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Inspection on 06/09/06 for Landemere Residential Care Home

Also see our care home review for Landemere Residential Care Home for more information

This inspection was carried out on 6th September 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.

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

The systems in place at Landemere promoted residents safety and well being and although the manager at Landemere was not yet registered with the commission for social care inspection the management team were effective in ensuring residents needs were met. Residents spoken with were very complimentary regarding the care and support provided to them by the staff team. The facilities within resident`s private accommodation were well maintained and furnished according to each resident`s personal preferences. Most of the resident`s spoken with stated that they enjoyed the meals provided.

What has improved since the last inspection?

Surveys of resident`s views have been undertaken and this had been fed back to resident at the residents meeting. Minutes of residents meetings demonstrated that discussions took place between staff and residents regarding preferences of meals and other issues or concerns and evidence was in place to show how any matters had been resolved and by whom.

What the care home could do better:

Although care plans and risk assessments were in place not all that were seen had been reviewed on a monthly basis. For residents changing needs to be met it is important to ensure all areas of care and support are reviewed each month. Many of the residents spoken with felt the activities provided both within Landemere and within the community were limited and felt that more could be done to occupy their time. The wording of the services complaints policy at stage 3 should be reviewed and amended accordingly to avoid confusion.

CARE HOMES FOR OLDER PEOPLE Landemere Residential Care Home Inverary Close Off Grampian Way Sinfin Derby Derbyshire DE2 3JX Lead Inspector Angela Kennedy Key Unannounced Inspection 6th September 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 Landemere Residential Care Home DS0000001991.V299712.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. Landemere Residential Care Home DS0000001991.V299712.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Landemere Residential Care Home Address Inverary Close Off Grampian Way Sinfin Derby Derbyshire DE2 3JX 01332 272007 01332 271224 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) www.anchor.org.uk Anchor Trust of Anchor Trust (Landemere) Vacant Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Landemere Residential Care Home DS0000001991.V299712.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th February 2006 Brief Description of the Service: Landemere is a purpose built care home for older people and was built in 1991.The home provides accommodation for up to 40 service users. It is situated close to local amenities and to bus routes serving Derby city centre. The accommodation is on two floors, with access to the first floor via staircase or shaft lift. All rooms are single occupancy, with en-suite facilities. Each room has the benefit of refreshment facilities and is fitted with a small refrigerator. Services include personal laundry, meals, and personal care designed to meet individual needs. The current scale of charges at the time of this inspection was £296 to £366 per week. Landemere Residential Care Home DS0000001991.V299712.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced key inspection, which means that the service was inspected against all the key national minimum standards. The inspection took place over a four and a half hour period. Four residents files were examined in detail looking at care plans, risk assessments, daily records, leisure and social activity records and other records relating to the health and welfare of the residents. Landemere’s medication administration practices were examined along with some of the health and safety records and practices. Menus were seen and the lunchtime meal was sampled. Two staff files were seen to look at the recruitment and training records. Several members of staff and residents were spoken with during the inspection. The manager was available throughout the inspection to assist in providing information and documents. What the service does well: The systems in place at Landemere promoted residents safety and well being and although the manager at Landemere was not yet registered with the commission for social care inspection the management team were effective in ensuring residents needs were met. Residents spoken with were very complimentary regarding the care and support provided to them by the staff team. The facilities within resident’s private accommodation were well maintained and furnished according to each resident’s personal preferences. Most of the resident’s spoken with stated that they enjoyed the meals provided. Landemere Residential Care Home DS0000001991.V299712.R01.S.doc Version 5.2 Page 6 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 contacting your local CSCI office. Landemere Residential Care Home DS0000001991.V299712.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Landemere Residential Care Home DS0000001991.V299712.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Resident’s needs are assessed prior to moving into Landemere to ensure their needs can be met. EVIDENCE: Pre –admission assessment had been undertaken in the four residents files seen that looked at their healthcare needs, social and mental health needs. From these assessments care plans (referred to as Lifestyle Agreements at Landemere) had been developed and evidence was in place within all of the residents files seen to demonstrate that reviews had taken place. Landemere Residential Care Home DS0000001991.V299712.R01.S.doc Version 5.2 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Resident’s health, personal and social care needs our set within a plan of care, further work is required to ensure any changing needs are identified and met. Landemere’s policy for dealing with medicines promotes residents safety. Resident’s dignity and privacy is maintained. EVIDENCE: Lifestyle Agreements were in place within all of the residents files seen and addressed all areas of personal care that had been identified within the preadmission assessment and included, daily living needs such as, mobility, washing, dressing, bathing, toileting, getting up and going to bed and sensory needs. Other areas of need addressed within each residents lifestyle agreement included, health care needs and mobility, dietary requirements and preferences including where the resident preferred to eat, cultural and religious requirements and family and friends. Landemere Residential Care Home DS0000001991.V299712.R01.S.doc Version 5.2 Page 10 Assessments were in place within the resident’s files seen regarding nutrition and weight records, tissue viability, mobility, continence, bathing and an evacuation risk assessment. Lifestyle Agreements seen had been signed and dated by the residents or if unable to sign this had been recorded within their files. The majority of Lifestyle Agreement and risk assessment had been reviewed on a monthly basis however evidence was in place that demonstrated that some had not been reviewed since June and July 2006. The medication practices of the home were examined and found to be satisfactory. None of the residents where administering their own medication on the day of inspection, although procedures were in place for any residents who was able to and wished to self-administer their medication. Resident’s spoken with said that they felt staff were respectful of their privacy and dignity. Evidence of residents’ opinions on this subject was seen in the satisfaction survey that had been undertaken by the home, and all residents that had undertaken this survey felt staff were respectful of their privacy and dignity needs. All of the residents’ private accommodation is fitted with a doorbell and all rooms are lockable with keys, which enables residents to lock their rooms if they wish to. Evidence was seen of staff ringing the door bell prior to entering private accommodation and residents spoken with confirmed that staff always ring or knock before entering. Landemere Residential Care Home DS0000001991.V299712.R01.S.doc Version 5.2 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): 12,13,14,15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Some of the residents’ social and recreational needs were not fully met by the home. Residents were supported and encouraged to maintain contact with family and friends and to exercise choice and control over their lives as much as possible. Choices were available at meal times and residents were able to choose where to dine. EVIDENCE: An activities co-ordinator is employed at the home for twenty hours each week and a programme of activities was seen this included bingo, nail care, shopping trips which are undertaken with individuals or small groups and church services held at Landemere. The manager stated that some residents went out to church and friends of the church provided transport. A hairdresser also visited Landemere on Tuesday afternoons and Thursday mornings. An in house library is also available at Landemere. Landemere Residential Care Home DS0000001991.V299712.R01.S.doc Version 5.2 Page 12 Some of the residents spoken with felt there was not enough activities and entertainment and said that they use to go out on day trips but this doesn’t happen anymore. Landemere has an open visiting policy and residents spoken with said that their families and friends were able to visit whenever they wished and were made to feel welcome. Landemere provides a relatives room where families of residents can stay overnight if they wish. Residents spoken with confirmed they were able to make choices and that staff supported them to retain their independence. Meals times at Landemere were as follows, breakfast from 8am onwards, lunch at 12 noon, evening meal at 5pm and supper between 8pm and 9pm. Meals were provided in one of the four dining rooms or within resident’s private accommodation if preferred. Lunch was taken with residents’ in one of the dining rooms. Three courses were served and two choices were available at the lunchtime meal. A positive atmosphere was noted between staff and residents throughout the meal. Although an alternative to the main meal was provided this was not written onto the menus. However the manager stated that staff asked residents’ in advance which choice they would prefer, this was confirmed by resident’s spoken with. Landemere Residential Care Home DS0000001991.V299712.R01.S.doc Version 5.2 Page 13 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 adequate this judgement has been made using available evidence including a visit to the service. The complaints procedure is accessible to residents, visitors and staff, however the wording within the procedure has the potential to cause confusion regarding the different stages of the complaint process and timescale. Residents’ are protected from abuse EVIDENCE: Landemere had received five complaints within the last twelve months and all had been dealt with satisfactorily and within the required twenty-eight day period. The Registered Provider Anchor Trust provides the complaints procedure at Landemere The complaints procedure has three stages that can be followed, none of the three stages state that the complainant will be responded to within the twenty eight day required period .The only timescales mentioned are in stage three of the complaint which states the person making the complaint must appeal within twenty eight days. Residents’ spoken with were aware of the complaints procedure and stated hat they would know how to make a complaint if they needed to. Landemere Residential Care Home DS0000001991.V299712.R01.S.doc Version 5.2 Page 14 Landemere was able to demonstrate that residents were protected from potential harm through written procedures and staff knowledge and training. Several staff training records were examined and demonstrated that staff had undertaken the appropriate training in order to enhance and promote residents’ safety and well being. Staff spoken with demonstrated a good understanding of safeguarding adults’ procedures. Landemere Residential Care Home DS0000001991.V299712.R01.S.doc Version 5.2 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): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Resident’s live in well-maintained environment and in general satisfactory standards of cleanliness are maintained. EVIDENCE: An inspection of the premises was undertaken and all areas seen were tastefully decorated and furnished to a good standard. In general the service smelt clean and fresh although in some areas of private accommodation an unpleasant odour was noted. Two residents private accommodation was viewed and both demonstrated individuality in style of décor and furnishings, rooms seen had their televisions and private telephones installed. A payphone was also available for residents use if required. Landemere Residential Care Home DS0000001991.V299712.R01.S.doc Version 5.2 Page 16 The laundry was seen and housed two washing machines both with built in sluicing facilities and two tumble dryers. Two rotary airers were also situated outdoors next to the laundry room and were used for drying ‘delicate’ clothing. Residents spoken with were very complimentary regarding the laundry service provided at Landemere. Landemere Residential Care Home DS0000001991.V299712.R01.S.doc Version 5.2 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): 27,28,29,30 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to the service. Adequate numbers and skill mix of staff indicate that residents’ needs are met. Staff receive appropriate training to enable them to meet residents’ needs and this will be further enhanced when all staff have achieved a National Vocational Qualification in care at level 2. Recruitment practices at Landemere are good but require further development to ensure residents’ welfare is protected. EVIDENCE: Staffing rotas clearly demonstrated the numbers of staff on each shift. Each shift had one senior cover. Three care staff were on duty with the senior care during the day and one waking staff each night with a waking senior care. Domestic and catering cover was on shift seven days a week and administrative cover was available Monday to Friday. Residents’ spoken with felt that adequate numbers of staff were available to meet their needs. At the time of inspection 20 of the staff care team had achieved a National Vocational Qualification (NVQ) at level 2 in care and two more staff were near completion, which will bring the percentage of trained staff to 30 . The manager confirmed that other staff were due to complete this training by April 2007, which would then bring the percentage of staff with an NVQ2 to 50 . Landemere Residential Care Home DS0000001991.V299712.R01.S.doc Version 5.2 Page 18 The recruitment records within two staff files were examined and in general were good. However it is now a requirement that a full employment history is sought from all employees prior to recruitment and not just the last ten years of employment history. Training records were seen and demonstrated that ongoing training is provided to all staff. It was evident that the service considers staff training as a priority to ensure residents needs and support are continuously met. The following training has been undertaken since the last inspection, safe guarding adults, health and safety, fire training, back care, food hygiene, rights and responsibilities first aid and administration of medication training by an external accredited trainer. Landemere Residential Care Home DS0000001991.V299712.R01.S.doc Version 5.2 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): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The current management team provide effective management and are accessible to residents needs and ensures that the service is run in the best interests of the residents. Residents’ financial interests are safeguarded and their health, safety and welfare are promoted and protected by the homes practices. EVIDENCE: Landemere has been without a registered manager since July 2005. The current manager has been in post since April 06 and previously worked as the deputy manager at Landemere. She has applied for registration and is due to undertake a fit persons interview with the commission for social care inspection within the near future. Landemere Residential Care Home DS0000001991.V299712.R01.S.doc Version 5.2 Page 20 Evidence was in place both on the day of inspection and in recent communications with the manager that demonstrate her competencies and knowledge and records seen on the day of inspection showed that both staff and residents were consulted regarding the practices of the home. Minutes of recent staff meetings were seen and demonstrated an open and transparent approach is used in communication. Minutes of residents’ meetings were seen and demonstrated that feedback had been given to residents’ following a recent satisfaction survey. All comments or concerns and opinions were recorded and the action to be taken and by whom. Evidence was in place to show that residents’ opinions were taken seriously and acted upon whenever possible. Residents’ financial transaction records were seen and were satisfactory. Robust procedures were in place to ensure the safe keeping of resident’s monies was in place. Some of the safe working practices at Landemere were examined and all were satisfactory this included service certificates for gas safety, electrical installations, emergency lighting, fire systems, hoists, specialist bath and call systems. An insurance certificate was in place for the mobile hairdresser that visited the home. A fire risk assessment was in place and weekly fire alarm checks were undertaken. Fire drills and practices had been undertaken on the 4th September 06. Monthly checks were carried out on the call systems and assessments were in place for all chemicals that are considered hazardous to health such as cleaning materials and detergents. Landemere Residential Care Home DS0000001991.V299712.R01.S.doc Version 5.2 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Landemere Residential Care Home DS0000001991.V299712.R01.S.doc Version 5.2 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. Standard OP7 Regulation 15 (2) Requirement Care plans and risk assessments must be reviewed each month or sooner if required, to ensure residents’ changing needs are identified and met Activities both within and outside of the service must be further developed with resident involvement; to ensure the expectations and preferences of activities meets the needs of the residents. The written complaints procedure must state that complaints will be responded to within 28 days. A full employment history, together with a satisfactory written explanation of any gaps in employment must be sought for all staff prior to employment at Landemere. Timescale for action 30/11/06 2. OP12 16 (2) (m) (n) 01/12/06 3 OP16 22 31/12/06 4 OP29 19 Schedule 2 (6) 31/10/06 Landemere Residential Care Home DS0000001991.V299712.R01.S.doc Version 5.2 Page 23 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. 2. Refer to Standard OP26 OP28 Good Practice Recommendations Action should be taken to eliminate any unpleasant odours within the building. A minimum ratio of 50 of staff should be trained in NVQ Level 2 (or equivalent). Landemere Residential Care Home DS0000001991.V299712.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Landemere Residential Care Home DS0000001991.V299712.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!