans contained evidence of a full pre – admission assessment being carried out prior to admission of service users to the home. This process was carried out by persons trained to do so. One service user who had recently moved into the home said she and her daughter had been involved in the assessment process prior to admission.
Lambton House B54 S7484 Lambton House V227729 190505 Stage 4.doc Version 1.30 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 There is a clear and consistant care planning process in place to enable adequately provide staff with the information they need to satisfactorily meet service users needs. EVIDENCE: Three care plans examined showed that they had been generated from a pre – admission assessment prior to admission. Care plans examined were up to date and current and covered all aspects of the health, personal and social needs of the service user. Care plans contained evidence of regular monthly review of care plans and risk assessments, but failed to provide evidence to show that service users had been involved in compiling or review of their plan of care. Lambton House B54 S7484 Lambton House V227729 190505 Stage 4.doc Version 1.30 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: This standard area was not assessed at this inspection. Lambton House B54 S7484 Lambton House V227729 190505 Stage 4.doc Version 1.30 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Staffs knowledge and understanding of Adult Protection issues provides a safe environment to protect service users from abuse. EVIDENCE: Since the last inspection the majority of staff have attended training on POVA (Protection of Vulnerable Adults) December 2004 and “No Secrets” March 2005. Staff spoken to during the inspection were able to demonstrate an awareness of POVA and said they would report immediately any incidents of abuse towards service users in the home. Training is ongoing to ensure all staff working in the home has the opportunity to gain knowledge of Adult Protection. Lambton House B54 S7484 Lambton House V227729 190505 Stage 4.doc Version 1.30 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25 and 26 The appearance of the home internally and externally creates a comfortable and safe environment for those living there and visiting. EVIDENCE: Since the last inspection evidence was available to show that an order had been placed for window replacement to the front elevation and will be completed before the end of May. This will improve the insulation standards for the comfort of service users. On touring the home it was observed to be traditional, comfortable well maintained and domestic in style. Service users spoken to were highly satisfied with the communal and personal accommodation. One service user recently admitted to the home commented “ The bed is like my own at home, nice and comfy”. Lambton House B54 S7484 Lambton House V227729 190505 Stage 4.doc Version 1.30 Page 13 The standard of cleanliness in the home was observed to be commendable, service users spoken to confirmed that they were satisfied with the cleanliness of their accommodation. The home had in place an adequate range of disability equipment to meet the collective needs of the service users. Enviromental health and safety checks are carried out and documented to ensure the protection of service users and other visitors to the home. Lambton House B54 S7484 Lambton House V227729 190505 Stage 4.doc Version 1.30 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 28 Staff are employed in adequate numbers and skill mix to meet the assessed needs of the service users living in the home. EVIDENCE: Records examined showed that staff are employed in adequate numbers to meet the collective needs of the people who live in the home. Training records showed that staff receive regular training to update their skills and abilities within their role of responsibility to enable them to deliver a good service to service users living in the home and other visitors. A service user commented “ All staff are so supportive “. Staff spoken to were able to demonstrate that they attend regular training and were positive towards developing their skills and abilities within their role of responsibility. Lambton House B54 S7484 Lambton House V227729 190505 Stage 4.doc Version 1.30 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 34, 36, 37 and 38 The home is ran efficently and effectively in the best interests of the people who live there. A robust system is in place for the recording and maintainance of records for the protection of service users. EVIDENCE: Since the last inspection the manager/provider said he is continuing to work towards NVQ4 in management which will enhance his skills in the delivery of the service to the people living in the home. Evidence was made available on the day of the inspection to show that the home is financially viable. The business is run effectively in providing the people who live in the home with a good standard of service. Lambton House B54 S7484 Lambton House V227729 190505 Stage 4.doc Version 1.30 Page 16 Since the last inspection a system of formal supervision for all staff has been implemented, which involves staff in discussion about all aspects of care within their role, philosophy of care in the home and career development needs. Records viewed for the protection of service users including staff records, care plans, health and safety and environmental were accurate, up to date and showed that the home was being run in an effective and efficient manner . Lambton House B54 S7484 Lambton House V227729 190505 Stage 4.doc Version 1.30 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x
COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 3 x x 3 x 3 3 3 Lambton House B54 S7484 Lambton House V227729 190505 Stage 4.doc Version 1.30 Page 18 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 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 1 Good Practice Recommendations The registered manager should update the Statement of Purpose and service user guide to include reference to CSCI, comments from service users/ relatives, a copy of Terms and Conditions of residency and produced in larger print. The registered manager should ensure that service users or their representative sign care plans as to their agreement and involvement. 2. 7 Lambton House B54 S7484 Lambton House V227729 190505 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection No 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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