CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE
Landermeads Care Home 265 High Road Chilwell Nottingham NG9 5DD Lead Inspector
Steve Keeling Unannounced Inspection 5th October 2005 10:30 X10029.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 Landermeads Care Home DS0000026449.V257494.R01.S.doc Version 5.0 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 and Care Homes for Adults 18 – 65*. 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. Landermeads Care Home DS0000026449.V257494.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Landermeads Care Home Address 265 High Road Chilwell Nottingham NG9 5DD 01159256996 0115 9224454 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) Landermeads Investments Limited Mr Robert Alan Heath Care Home 89 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (34), Old age, not falling within any other of places category (73), Physical disability (16), Terminally ill (4) Landermeads Care Home DS0000026449.V257494.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. 5. 4 Registered Nurses and 10 care staff on day duty 2 Registered Nurses and 6 care staff on night duty Lander House 34 beds Older People Meads Unit 39 beds DE.E of which 5 beds are for adults between 50 and 65 yrs DE Catherine Tam House 16 beds Young Adults PD. Date of last inspection 01/03/05 Brief Description of the Service: Situated in a quiet residential area of Chilwell, close to the local amenities, Landermeads consists of three distinct units: The Meads, Lander House and Catherine Tam House. In total these units provide accommodation for 89 service users. The Meads is a converted detached house, providing accommodation for 39 service users, many of who have dementia. Lander House provides accommodation for 34 service users requiring nursing and personal care. Catherine Tam House provides accommodation for 16 younger adults with physical disabilities. The home provides a variety of equipment to meet service users complex needs. The bathing facilities have also been designed to meet a range of needs. The home is well furnished, maintained and of a good decorative standard. The exterior consists of well-established gardens and a good-sized car park. All areas of the home are accessible to service users. Landermeads Care Home DS0000026449.V257494.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over five hours. It consisted of reading policy documents, examining records and a partial tour of the premises. Discussions took place with the manager and staff. The majority of the time was spent in discussions with service users and two visiting family members. What the service does well:
The residents spoken with during this inspection were very happy with the care they receive and made many positive comments. They described the staff as helpful and considerate and said that staff ensure that their privacy and dignity is respected at all times. Visitors to the home also confirmed that they are very happy with the services provided to their relatives and were appreciative of the hospitality afforded them. The observed interaction between staff and residents indicated relationships of mutual respect. Observations would also indicate good working relationships between management and staff. All of which contributed to a relaxed and happy atmosphere within the home. Service users spoken with described a wide range of activities and entertainment available to them. Two activities organisers are employed to provide stimulation for the residents. The visitors confirmed that they were always welcome if they wished to join in. The residents said that they enjoyed the food provided at the home and could ask for an alternative meal if they did not want the food suggested on the menu. Special diets were catered for and an individuals nutritional intake would be monitored when necessary. The areas of the home viewed during this inspection had been well maintained and residents had been encouraged to personalise their rooms with pictures ornaments and small items of furniture. The service users spoken with said they liked their rooms and confirmed that staff did not enter before knocking. Landermeads Care Home DS0000026449.V257494.R01.S.doc Version 5.0 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. Landermeads Care Home DS0000026449.V257494.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Landermeads Care Home DS0000026449.V257494.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3 4and 5. Service users’ are not admitted until a needs assessment has been carried and the home can assure them that identified needs can be met. Once admitted the service user receives a statement of terms and conditions that meets the national minimum standard. Prospective service users, for the Catherine Tam unit have well planned gradual admissions. EVIDENCE: Service users case files contained full assessments that had been carried out prior to admission. Pre-admission visits are recorded and trial stays at Catherine Tam are part of the admission procedure. Signed statements of terms and conditions were seen and met the requirement.
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The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are 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 and 10. Service users, health needs are identified, monitored and met appropriately. People are encouraged to maintain optimum independence in a safe environment. Personal support is provided in a manner designed to protect the privacy and dignity of service users’. EVIDENCE: Care plans contained evidence of identifying health needs and of appropriate referrals to health specialists. Both service users’ and visitors to the home confirmed that staff treat them with respect. Observations during the
Landermeads Care Home DS0000026449.V257494.R01.S.doc Version 5.0 Page 11 inspection indicated that staff and service users’ have relationships of mutual respect. Landermeads Care Home DS0000026449.V257494.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the 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 and 14. Service users’ are able to set their own daily routines and follow their own interests. Any assistance required is given discretely. Family and friends are made welcome at the home. EVIDENCE: Observations during the inspection showed that staff give help appropriate eely in a discrete manner. Service users’ and visitors’ spoken with confirmed that the home provides a range of activities and makes every effort to ensure that everyone can follow their own interests.
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The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) 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 and 18 Service users’ complaints would be taken seriously and properly investigated. The home makes every effort to protect service users’. EVIDENCE: The home had satisfactory policies on protecting vulnerable adults including a “whistle blowers” policy. A complaint received within the last six months had been fully investigated, the proceedings recorded and a satisfactory outcome reached within the timescales of the homes complaints procedure. Landermeads Care Home DS0000026449.V257494.R01.S.doc Version 5.0 Page 14 Environment
The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) 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, and 26. The home offers a good standard of accommodation that was well maintained. All areas of the home were accessible to residents. EVIDENCE: The communal areas of the home were well decorated and furnished with a variety chairs to suit all needs. Where necessary specialist chairs had been
Landermeads Care Home DS0000026449.V257494.R01.S.doc Version 5.0 Page 15 provided for people with a physical disability. Service users’ spoken with expressed satisfaction with their own rooms and communal areas. During the partial tour of the premises there were no observable health and safety risks. Landermeads Care Home DS0000026449.V257494.R01.S.doc Version 5.0 Page 16 Staffing
The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the 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 and 30. The homes recruitment policy and subsequent training programme for staff ensures that service users are cared for by suitable competent people. EVIDENCE: A sample of staff files were examined and found to contain all the information required by statute. New members of staff received induction training and thereafter the home provided a yearly training programme accessible to all. Staff were provided with contracts of employment, job descriptions and received appropriate supervision. Landermeads Care Home DS0000026449.V257494.R01.S.doc Version 5.0 Page 17 Management and Administration
The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,35,36 and 38 Landermeads is a well run home that has managed to retain a core team of experienced and enthusiastic staff. Service users’ are protected but able to maintain independence. EVIDENCE: Landermeads Care Home DS0000026449.V257494.R01.S.doc Version 5.0 Page 18 The home had a satisfactory health and safety policy and all potentially hazardous substances were properly stored. Visitors’ spoken to said the home was always tidy and they had never seen anything to give them concern about health and safety issues. Staff received proper supervision and training in fire safety awareness. Landermeads Care Home DS0000026449.V257494.R01.S.doc Version 5.0 Page 19 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 X 2 3 3 3 4 3 5 3 6 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 ENVIRONMENT Standard No Score 19 3 20 3 21 X 22 X 23 X 24 X 25 X 26 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 X 32 3 33 X 34 X 35 3 36 3 37 X 38 3 Landermeads Care Home DS0000026449.V257494.R01.S.doc Version 5.0 Page 20 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. 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 7 OP Good Practice Recommendations The initial care plan should be in place within 48 hours of admission. Landermeads Care Home DS0000026449.V257494.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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