Inspection on 08/08/07 for Landermeads Care Home

This inspection was carried out on 8th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Landermeads Care Home 04/07/06

Landermeads Care Home 04/01/06

Landermeads Care Home 05/10/05

Landermeads Care Home 01/03/05

Landermeads Care Home 16/11/04

Landermeads Care Home 05/03/04

Landermeads Care Home 05/01/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Landermeads Care Home 265 High Road Chilwell Nottingham NG9 5DD Lead Inspector Steve keeling Unannounced Inspection 8th August 2007 09:00 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.V348249.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 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.V348249.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Landermeads Care Home Address 265 High Road Chilwell Nottingham NG9 5DD 0115 925 6996 0115 922 4454 ros@landermeads.com 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 Mrs Rosalind 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.V348249.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Service will limit its services to the following categories of Service Users Old Age not falling within any other category (OP) 73 (both) Physical Disability (PD) 16 (both) Terminally Ill (TI) 4 (both) Dementia , over 65 years of age (DE/E) 34 (both) Dementia (DE) 5 (both) 1 named person under the age of 65 with physical disabilities (1).(Name available in the documentation relating to minor variation dated 8th November 4th July 2006 2. Date of last inspection Brief Description of the Service: Landermeads is an 89 bedded home situated in Chilwell on the outskirts of Nottingham. The home is divided into three units: The Meads, Lander House and Catherine Tam House. The Meads provides care for 39 residents, the majority of whom have dementia. Lander House provides care for 34 residents who require nursing and personal care. Catherine Tam House provides care for 16 younger adults with physical disabilities. The internal and external environment is suitable for residents with limited mobility and is wheelchair accessible throughout. The home is surrounded by well-established gardens and car-parking facilities are available. A copy of a statement of purpose and service users guide is available to all residents and their representatives. The fees currently charged at the home range from £520 to £595. There is an extra charge newspapers, hairdressing, toiletries and podiatry services. Landermeads Care Home DS0000026449.V348249.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for residents and their views on the service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. One inspector conducted the unannounced visit. The main method of inspection used was called ‘case tracking’ which involved selecting two residents and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. The deputy manager, one member of staff and visitors to the home were spoken with as part of this visit. Documents were read as part of this visit and medication management was inspected to form an opinion about the health and safety of residents at the home. A partial tour of the building was undertaken which included a sample of resident’s bedrooms, to make sure that the environment is safe and homely. A review of all the information we have received about the home since the last inspection was considered in planning this visit and this helped decide what areas were looked at. A range of additional information was used to determine the outcome of this visit, which includes information received from residents and relatives in response to pre-inspection questionnaires and information provided by the registered provider within an Annual Quality Assurance Assessment (AQAA). As part of the inspection process, the conditions of registration were reviewed with manager and the Centralised Registration Team at CSCI will follow up the issuing of new certificate to remove the current age restrictions, terminally ill category and the named person, in line with the new guidance on conditions of registration. Landermeads Care Home DS0000026449.V348249.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The Service Users Guide could include the fees charged at the home to ensure potential residents can assess the suitability of the home in meeting their needs. Quality auditing systems could be improved to ensure that care planning and medication management is effective in promoting the residents safety. Staff supervision could be improved to promote the health and wellbeing of the residents. Personal Care Plans (PCP) and evaluation processes could be improved to promote the health and wellbeing of residents. The administration of medication could be improved to promote the safety of the residents. Landermeads Care Home DS0000026449.V348249.R01.S.doc Version 5.2 Page 7 Quality auditing systems could be improved to ensure that care planning and medication management is effective in promoting the residents safety. Staff supervision could be improved to identify the developmental needs of individual staff employed at the home. 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. The summary of this inspection report can be made available in other formats on request. Landermeads Care Home DS0000026449.V348249.R01.S.doc Version 5.2 Page 8 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.V348249.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): OP1, OP3, YA 1, YA2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information relating to the care home is contained within the Service Users Guide (SUG), which provides information relating to the service. People have assessments performed prior to moving into the home and potential residents are provided with the opportunity to visit the home prior to gaining residency so they can determine the suitability of the service in meeting their needs. EVIDENCE: Landermeads Care Home DS0000026449.V348249.R01.S.doc Version 5.2 Page 10 The resident’s pre inspection survey asked residents, “Did you receive enough information about this home before you moved in so you could decide if it was the right place for you?” 85 of the responses received by the CSCI stated, “yes”. A Statement of Purpose is made available to all residents and their representatives, which sets out the aims, objectives, philosophy of care and the services and facilities at the home. The statement of purpose also contains a complaints procedure, which is available in signs, and symbols formats to aid residents who require assistance to communicate. The fees charged at the home are not currently included in the guide but information received within the AQAA showed that the registered person is currently updating the guide to include this information. Records showed, and a resident confirmed that, suitably qualified staff perform pre admittance assessments. Additional professional assessments are also used when available. Potential residents and their representatives can also visit the home prior to gaining residency to determine the suitability of the service in meeting their needs. Landermeads Care Home DS0000026449.V348249.R01.S.doc Version 5.2 Page 11 Health and Personal Care 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. JUDGEMENT – we looked at outcomes for the following standard(s): OP7, OP8, OP9, OP10. YA6, YA9, YA16, YA18, YA19, YA20. Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. Residents Personal Care Plans (PCP) do not address all the needs of the residents, which could compromise their safety. The homes policies and procedures in relation to the administration of medication had not been fully adhered to which could compromise the safety of the residents. Residents are treated with respect and dignity and their privacy is maintained. Landermeads Care Home DS0000026449.V348249.R01.S.doc Version 5.2 Page 12 EVIDENCE: The resident’s pre inspection survey asked residents “Do you receive the care and support you need?” 71 of the responses received by the CSCI stated, “always” with 29 stating “usually”. Information with the AQAA said that comprehensive Personal Care Plans (PCP) are formulated for each resident and that each resident is allocated a designated qualified member of staff who is responsible for completing the plans. Records showed and a resident confirmed that residents are encouraged to be involved in the care planning process. Records showed that care-planning documentation relating to wound management was not effective in promoting the health and wellbeing of a resident. A wound management care plan stated that a wound should be redressed on a daily basis but records showed that the wound had only been redressed on five occasions since the 30th May 2007. Furthermore, the resident had another wound, which was being dressed by staff at the home, but no care plan had been developed in relation to the wound. A resident who had a history of skin breakages did not have a risk assessment or care plan to address the concerns. The deputy manager and a senior member of the nursing staff addressed the concerns on the day of the visit to ensure the health and wellbeing of the residents was maintained. Medication, which requires refrigeration, was stored within a secure fridge in the medication room and records showed that the fridge temperature was correct. An examination of Medication Administration Records (MAR) showed that some of the records had not been filled out properly as gaps were present with no explanation as to why the medication had not been given. The resident’s pre inspection survey asked residents “do staff listen and act on what you say?” 85 of the responses received by the CSCI stated, “yes”. Landermeads Care Home DS0000026449.V348249.R01.S.doc Version 5.2 Page 13 A resident said that the care staff always promote respect and dignity whilst performing personal care, respect her wishes in relation to how she spends her days and she felt confident that she receives that support she requires. A visitor confirmed that the staff always promotes the respect and dignity of the residents and said “the home is fantastic”. Landermeads Care Home DS0000026449.V348249.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): OP12, OP13, OP15 YA12, YA13, YA15, YA17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can participate in a range of activities. The resident’s rights and responsibilities are upheld and they can maintain contact with their family and friends as they wish. Residents are provided with a well-balanced, varied menu. Landermeads Care Home DS0000026449.V348249.R01.S.doc Version 5.2 Page 15 EVIDENCE: The resident’s pre inspection survey asked residents “Are there activities arranged in the home that you can take part in?” 72 of the responses received by the CSCI stated, “always” with 28 stating “usually”. The survey for relatives, carers and advocates asked, “What do you feel the care home does well”. Comments included “The home is staffed by very caring and friendly people, dedicated to the wellbeing of all in their care”. Social activity co-ordinators are employed at the home to provide a varied and stimulating social activities programme. Records showed and residents confirmed that activities include board games, arts and crafts, sing-a-long sessions, quizzes and cooking sessions. A wheelchair accessible minibus has been recently purchased and residents are able to access trips out to football matches, local parks, garden centres, shopping expeditions, swimming sessions and the cinema. Holy Communion is performed each Sunday and links with other religious denominations in the local community have been established when required for residents of all faiths. A large well equipped sensory room is available to residents together with two sensory gardens with raised beds and seating areas to facilitate the resident’s interest in gardening. A chicken house has been recently purchased to house a few chickens with the intention to involve residents in their care if they wish. A resident spoken with said she was satisfied with the social activities and said that her personal choice is always respected if she chooses not to participate in the activities. Residents and a visitor to the home confirmed that an open door policy is promoted. They confirmed that residents have the choice of entertaining visitors in their own bedroom or they can use the communal areas throughout the home. A Visitor spoken with confirmed that she is always offered a drink and the staff are welcoming at all times. The resident’s pre inspection survey asked residents “Do you like the meals at the home?” 57 of the responses received by the CSCI stated, “always” with 28 stating “usually” and 15 stating “sometimes”. A resident stated that the menu could be a little repetitive especially at teatime, although she confirmed that a choice is always available. Liquidised Landermeads Care Home DS0000026449.V348249.R01.S.doc Version 5.2 Page 16 meals are available for residents who are unable to chew or can only swallow with difficulty. We observed that residents who require help at meal times were supported by care staff in a patience and respectful manner. Landermeads Care Home DS0000026449.V348249.R01.S.doc Version 5.2 Page 17 Complaints and Protection 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. JUDGEMENT – we looked at outcomes for the following standard(s): OP16, OP18, YA22, YA23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints and concerns are effectively managed. Residents confirmed that they felt safe at the home and were confident that the staff would deal with concerns and complaints efficiently. EVIDENCE: The resident’s pre inspection survey asked residents “do you know how to make a complaint?” 85 of the responses received by the CSCI stated, “yes”. The survey also asked residents “Do staff listen and act on what you say?” 100 of the responses received by the CSCI stated, “yes”. Complaints procedures are on display throughout the home and residents or their representatives are given the complaints procedure within the Service Users Guide. The complaints procedure is also made available in signs and symbol format to aid residents to highlight any concerns or complaints. Landermeads Care Home DS0000026449.V348249.R01.S.doc Version 5.2 Page 18 Residents spoken with felt confident that they could report and concerns to the staff and were confident that they would be addressed effectively. We asked a visitor to the home if she knows what to do if she was not happy with the service and would she be confident enough to make a complaint. The visitor said, “I would speak to the manager, but I have no concerns”. The manager was not investigating any complaints at the time of the visit. CSCI has received one complaint relating to the service provision at the home since the last unannounced visit, which the registered provider was required to investigate. Records showed that the complaint had been well managed. Information with the AQAA showed that policies and procedures are in place to promote the safety of residents, which includes safeguarding adults and a prevention of abuse policy. A member of the care staff confirmed that the policies and procedures are readily available to provide guidance and information and was able to demonstrate a good knowledge of her responsibilities in reporting suspected abuse. Landermeads Care Home DS0000026449.V348249.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): OP19, OP22, OP26, YA24, YA29, YA30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a homely, comfortable and safe environment, which is clean and hygienic. Specialist equipment is available to promote residents independence. Landermeads Care Home DS0000026449.V348249.R01.S.doc Version 5.2 Page 20 EVIDENCE: The resident’s pre inspection survey asked residents “ Is the home fresh and clean?” 85 of the responses received by the CSCI stated, “yes” with 15 of respondents saying “usually”. The homes internal environment, including the dining rooms and the lounge areas, are clean, fresh and homely throughout. Resident’s bedrooms are well maintained, clean and fresh. Window restrictors and radiator guards are evident throughout the home to promote the safety of residents. Residents are encouraged to personalise their bedrooms with small items of furniture, televisions, radios and family pictures to further promote a homely environment. Residents and visitors to the home were very satisfied with the standard of cleanliness and confirmed that bedrooms are cleaned on a daily basis, as are the communal areas. Equipment to promote the residents independence is available throughout the home, such as adjustable height beds, hoists, stand aids, alternating electric mattresses, wheelchair weight scales and specialist bathing equipment. As mentioned earlier in the report (OP12) a well maintained, very pleasant secure garden area is available for residents to use in the summer months. The garden area is accessible to residents with impaired mobility and has a range of garden seating for residents and their visitors to use. Landermeads Care Home DS0000026449.V348249.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): OP27, OP28, OP29, OP30 YA32, YA34, YA35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are met by the number of staff employed at the home and staff receive training to promote the health and wellbeing of the residents. Recruitment practices are effective in promoting the safety of residents. EVIDENCE: The resident’s pre inspection survey asked residents “ Are staff available when you need them? 43 of the responses received by the CSCI stated “always” and 57 said “usually”. Landermeads Care Home DS0000026449.V348249.R01.S.doc Version 5.2 Page 22 The survey for relatives, carers and advocates asked, “Do the care staff have the right skills and experience to look after people properly?” 80 of the responses received by the CSCI stated, “always” with 20 stating “usually”. Residents and visitors to the home said there always appears to be enough staff on duty and staff are always available when needed. Records showed that members of staff only commence employment once satisfactory Protection of Vulnerable Adult (POVA) checks and Criminal Record Bureau (CRB) checks have been obtained, together with two satisfactory references. Records showed that the staff induction process has been recently amended to adhere to the “Skills for Care” Induction Standards. The service has achieved 48 of staff trained to, or working towards a National Vocational Qualification (NVQ) Level Two and above, thus ensuring a suitably qualified workforce is employed at the home. The deputy manager and staff confirmed that additional training is provided in relation to fire prevention, health and safety, moving and handling, medication management, infection control, tissue viability, abuse awareness, falls awareness and continence promotion. We were provided with a copy of computerised records relating to staff training. The records only evidenced the training provided in 2007 and it was not effective in highlighting the training opportunities provided to staff prior to this period. Landermeads Care Home DS0000026449.V348249.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): OP31, OP33, OP35, OP38. YA37, YA39, YA42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Landermeads Care Home DS0000026449.V348249.R01.S.doc Version 5.2 Page 24 Comprehensive quality auditing systems are not in place to ensure that care planning and medication management is effective in promoting the residents safety. Not all staff has received effective supervision, which could compromise the safety of residents. Appropriate measures are in place to ensure that residents’ financial interests are safeguarded and routine maintenance is effective in promoting safety. EVIDENCE: Residents and staff spoken with felt confident that the home was well run and had confidence in the manager’s leadership and management abilities. A visitor stated, “The manager is very good, I feel confident that she is doing a good job”. A member of staff said that she felt supported and valued by the manager and said, “ the manager is approachable and professional”. Information provided within the AQAA shows that policies and procedures are updated on an annual basis and staff confirmed that they have access to the policies and procedures at all times for reference and guidance. Annual quality assurance reviews are performed at Catherine Tam House in the form of a “The Quality Tree”. The Quality Tree involves residents, their representatives and professionals being provided questionnaires on an annual basis to determine their satisfaction levels. The findings of the questionnaires are correlated and made available at the home. The deputy manager confirmed that quality-monitoring audits are not performed in relation to the management of care plans and medication management. The manager also confirmed that regulation 26 visits are not been performed. The acting manager said, and records confirmed that some care staff have not received formal supervision sessions to ensure they are effectively supported and developed to perform their roles within the home. Activities coordinators facilitate residents meetings on each unit on a bimonthly basis. The meetings provide an opportunity to consult resident on any planned developments at the home and provide resident with a forum to discuss the quality of care provided. Residents or their representatives are encouraged to manage their own Landermeads Care Home DS0000026449.V348249.R01.S.doc Version 5.2 Page 25 financial affairs whenever possible. A case tracked resident confirmed that she required assistance to manage her financial affairs and records showed that all transactions are recorded on a computerized system together with evidence of receipts for expenditures. Information supplied by the registered provider within the AQAA evidenced that resident’s health and wellbeing is promoted by effective routine maintenance. Landermeads Care Home DS0000026449.V348249.R01.S.doc Version 5.2 Page 26 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 2 x 3 3 4 x 5 x 6 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 ENVIRONMENT Standard No Score 19 3 20 x 21 x 22 x 23 x 24 x 25 x 26 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 x 33 2 34 x 35 3 36 1 37 x 38 3 Landermeads Care Home DS0000026449.V348249.R01.S.doc Version 5.2 Page 27 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 OP1 YA1 Regulation 5 Requirement To ensure that potential residents can make an informed choice about whether they wish to be live at the home the Service User Guide must be updated to include the current fees charged at the home The promote the safety and well being of all residents, care plans for each resident must be formulated which sets out the residents specific needs, to include wound management and pressure sore prevention, and how the needs can be met. To promote the health and wellbeing of residents their changing needs must be identified through effective assessment procedures. To promote the safety and wellbeing of residents nursing staff must adhere to the homes policy in relation to the administration of medicines. To ensure service provision is effectively monitored Regulation 26 visit must be performed on a monthly basis and a copy of the Regulation 26 reports must be DS0000026449.V348249.R01.S.doc Timescale for action 30/09/07 2 OP7 YA6 15 30/09/07 3 OP8 YA19 12 30/09/07 4 OP9 YA20 13 30/09/07 5 OP31 YA37 26 30/09/07 Landermeads Care Home Version 5.2 Page 28 made available to CSCI. 6 OP33 YA39 24 To promote the health and 30/09/07 wellbeing of residents, effective quality auditing procedures must be performed to reflect that the quality of care provided at the home is reviewed at appropriate intervals and systems are in place for improving service provision. To promote the health and 30/09/07 wellbeing of residents staff at the home must receive supervision to identify the developmental needs of individual carers. 7 OP36 YA36 18 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 OP30 YA35 OP36 YA36 Good Practice Recommendations The staff training matrix should be further developed to identify past training opportunities provided to all staff employed at the home. To promote the health and wellbeing of residents staff at the home should receive supervision on a bi-monthly basis to identify the developmental needs of individual carers. Landermeads Care Home DS0000026449.V348249.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. Landermeads Care Home DS0000026449.V348249.R01.S.doc Version 5.2 Page 30 - 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. 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