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Inspection on 03/02/06 for Lancum House Care Home

Also see our care home review for Lancum House Care Home for more information

This inspection was carried out on 3rd February 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Care plans and associated documentation were written to a very high standard. Service users spoken to gave very positive feedback about all aspects of life at the home. Records relating to the death of a service user were satisfactory. Staff demonstrated a very good knowledge of the service users in their care. The home was clean and tidy, and free from odour. Staffing levels were adequate, and recruitment practice was satisfactory.

What has improved since the last inspection?

The inspector had not visited the home prior to this occasion.

What the care home could do better:

The statement of purpose should contain additional information to ensure that service users are fully informed. One issue in relation to medication should be improved.A full refurbishment of the home is planned, which will provide the necessary improvements in some areas. The recruitment policy requires additional information. Three fire exits were blocked, and chemicals were not locked away. The medication trolley was stored in the sluice, which must be relocated to a cleaner area.

CARE HOMES FOR OLDER PEOPLE Lancum House Care Home Bush Close Hardwick Road Wellingborough Northants NN8 3GL Lead Inspector Mrs Sarah Smart Unannounced Inspection 3rd February 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 Lancum House Care Home DS0000060026.V276433.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. Lancum House Care Home DS0000060026.V276433.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lancum House Care Home Address Bush Close Hardwick Road Wellingborough Northants NN8 3GL 01933 442440 01933 443404 Lancum.House@shaw-homes.co.uk 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) Shaw Healthcare (de Montfort) Ltd Mr Michael Scott Care Home 35 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (35), of places Physical disability over 65 years of age (10) Lancum House Care Home DS0000060026.V276433.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. All re-development work detailed in the refurbishment plan submitted to the Commission on the 25.04.04 must be completed by March 2009 The home may continue to accommodate 1 named service user who falls within the registration category LD(E)) No one falling within the category of DE(E) may be admitted into the home where there are 10 service users who fall within the category of DE(E) already accommodated within the home No one falling within the category of PD(E) may be admitted into the home where there is 10 service users who falls within the category of PD(E) already accommodated within the home 26/07/05 4. Date of last inspection Brief Description of the Service: Lancum House is a purpose built residential care home for the elderly, formerly owned by the Northamptonshire County Council Social Services Department, and now owned by Shaw healthcare. The accommodation for service users is set out on the ground floor. The first floor accommodates the managers office, and an area used for training and as a staff room. Service users rooms are divided into small individual areas called flats. Each flat has a small lounge and dining area, and the service users bedrooms. All rooms are single occupancy. The is a communal lounge area and a larger foyer area where service users frequently choose to sit. The home has a wide corridor that is called the street, where tables and chairs are placed for the service users use. There is also a shop and a licensed bar in this area. The home is surrounded by pleasant gardens and is situated in a residential area close to the town centre and other local amenities. Lancum House Care Home DS0000060026.V276433.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was undertaken between the hours of 9.30 and 1.15. Preparation for the inspection included, review of the previous inspection report, requirements and recommendations, and took approximately 1.5 hours. The primary method of inspection used was ‘case tracking’. This involves selecting a number of service users and tracking their care and experiences through review of their records, discussion with them, the care staff and observation of care practices. The following areas were covered during the inspection: case tracking, medication, sample of policy review, staff rota, staff files, tour of the premises, service users finances, previous requirements made, and staff and service user interviews. Two service users were case tracked. Three staff members were interviewed at length, and several others briefly, whilst three service users were spoken to in detail. What the service does well: What has improved since the last inspection? What they could do better: The statement of purpose should contain additional information to ensure that service users are fully informed. One issue in relation to medication should be improved. Lancum House Care Home DS0000060026.V276433.R01.S.doc Version 5.1 Page 6 A full refurbishment of the home is planned, which will provide the necessary improvements in some areas. The recruitment policy requires additional information. Three fire exits were blocked, and chemicals were not locked away. The medication trolley was stored in the sluice, which must be relocated to a cleaner area. 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. Lancum House Care Home DS0000060026.V276433.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 Lancum House Care Home DS0000060026.V276433.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): 1,6 Service users are adequately informed, other than in relation to fire. EVIDENCE: The statement of purpose was viewed, and was noted to contain all of the information outlined in schedule 1 with the exception of the fire precautions and procedures. This information must be added. The home does not provide intermediate care. Lancum House Care Home DS0000060026.V276433.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): 7,8,9,11 Service users healthcare and personal needs are met, and records are very well maintained. EVIDENCE: Two service users care plans were viewed. The individual service users files contained a huge amount of relevant information. The care plans in particular were written to an extremely high standard, giving a step by step guide to meeting that persons needs. These were all reviewed. The assessments were full, and identified needs and strengths for the service user in each area. Healthcare assessments were accurately recorded. One service users nutritional score identified that she was at high risk, however there was no evidence that this had been referred to the district nurse, GP or dietician. The team leader stated that although the score was very high, the service user eats ample amounts of a very good diet. The inspector recommended that an entry in relation to this was made on the assessment form, which the team leader did at the time. One service users daily notes did not have daily entries. Lancum House Care Home DS0000060026.V276433.R01.S.doc Version 5.1 Page 10 Samples of medication were viewed. In two instances a service user had been prescribed 28 doses of antibiotics, however the number of signatures on the charts exceeded this number. The medication trolleys were stored in the sluices, and although the team leader explained that the sluices are not used, the potential for use for dirty items remains. The trolleys must be relocated. Service users wishes in the event of their death were recorded, and the death policy contained satisfactory information. Service users spoken to said that their needs are met, and they are happy with the care that they receive. Staff demonstrated a very good knowledge of the service users in their care. Lancum House Care Home DS0000060026.V276433.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): These standards were not assessed on this occasion. EVIDENCE: These standards were not assessed on this occasion. Lancum House Care Home DS0000060026.V276433.R01.S.doc Version 5.1 Page 12 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): These standards were not assessed on this occasion. EVIDENCE: These standards were not assessed on this occasion. Lancum House Care Home DS0000060026.V276433.R01.S.doc Version 5.1 Page 13 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): 19,20,21,22,23,24,25,26 The premises are satisfactory, although would very much benefit from the planned refurbishment. EVIDENCE: The home appeared adequately maintained, although in need of refurbishment in some areas. The inspector was advised that a full refurbishment is planned in the future. A previous requirement had been made in relation to providing a separate area of accommodation for service users with dementia. Whilst this would be seen as best practice, it will mean asking service users to move rooms. During the refurbishment programme planned, service users will also be asked to move rooms, meaning that some service users may have to move more than once, which could be detrimental to their health. Now that the refurbishment is planned, this requirement has been removed. Each flat has a lounge diner, and the grounds of the home are safe and accessible. Lancum House Care Home DS0000060026.V276433.R01.S.doc Version 5.1 Page 14 Bathrooms in some instances appeared rather worn, but are planned for refurbishment. Staff stated that all of their equipment was in working order. The statement of purpose clearly advised the reader that some bedrooms are below the minimum standard. Those seen were personalised by the service user, and service users stated that they are happy with their rooms. All areas of the home were clean and tidy, and odour free at the time of the inspection. Lancum House Care Home DS0000060026.V276433.R01.S.doc Version 5.1 Page 15 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): 27,29 Staffing levels and recruitment practices are satisfactory, although the policy should be improved. EVIDENCE: The staff rota indicated that there is a team leader on each day shift, plus 5 support workers in the morning, 4 in the afternoon, and a total of three support workers at night. The service users spoken to stated that they felt there were sufficient staff, and that their needs were met timely, however staff spoken to felt that additional assistance would allow more time to spend talking to the service users etc. A sample of staff files were viewed. They were noted to contain all of the required documentation. The recruitment policy was viewed. Whilst the staff files demonstrated that recruitment is satisfactory, the policy did not advise the reader about obtaining Criminal Records Bureau Checks or Povafirst checks. This information should be added. Lancum House Care Home DS0000060026.V276433.R01.S.doc Version 5.1 Page 16 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): 35,38 Some aspects of health and safety management must be addressed. EVIDENCE: A sample of service users money was checked. Whilst two were accurate, one wallet contained £1 more than the recorded amount. The finance administrator responded by checking all service users money, and found a second to be in the same position. She stated that these two service users had been loaned money from the petty cash recently which had not been paid back correctly. Due to the prompt action taken a requirement has not been made in relation to this. During the inspection three fire exits were blocked. In one instance the handyman has left a table and paint tray in a fire exit, and the other two were blocked by lounge furniture. Although time the team leader removed the obstacles immediately they were pointed out by the inspector, due to the Lancum House Care Home DS0000060026.V276433.R01.S.doc Version 5.1 Page 17 seriousness of the action and the number of times it occurred a requirement has been made. Again in several instances chemicals were stored in areas where the doors were not locked, meaning that the chemicals were accessible to the service users. The doors to the sluices and the laundry were locked by the team leader at the time of the inspection, however due to the risk of harm, a requirement has been made. Lancum House Care Home DS0000060026.V276433.R01.S.doc Version 5.1 Page 18 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 2 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X 2 Lancum House Care Home DS0000060026.V276433.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? yes 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 OP12 Regulation 16(2) Requirement Suitable activities must be provided according to the assessed needs of service users with a diagnosis of dementia. This requirements timescale of 1.9.05 has not been met. A further timescale has been set. The statement of purpose must contain all of the required information. A plan, including timescales which will be met, must be submitted to the Commission for Social Care Inspection, in relation to the refurbishment of the premises. The recruitment policy must advise the reader of Criminal Records Bureau Checks and povafirst checks. Fire exits must be clear and accessible at all times. Chemicals must be stored securely at all times. The medication trolley must not be stored in a potentially dirty area. Timescale for action 31/03/06 2 3 OP1 OP19 4 19 15/04/06 31/03/06 4 OP29 19 15/04/06 5 6 7 OP38 OP38 OP9 23 12 13 20/02/06 20/02/06 28/02/06 Lancum House Care Home DS0000060026.V276433.R01.S.doc Version 5.1 Page 20 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 OP9 Good Practice Recommendations Medication records should be maintained accurately. Lancum House Care Home DS0000060026.V276433.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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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